Urodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy I (PD06): Podium 6: Friday, September 10, 2021
PD06-06 IMPACT OF ROBOTIC ARTIFICIAL URINARY SPHINCTER IMPLANTATION IN FEMALE PATIENTS ON QUALITY OF LIFE AND PATIENTS-REPORTED OUTCOMES
INTRODUCTION AND OBJECTIVE:
Artificial urinary sphincter (AUS) is commonly used in France in female patients with stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD). However, female AUS has never been assessed using validated questionnaires so far. The aim of the present study was to assess the functional outcomes of robotic artificial urinary sphincter implantation using validated questionnaires
The data of all female patients undergoing a robotic AUS implantation at a single academic center between 2014 and 2019 were collected prospectively. Preoperativley, all patients underwent urodynamics and filled out an Urinary Symptoms Profile (USP) questionnaire (SUI subscore /9; overactive bladder subscore /21 ; voiding symptoms subscore /9), a ICIQ-SF questionnaire and a Patient Global Impression of Improvement (PGII). The same questionnaires were filled out at 3 months postoperatively.
Over the study period, 57 robotic female AUS implantations were performed by two surgeons. Eight patients had neurogenic SUI (14%). The median patients’ age was 66 years and 84.2% had a history of previous SUI surgery. The median cuff size was 75 mm. There were ten intraoperative complications (5 bladder neck injuries and 5 vaginal injuries ; 17.5%) and 16 postoperative complications (28.1%) all Clavien grades 1 or 2 except three Clavien 3B: two early vaginal erosion with AUS explantation and one suspicion of AUS infection with surgical exploration (major complications rate: 5.3%). The median length of stay was 3 days. All patient-reported outcomes were significantly improved at 3 months. The USP SUI subscore decreased from 7.4/9 preoperatively to 0.7/9 at 3 months (p<0.0001), the USP OAB subscore dwindled from 12.6 to 5.2 (p<0.0001) and the ICIQ-SF from 16.3 to 3.1 (p<0.0001). The AUS implantation improved patients’ quality of life with the ICIQ-qol decreasing from 8.4 preoperatively to 1.3 at 3 months (p<0.0001). The 3-month PGII was 1/7 (very much improved) in 41 patients (74.5%), 2/7 (improved) in 5 patients (9.1%), 3/7 in four patients (7.3%) and 4/7 (unchanged) in five patients (9.1%).
Robot-assisted AUS implantation in female patients has a low morbidity and improves the patients-reported outcomes and quality of life of female patients with SUI due to ISD.
Source of Funding:
None© 2021 by American Urological Association Education and Research, Inc.