PD24-08 ROBOT ASSISTED BLADDER NECK ARTIFICIAL URINARY SPHINCTER IMPLANTATION IN NEUROLOGICAL MALE PATIENTS: PRELIMINARY RESULTS

Abstract

You have accessJournal of UrologyCME1 May 2022PD24-08 ROBOT ASSISTED BLADDER NECK ARTIFICIAL URINARY SPHINCTER IMPLANTATION IN NEUROLOGICAL MALE PATIENTS: PRELIMINARY RESULTS Benoit Peyronnet, Thibault Tricard, Thibaut Brierre, Juliette Hascoet, Thomas Prudhomme, Baptiste Poussot, Andrea Manunta, Evelyne Castel-Lacanal, Christian Saussine, and Xavier Gamé Benoit PeyronnetBenoit Peyronnet More articles by this author , Thibault TricardThibault Tricard More articles by this author , Thibaut BrierreThibaut Brierre More articles by this author , Juliette HascoetJuliette Hascoet More articles by this author , Thomas PrudhommeThomas Prudhomme More articles by this author , Baptiste PoussotBaptiste Poussot More articles by this author , Andrea ManuntaAndrea Manunta More articles by this author , Evelyne Castel-LacanalEvelyne Castel-Lacanal More articles by this author , Christian SaussineChristian Saussine More articles by this author , and Xavier GaméXavier Gamé More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002566.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In neurological male patients, implanting the artificial urinary sphincter (AUS) cuff at the bladder neck is an option aiming to decrease the risk of erosion. The robotic approach may decrease the morbidity of bladder neck AUS implantation but only scant evidence exist. The aim of this study was to report the preliminary results of robot-assisted bladder neck AUS implantation in male patients with neurogenic stress urinary incontinence (SUI) METHODS: The charts of all male patients with spina bifida (SB) or spinal cord injury (SCI) who underwent a primary robotic bladder neck AUS implantation at three academic centers between 2011 and 2020 were retrospectively reviewed. The procedure was performed with the Da-Vinci robot (Si and Xi) using a four arm transperitoneal approach. The primary endpoint was continence at 3 months and at the last follow-up categorized as: complete continence (0 pads), improved SUI, unchanged SUI, or worsened SUI. Patient characteristics, perioperative outcomes, and follow-up data were also collected. RESULTS: Eleven patients were included over the study period: 7 SCI and 4 SB. The median age was 40 years. One patient had a supra-trigonal cystectomy with concomitant robot-assisted augmentation cystoplasty. The median length of hospitalization was 4 days. There were 2 post-operative complications (33.3%): one Clavien 3 and one Clavien 4. After a median follow-up of 14 months, only one explantation was required (16.7%) due to early AUS infection in the patient who had a concomitant augmentation cystoplasty. Three patients underwent device revision at 4, 7 and 12 months respectively for pump repositioning (n=1) and early recurrence of SUI with cuff downsizing in the two later cases. At 3 months and at the last follow-up, four patients had recovered complete continence (36.4%), 6 patients had improvement in SUI (54.5%) and one patient had unchanged incontinence (9%). CONCLUSIONS: In this preliminary experience, robot-assisted bladder neck AUS implantation for neurogenic SUI yielded interesting results. The functional outcomes were satisfactory but the high rate of early revisions, already reported in the literature (Hervé, BMJ case report 2017), should prompt further evaluation in the upcoming years. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e418 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benoit Peyronnet More articles by this author Thibault Tricard More articles by this author Thibaut Brierre More articles by this author Juliette Hascoet More articles by this author Thomas Prudhomme More articles by this author Baptiste Poussot More articles by this author Andrea Manunta More articles by this author Evelyne Castel-Lacanal More articles by this author Christian Saussine More articles by this author Xavier Gamé More articles by this author Expand All Advertisement PDF DownloadLoading ...