Outcomes of robot-assisted urinary sphincter implantation for male neurogenic urinary incontinence.

Abstract

OBJECTIVES\nTo report the functional outcomes of Robot-assisted laparoscopic Artificial Urinary Sphincter (R-AUS) insertion in men with neurogenic stress urinary incontinence (SUI).\n\n\nPATIENTS AND METHODS\nA monocentric retrospective study included all consecutive adult male neuro-urological patients who underwent R-AUS for SUI between January 2011 and August 2018. The Artificial Urinary Sphincter (AUS) was implanted through a transperitoneal robot-assisted laparoscopic approach. Intra and early postoperative complications were reported (Clavien s classification). Continence was defined as no pad usage. Revision and explantation rates were also evaluated.\n\n\nRESULTS\nOverall, nineteen men, median age 45 years (IQR 37 to 54) were included. No conversion to laparotomy was needed. Three minor (Clavien I-II) early postoperative complications occurring in 3 (15.8%) patients were reported. The median follow-up was 58 months (IQR 36-70). At the end of the follow-up, continence rate was 89.5%. The AUS revision and explantation rates were 5.3% and 0% respectively.\n\n\nCONCLUSION\nRobot-assisted laparoscopic approach is a safe and efficient procedure for AUS implantation in adult male neuro-urological patients, referring to the challenging open technique.