PD27-06 COMPARISON OF OPEN AND ROBOT-ASSISTED ARTIFICIAL URINARY SPHINCTER IMPLANTATION IN FEMALE PATIENTS WITH STRESS URINARY INCONTINENCE: A MULTICENTER STUDY

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy II (PD27)1 Apr 2020PD27-06 COMPARISON OF OPEN AND ROBOT-ASSISTED ARTIFICIAL URINARY SPHINCTER IMPLANTATION IN FEMALE PATIENTS WITH STRESS URINARY INCONTINENCE: A MULTICENTER STUDY Benoit Peyronnet*, Grégoire Capon, Olivier Belas, Thibaut Tricart, Juliette Hascoet, Vincent Cardot, Frederic Dubois, Vidart Adrien, Aurelien Descazeaud, Lucas Freton, Jean-Nicolas Cornu, Anna Goujon, Frederic Thibault, Luc Corbel, Emmanuel Della Negra, Laurence Peyrat, Philippe Grise, Francois Haab, and Georges Fournier Benoit Peyronnet*Benoit Peyronnet* More articles by this author , Grégoire Capon Grégoire Capon More articles by this author , Olivier BelasOlivier Belas More articles by this author , Thibaut TricartThibaut Tricart More articles by this author , Juliette HascoetJuliette Hascoet More articles by this author , Vincent CardotVincent Cardot More articles by this author , Frederic DuboisFrederic Dubois More articles by this author , Vidart AdrienVidart Adrien More articles by this author , Aurelien DescazeaudAurelien Descazeaud More articles by this author , Lucas FretonLucas Freton More articles by this author , Jean-Nicolas CornuJean-Nicolas Cornu More articles by this author , Anna GoujonAnna Goujon More articles by this author , Frederic ThibaultFrederic Thibault More articles by this author , Luc CorbelLuc Corbel More articles by this author , Emmanuel Della NegraEmmanuel Della Negra More articles by this author , Laurence PeyratLaurence Peyrat More articles by this author , Philippe GrisePhilippe Grise More articles by this author , Francois HaabFrancois Haab More articles by this author , and Georges FournierGeorges Fournier More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000884.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Several preliminary series have reported the use of a robotic approach for artificial urinary sphincter (AUS) implantation in female patients with stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD). However, to date, only one small sample single-center series have aimed to compare the outcomes of robotic AUS to the ones of open AUS implantation in female patients. The aim of the present study was to compare the outcomes of robotic vs. open AUS implantation in women with SUI caused by ISD in a large multicenter cohort. METHODS: The data of all female patients who underwent open or robot-assisted AUS implantation for SUI due to ISD from 2006 to 2018 at 10 departments of urology were included in a retrospective study. At the beginning of the study period, all surgeons performing robotic implantation had either no or little (<20 cases) experience of AUS implantation. Conversely, in the open group, two of the 5 surgeons involved had performed > 20 AUS implantations. Perioperative and functional outcomes between the open and robotic groups were compared RESULTS: 135 patients were included: 71 in the robotic group and 64 in the open group. The mean operative time was longer in the robotic group (179.9 vs. 126.2 min; p<0.0001). The intraoperative complication (i.e. intraoperative bladder neck and/or vaginal injury) rate was higher in the open group (12.7% vs. 27.4%; p =0.03) as were the rate of postoperative complications (15.5% vs. 46.8%; p<0.0001), the rate of “major” Clavien grade≥3 complications (2.8% vs. 17.2%; p=0.01) and the length of hospital stay (4.1 vs. 6.5 days; p=0.002). After a median follow-up of 12.2 months and 25.5 months in the robotic and open groups respectively, the rate of patients fully continent (i.e. 0 pad per day) was higher in the robotic group (83.3% vs. 62.3%; p=0,01) as was the estimated 1-year explantation-free survival (98.6% vs. 78.3%; p=0.001; figure 1). CONCLUSIONS: The robot-assisted approach, even when performed by low experienced surgeons in their learning curve, may decrease the perioperative morbidity of AUS implantation in women when compared to the open approach and possibly improve functional outcomes, likely due to a lower explantation rate. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e551-e551 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benoit Peyronnet* More articles by this author Grégoire Capon More articles by this author Olivier Belas More articles by this author Thibaut Tricart More articles by this author Juliette Hascoet More articles by this author Vincent Cardot More articles by this author Frederic Dubois More articles by this author Vidart Adrien More articles by this author Aurelien Descazeaud More articles by this author Lucas Freton More articles by this author Jean-Nicolas Cornu More articles by this author Anna Goujon More articles by this author Frederic Thibault More articles by this author Luc Corbel More articles by this author Emmanuel Della Negra More articles by this author Laurence Peyrat More articles by this author Philippe Grise More articles by this author Francois Haab More articles by this author Georges Fournier More articles by this author Expand All Advertisement PDF downloadLoading ...