Robotic-assisted artificial urinary sphincter revisions for women suffering from non-neurogenic stress incontinence: a single center experience

• Published in: World journal of urology 2023-06, Vol.41 (6), p.1691-1696
• Main Authors: Bazinet, Amélie, Vaessen, Christophe, Mozer, Pierre, Popelin, Marie-Bérénice, Rod, Xavier, Chartier-Kastler, Emmanuel
• Format: Article
• Language: English
• Subjects: Child, Preschool; Complications; Female; Humans; Medicine; Medicine & Public Health; Nephrology; Oncology; Original Article; Postoperative; Prosthesis Implantation - methods; Retrospective Studies; Robotic Surgical Procedures; Robotics; Safety; Sphincter; Treatment Outcome; Urinary incontinence; Urinary Incontinence, Stress - etiology; Urinary Sphincter, Artificial - adverse effects; Urology
• ISSN: 1433-8726; 0724-4983; 1433-8726
• DOI: 10.1007/s00345-023-04399-8

Purpose Patients with artificial urinary eventually need surgical revision. Unfortunately, in women, this requires another invasive abdominal intervention. Robotic-assisted revision may provide a less invasive and more acceptable approach for sphincter revision in women. We wanted to determinate the continence status after robotic-assisted artificial urinary sphincter revision among women with stress incontinence. We also examined postoperative complications and the safety of the procedure. Methods The chart of the 31 women with stress urinary incontinence who underwent robotic-assisted AUS revision at our referral center from January 2015 to January 2022 were reviewed retrospectively. All patients underwent a robotic-assisted artificial urinary sphincter revision by one of our two expert surgeons. The primary outcome was to determinate the continence rate after revision and the secondary outcome aimed to evaluate the safety and feasibility of the procedure. Results Mean patients age was 65 years old, and the mean time between the sphincter revision and previous implantation was 98 months. After a mean follow-up of 35 months, 75% of the patients were fully continent (0-pad). Moreover, 71% of the women were back to the same continence status as with the previously functional sphincter, while 14% even have an improved continence status. Clavien–Dindo grade ≥ 3 and overall complications occurred in 9% and 20.5% of our patients, respectively. This study is mainly limited by its retrospective design. Conclusion Robotic-assisted AUS revision carries satisfying outcome in terms of continence and safety.