Artificial Urinary Sphincter in Women: A Systematic Review of Clinical Outcomes and Technological Evolutions.
O Decombe, L Lenfant, B Faurie et al.
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In 30 seconds
This systematic review examined clinical outcomes, surgical approaches, quality of life, and device developments for artificial urinary sphincter (AUS) implantation in women with stress urinary incontinence related to intrinsic sphincter deficiency. A PubMed search of studies published from 2019 to 2025, conducted under PRISMA 2020 guidelines, identified 30 studies, predominantly retrospective. Reported continence rates ranged from 59% to 84%; revision rates ranged from 6% to 69%, and explantation rates from 2% to 34%. Minimally invasive and robotic approaches are emerging, but comparative evidence and long-term device-survival data remain limited.
Key findings
- Across included studies, reported continence rates ranged from 59% to 84%.
- Revision rates ranged from 6% to 69%, while explantation rates ranged from 2% to 34%.
- The evidence base was generally low-level and dominated by retrospective studies, often single-centre case series.
- AUS implantation may improve quality of life; possible benefits for female sexual function are preliminary.
Why it matters
AUS remains a salvage option for women with severe stress incontinence related to intrinsic sphincter deficiency, including complex cases after prior treatment. The wide ranges in continence, revision, and explantation outcomes underscore the need to discuss both potential functional benefit and device-related burden. Evidence on newer surgical approaches and technologies is not yet sufficient to establish their comparative or long-term advantages.
What to keep in mind
The review found a generally low level of evidence, with most studies retrospective and single-centre. Comparative evidence for surgical approaches and long-term device-survival data were limited.