PD27-07: Robot-assisted artificial urinary sphincter implantation in female patients: an international multicenter study
Friday, May 15, 2020
7:00 AM – 9:00 AM
benoit peyronnet, frank van der aa, vincent cardot, grégoire capon, xavier biardeau, olivier belas, frederic dubois, juliette hascoet, vincent cardot, frederic dubois, vidart adrien, aurelien descazeaud, andrea manunta, luis castro-sader, marta allue, frederic thibault, rainer hein, pierre lecoanet, georges fournier
Introduction: The morbidity related to artificial urinary sphincter (AUS) implantation in women is usually considered as the drawback which has limited its widespread. In order to decrease this morbidity, several teams have recently reported the use of a robotic approach to implant the AUS in female patients. The aim of this study was to report the perioperative and functional outcomes of robotic AUS implantation in women.
Methods: All female patients who underwent robotic AUS implantation using a standardized technique (anterior approach) between 2013 and 2019 at fourteen european institutions were included in a retrospective study. The indication for AUS implantation was type III stress urinary incontinence and intrinsic sphincter deficiency defined as a combination of a low urethral closure pressure/Valsalva leak point pressure and loss of urethral mobility. The primary endpoint was the functional outcome categorized as dry (0 pads), improved or unchanged.
Results: One hundred and twenty-three patients underwent robotic AUS implantation. Patients’ characteristics are summarized in table 1. There were 20 intraoperative complications (16.3%): 12 bladder neck injuries and 8 vaginal injuries. Surgeons carried on with AUS implantation in all cases. Twenty-two patients experienced postoperative complications (18%) but only four were Clavien =3 (3.3%): three early AUS explantations (2 due to vaginal erosion, 1 due to infection) and one reoperation for bladder fistula. After a mean follow-up of 13 months, there were 5 AUS explantations performed in total (4.1%): the 3 early explantations reported above, one for chronic urinary retention and one for urethral erosion. At the latest follow-up visit, 99 patients were dry (80.5%), 12 were improved (6.9%) and 12 were unchanged (9.8%).
Conclusions: This study is the first international multicenter series assessing the outcomes of robotic AUS implantation in women using a standardized technique. This series confirm the promising perioperative and functional outcomes reported in previous studies. Source of