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Purpose <p>To evaluate perioperative, functional, and safety outcomes of robot-assisted artificial urinary sphincter (AUS) implantation via a posterior vesicovaginal approach in women with stress urinary incontinence (SUI) secondary to intrinsic sphincter deficiency (ISD).</p> Methods <p>A prospective single-centre study included consecutive women undergoing robot-assisted AUS implantation between September 2018 and March 2026. Functional outcomes were assessed using the 24-h pad test and International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF). Primary outcome was continence (complete or social). Secondary outcomes included perioperative results, complications (Clavien–Dindo), device-related events, and revision-free survival. Follow-up was conducted at regular intervals up to a mean of 38.1 months.</p> Results <p>Twenty-nine patients (mean age 57.1&#xa0;year; 89.7% with prior SUI surgery) were included. Complete continence was achieved in 86.2% and social continence in 6.9%, with a failure rate of 6.9%. Significant improvements were observed in ICIQ-SF score (mean reduction 16.5 points; <i>p</i> &lt; 0.001) and pad weight (mean reduction 670.5&#xa0;g; <i>p</i> &lt; 0.001). Mean operative time was 171.6&#xa0;min and hospital stay 2.4 days. Intraoperative bladder injury occurred in 37.9% but was managed without sequelae. Early postoperative complications occurred in 13.8% (no reinterventions). Two patients (6.9%) required revision for mechanical failure; no infections or explantations were observed. Revision-free survival was 93.1%. Patient satisfaction was high (93.1% improved).</p> Conclusions <p>Robot-assisted AUS implantation via a posterior vesicovaginal approach is a safe and effective option for women with SUI due to ISD, providing high continence rates, low postoperative complication and revision rates, and durable mid-term outcomes.</p>

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Robot-assisted artificial urinary sphincter implantation via a posterior vesicovaginal approach for female stress urinary incontinence due to intrinsic sphincter deficiency: mid-term outcomes from a prospective single-centre study

  • 期刊论文

  • 发表日期：

    2026年7月22日

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  • David Carracedo,
  • Pietro Moscatiello,
  • Tamara Jerez,
  • Lucía Esteban,
  • Carmen Grañen,
  • Nathalie Pereira,
  • Miguel A. Sánchez

摘要

Purpose

To evaluate perioperative, functional, and safety outcomes of robot-assisted artificial urinary sphincter (AUS) implantation via a posterior vesicovaginal approach in women with stress urinary incontinence (SUI) secondary to intrinsic sphincter deficiency (ISD).

Methods

A prospective single-centre study included consecutive women undergoing robot-assisted AUS implantation between September 2018 and March 2026. Functional outcomes were assessed using the 24-h pad test and International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF). Primary outcome was continence (complete or social). Secondary outcomes included perioperative results, complications (Clavien–Dindo), device-related events, and revision-free survival. Follow-up was conducted at regular intervals up to a mean of 38.1 months.

Results

Twenty-nine patients (mean age 57.1 year; 89.7% with prior SUI surgery) were included. Complete continence was achieved in 86.2% and social continence in 6.9%, with a failure rate of 6.9%. Significant improvements were observed in ICIQ-SF score (mean reduction 16.5 points; p < 0.001) and pad weight (mean reduction 670.5 g; p < 0.001). Mean operative time was 171.6 min and hospital stay 2.4 days. Intraoperative bladder injury occurred in 37.9% but was managed without sequelae. Early postoperative complications occurred in 13.8% (no reinterventions). Two patients (6.9%) required revision for mechanical failure; no infections or explantations were observed. Revision-free survival was 93.1%. Patient satisfaction was high (93.1% improved).

Conclusions

Robot-assisted AUS implantation via a posterior vesicovaginal approach is a safe and effective option for women with SUI due to ISD, providing high continence rates, low postoperative complication and revision rates, and durable mid-term outcomes.