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Current Use of the Artificial Urinary Sphincter in Adult Females

  • Female Urology (L Cox, Section Editor)
  • Published:
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Abstract

Purpose of Review

The aim of the present report was to review the recent evidences regarding the use of artificial urinary sphincter (AUS) in adult females.

Recent Findings

While the excellent functional outcomes of AUS in female patients with stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD) have been reported for decades, its use has remained confidential in most countries likely due to its challenging implantation and inherent morbidity. Over the past few years, laparoscopic and, more recently, robotic techniques of AUS implantation in female patients have been described with promising perioperative outcomes. As a result, the use of AUS has increased in several countries. The indications are mostly recurrent or persistent SUI after previous anti-incontinence procedures and neurogenic SUI. Owing to its unique potential to restore continence while maintaining low outlet resistance during the voiding phase, AUS may be of special interest in female patients with detrusor underactivity. High level of evidence data from trials which are underway, along with developments in robotic surgery and technological refinements of the device, may well, almost 50 years after its introduction, give to the AUS its momentum as a major contributor in the female SUI armamentarium.

Summary

While the use of AUS in female patients has been restricted to some countries and a few high-volume centers, it has started spreading again over the past few years, thanks to the rise of minimally invasive approaches which facilitate its implantation, and this is yielding promising outcomes.

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Authors and Affiliations

  1. Department of Urology, University of Rennes, Rennes, France

    Benoit Peyronnet

  2. Service d’Urologie, Hopital Pontchaillou, 2 rue Henri Le Guilloux, 35000, Rennes, France

    Benoit Peyronnet

  3. Department of Urology, University College London Hospital, London, UK

    Tamsin Greenwell & Jeremy Ockrim

  4. Department of Urology, University of Alberta, Edmonton, Canada

    Gary Gray

  5. Department of Urology, Houston Methodist Hospital, Houston, TX, USA

    Rose Khavari

  6. Department of Urology, Addenbrooke’s Hospital, Cambridge, UK

    Nikesh Thiruchelvam

  7. Department of Urology, University of Bordeaux, Bordeaux, France

    Grégoire Capon

  8. Department of Urology, University Hospital Ramon y Cajal, Madrid, Spain

    Luis Lopez-Fando

  9. Department of Urology, William Beaumont Hospital, Royal Oak, MI, USA

    Jason Gilleran

  10. Department of Urology, University of Brest, Brest, France

    Georges Fournier

  11. Department of Urology, Maastricht University Medical Centre, Maastricht, Netherlands

    Gommert A. Van Koeveringe

  12. University Hospitals, KU Leuven, Leuven, Belgium

    Frank Van Der Aa

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  1. Benoit Peyronnet
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  2. Tamsin Greenwell
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Correspondence to Benoit Peyronnet.

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Conflicts of Interest

Dr. Peyronnet is a consultant for Allergan, Medtronic, Astellas, Pierre Fabre and reports personal fees from Boston Scientific, outside the submitted work.

Dr. Thiruchelvam reports personal fees from Boston Scientific, during the conduct of the study; personal fees from Teleflex, personal fees from Coloplast, personal fees from Galvani, outside the submitted work.

Dr. Greenwell reports personal fees from Boston scientific, other from Astellas, other from Axonics, other from Contura, other from ferring, other from June Medical, other from Laborie, other from Medtronic, outside the submitted work.

Dr. Van Koeveringe reports personal fees from Boston Scientific, outside the submitted work.

Dr. Gray reports personal fees from Boston scientific, grants from Bioness, personal fees from Axonics, from Contura, outside the submitted work.

Dr. Fournier reports personal fees from Boston Scientific, outside the submitted work.

Dr. Capon reports personal fees from Boston Scientific, outside the submitted work.

Dr. Van der Aa reports personal fees from Boston Scientific, other from Cousin, personal fees from Promedon, outside the submitted work.

Dr. López-Fando reports personal fees from Astellas Pharma SA, personal fees from Neomedic, personal fees from Boston Scientific, personal fees from Wellspect, personal fees from Coloplast, outside the submitted work.

Dr. Khavari and Dr. Gilleran each have nothing to disclose.

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Peyronnet, B., Greenwell, T., Gray, G. et al. Current Use of the Artificial Urinary Sphincter in Adult Females. Curr Urol Rep 21, 53 (2020). https://doi.org/10.1007/s11934-020-01001-1

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