Medical malpractice after artificial urinary sphincter implantation.

Background: Artificial urinary sphincter (AUS) remains the gold standard of urinary incontinence management for moderate and severe cases. However, risks such as erosion, infection, and mechanical failure are present when using these sphincters. Therefore, it is essential to explore this aspect of AUS in order to deliver more effective patient care. This analysis offers the first investigation into medical malpractice cases pertaining to AUS placement. Methods: The LexisNexis+ and Westlaw databases were used to access all federal and state cases, jury verdicts, and settlements. The LexisNexis+ and Westlaw databases were queried for the term "artificial urinary sphincter" or "artificial urethral sphincter" between the years 1990 and 2024. Cases selected for patients suing a urologist or medical system after implantation of an AUS. Common reasons for exclusion included the plaintiff suing a urologist who performed prostate surgery requiring eventual placement of AUS. Results: Investigation of the LexisNexis+ database yielded 103 cases. The Westlaw database offered 41 cases. After exclusion criteria, 24 cases were included from the LexisNexis+ database and 3 cases from Westlaw; 14 cases were ruled in favor of the defendant; 4 cases were ruled in favor of the plaintiff with awards ranging from $46,400-$980,000; 4 cases were settled with payouts ranging from $70,000-$4,500,000. The most common cause for litigation included damage to a device, which was a precipitating issue in 46% of cases. Failure of technique of AUS placement was alleged in 33% of cases. The region of the United States with the most cases was the South with 58% of cases. Precipitating issues that resulted in outcomes in favor of the plaintiff were diverse and included failure of informed consent, failure of technique, infection, pain, and damage to the device. Conclusions: Urologic surgeons placing artificial urethral sphincters face the risk of medical malpractice litigation.