title: Artificial urinary sphincter implantation in women with stress urinary incontinence: preliminary comparison of robot-assisted and open approaches.
abstract: OBJECTIVE
  We aimed to compare outcomes of open and robot-assisted artificial urinary sphincter (AUS) implantation in female patients.
  
  
  METHODS
  The charts of all female patients who underwent an AUS implantation between 2008 and 2014 in a single center were retrospectively reviewed. From 2008 to 2012, AUS were implanted using an open approach and from 2013 to 2014 using a robot-assisted approach. Perioperative and functional parameters were compared between groups. The primary endpoint was continence status.
  
  
  RESULTS
  Twenty-four women were assessed: 16 in the open group and eight in the robot-assisted group. Three patients had neurogenic stress urinary incontinence. Most patients had undergone previous procedures for urinary incontinence (15 in the open group and seven in the robotic group). Mean operative time was similar in both groups (214 vs. 211 min; p = 0.90). Postoperative complicationsrate was lower in the robot-assisted group (25 vs. 75 %; p = 0.02). There was a trend toward a lower intraoperative complication rate (37.5 vs. 62.5 %; p = 0.25), decreased blood loss (17 ml vs. 275 ml; p = 0.22), and shorter length of stay (3.5 vs. 9.3 days; p = 0.09) in the robot-assisted group. Continence rates were comparable in both groups (75 vs. 68.8 %; p = 0.75). Three AUS explantations were needed in the open group (18.8 %) compared with one in the robot-assisted group (12.5 %; p = 0.70).
  
  
  CONCLUSIONS
  In female patients, the robot-assisted approach compared with open AUS implantation could decrease intraoperative and postoperative complication rates, length of hospital stay, and blood loss.
authors.affiliation: Department of Urology, CHU Rennes, Rennes, France. peyronnetbenoit@hotmail.fr.|Service d'Urologie, Hopital Pontchaillou, 2 rue Henri Le Guilloux, 35000, Rennes, France. peyronnetbenoit@hotmail.fr.
authors.forename: Benoit
authors.initials: B
authors.lastname: Peyronnet
authors.affiliation: Department of Urology, CHU Rennes, Rennes, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Vincendeau
authors.affiliation: Department of Urology, CHU Rennes, Rennes, France.
authors.forename: Lauranne
authors.initials: L
authors.lastname: Tondut
authors.affiliation: Department of Urology, CHU Rennes, Rennes, France.
authors.forename: Karim
authors.initials: K
authors.lastname: Bensalah
authors.affiliation: Department of Physical Medicine and Rehabilitation, CHU Rennes, Rennes, France.
authors.forename: Mireille
authors.initials: M
authors.lastname: Damphousse
authors.affiliation: Department of Urology, CHU Rennes, Rennes, France.
authors.forename: Andréa
authors.initials: A
authors.lastname: Manunta
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D012371:Robotics / Q000706:statistics & numerical data*; D016741:Urinary Sphincter, Artificial; D013520:Urologic Surgical Procedures / Q000706:statistics & numerical data*
keywords: Artificial urinary sphincter; Female; Robot; Urinary incontinence