Minerva urology and nephrology · 2025
Robot-assisted artificial urinary sphincter revision in "non-neurogenic" stress urinary incontinence in female patients: surgical technique and outcomes.
СтатьяНазвание и аннотация: Перевод в очереди
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Corrales Mariela, Geretto Paolo, Moriconi Martina, Gallo Maria L, DE Cillis Sabrina, Phé Veronique
Аннотация
BACKGROUND: Robot-assisted artificial urinary sphincter (AUS) implantation is a suitable option for the treatment of severe stress urinary incontinence (SUI) in female patients. However, to the best of our knowledge, any report of robotic AUS revision in case of recurrent SUI is available. The present study aims to provide the outcomes of a cohort of female patients subjected to robot-assisted AUS revision at a single tertiary referral center and to describe the surgical technique.
METHODS: The main surgical steps are the following: through robotic technique, the AUS reservoir and urethral cuff are found by following the connection tubes. The reservoir and the activating pump are then removed, and the urethral cuff is opened. A measuring tape is used to obtain the correct size of the bladder neck and to choose the correct new cuff, which is then placed. The reservoir is replaced, and the connection tubes are exteriorized. Finally, a subcutaneous passage towards the right labia majora is obtained and the connections are closed. The outcomes of a retrospective cohort of female patients subjected to robotic AUS revision according to the described technique are also provided.
RESULTS: Four patients were included. The median age was 63 (51-76 years); the median time to revision was 12 years (5-16 years). Median operative time was 160.5 (130-185 minutes). The reason for the AUS revision was a mechanical failure of the device in all cases. Any intra-operative or severe postoperative complication (Clavien-Dindo ≥3) was observed. After AUS activation at 4 weeks, all patients were dry.
CONCLUSIONS: Robotic AUS revision in female patients is a feasible and safe technique and can give excellent functional outcomes.
METHODS: The main surgical steps are the following: through robotic technique, the AUS reservoir and urethral cuff are found by following the connection tubes. The reservoir and the activating pump are then removed, and the urethral cuff is opened. A measuring tape is used to obtain the correct size of the bladder neck and to choose the correct new cuff, which is then placed. The reservoir is replaced, and the connection tubes are exteriorized. Finally, a subcutaneous passage towards the right labia majora is obtained and the connections are closed. The outcomes of a retrospective cohort of female patients subjected to robotic AUS revision according to the described technique are also provided.
RESULTS: Four patients were included. The median age was 63 (51-76 years); the median time to revision was 12 years (5-16 years). Median operative time was 160.5 (130-185 minutes). The reason for the AUS revision was a mechanical failure of the device in all cases. Any intra-operative or severe postoperative complication (Clavien-Dindo ≥3) was observed. After AUS activation at 4 weeks, all patients were dry.
CONCLUSIONS: Robotic AUS revision in female patients is a feasible and safe technique and can give excellent functional outcomes.