Background: The artificial urinary sphincter has been an effective treatment for stress urinary incontinence caused by intrinsic sphincter deficiency in women. However, the use of this device has been limited by the technical difficulties and risks associated with the open implantation procedure. Preliminary studies using robotic techniques have shown promising results, but only one small study has compared robotic to open procedures. This study aims to compare the outcomes of robotic and open artificial urinary sphincter implantation in women with stress urinary incontinence due to intrinsic sphincter deficiency in a large multicenter cohort. Methods: Data were collected retrospectively from female patients who underwent open or robot-assisted artificial urinary sphincter implantation from 2006 to 2020 at 12 urology departments. The primary outcome was the rate of complications within 30 days after surgery, graded using the Clavien-Dindo Classification. Perioperative and functional outcomes were compared between the two groups. Results: A total of 135 patients were included, with 71 in the robotic group and 64 in the open group. The open group had a higher rate of intraoperative complications (27.4% vs. 12.7%; p = 0.03) and postoperative complications (46.8% vs. 15.5%; p < 0.0001). More patients in the robotic group achieved full continence (83.3% vs. 62.3%; p = 0.01). The open group had higher explantation (27.4% vs. 1.4%; p < 0.0001) and revision rates (17.5% vs. 5.6%; p = 0.02). The estimated 1-year explantation-free survival rate was higher in the robotic group. (98.6% vs. 78.3%; p = 0.001). Conclusions: Robot-assisted implantation may reduce perioperative morbidity and improve functional outcomes compared to open implantation in women with stress urinary incontinence.
Journal of clinical medicine. 2025 Jan 06*** epublish ***
Alexandre Dubois, Grégoire Capon, Olivier Belas, Adrien Vidart, Andrea Manunta, Juliette Hascoet, Lucas Freton, Frederic Thibault, Vincent Cardot, Frédéric Dubois, Luc Corbel, Emmanuel Della Negra, François Haab, Laurence Peyrat, Jean-Nicolas Cornu, Philippe Grise, Aurélien Descazeaud, Georges Fournier, Benoit Peyronnet
Department of Urology, University of Rennes, 35000 Rennes, France., Department of Urology, University of Bordeaux, 33404 Bordeaux, France., Department of Urology, Pole Le Mans Sud, 72100 Le Mans, France., Department of Urology, Foch Hospital, 92150 Suresenes, France., Department of Urology, Hopital Robert Schuman, 57070 Vantoux, France., Department of Urology, Clinique Bizet, 75116 Paris, France., Department of Urology, Hospital Privé Saint-Grégoire, 35760 Saint-Grégoire, France., Department of Urology, Centre Briochin d'Urologie de l'Hopital Privé Cotes-D'armor, 22190 Plerin, France., Department of Urology, Institut Montsouris, 75014 Paris, France., Department of Urology, Hopital Diaconesses Croix-Saint Simon, 75020 Paris, France., Department of Urology, University of Rouen, 76031 Rouen, France., Department of Urology, University of Limoges, 87000 Limoges, France., Department of Urology, University of Brest, 29609 Brest, France.