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).
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.
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).
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.
World journal of urology. 2026 Jul 22*** epublish ***
David Carracedo, Pietro Moscatiello, Tamara Jerez, Lucía Esteban, Carmen Grañen, Nathalie Pereira, Miguel A Sánchez
Urology Department, Rey Juan Carlos Universitariy Hospital, Calle Gladiolo S/N, Móstoles, CP 28050, Madrid, Spain. ., Urology Department, Sanitas La Zarzuela Hospital, Madrid, Spain., Urology Department, Rey Juan Carlos Universitariy Hospital, Calle Gladiolo S/N, Móstoles, CP 28050, Madrid, Spain.