Evaluating robot-assisted artificial urinary sphincter implantation in women with stress urinary incontinence

This study aimed to investigate the safety and effectiveness of a robotic implantation of an artificial urinary sphincter (AUS) for stress urinary incontinence (SUI) in women. This study found that female patients with SUI benefit from robotic AUS implantation. 

Urinary incontinence is the unintentional loss of urine. Stress urinary incontinence (SUI) happens when physical movement or activity — such as coughing, sneezing, running or heavy lifting — puts pressure (stress) on the bladder. This can be more common in menopausal women or in women who have given birth.

One treatment for SUI is the implantation of an artificial urinary sphincter (AUS). This can help with leakage. This surgery can be carried out by classic methods (open surgery) or by using special tools, often called robotic surgery. Open surgery is associated with long-term side effects. It is thought that robotic surgery can help with side-effects as smaller cuts can be made during surgery. The safety and effectiveness of robotic AUS implantation in women remain under investigation. 

49 patients with SUI underwent robotic implantation of an AUS and were included in this study. Patients were followed up for an average of 18.5 months. 

At 3 months after surgery, 81.6% of patients experienced no urinary leakage and 12.2% of patients had improved symptoms.

Side-effects during the surgery (16.3%) were injuries to the neck of the bladder or vagina. 9 (18.3%) patients reported side-effects within 3 months from the surgery. These included mostly urinary retention or urinary tract infections

This study found that female patients with stress urinary incontinence may benefit from robotic AUS implantation. 

Most of the 10 surgeons involved were not highly experienced in female AUS implantation and/or in robotic surgery. Results could be improved if the surgeons were experienced in this technique.