Frailty Is Associated With Postoperative Complications and Device Removal and Revision in Men Undergoing Surgery for Stress Urinary Incontinence

PURPOSE: Our goal was to understand the association between frailty and postoperative complications after artificial urinary sphincter (AUS) and male urethral sling placement. MATERIALS AND METHODS: This was a retrospective study of Medicare beneficiaries undergoing AUS or sling from 2014 to 2016. Baseline frailty was quantified using the Claims-Based Frailty Index (CFI): not frail (<0.15), prefrail (0.15-0.24), and mildly-to-severely frail (≥0.25). Thirty-day complications and device revision/removal were analyzed using generalized linear regression models with log link, Poisson distribution, and robust standard errors. CONCLUSIONS: Frailty, independent of age and comorbidity, was associated with increased odds of 30-day complications and device revision/removal. Thus, frailty, more than comorbidity, is an important yet often unrecognized factor that should be considered during preoperative decision-making for AUS or sling procedures.