J Robot Surg. 2025 Nov 17;20(1):16. doi: 10.1007/s11701-025-02975-1.
ABSTRACT
The present research provides a comprehensive systematic review of the safety and effectiveness of robotic-assisted artificial urinary sphincter (AUS) implantation in treating urodynamic stress incontinence. In line with the PRISMA framework and a protocol registered in PROSPERO, we conducted a comprehensive search of PubMed, Web of Science, and the Cochrane Library for relevant studies published from inception to August 2025. Key perioperative parameters-operative time, estimated blood loss, hospital stay, continence rate, and complication rate-were extracted. Data analysis was carried out using STATA software, with heterogeneity assessed by the I² statistic and sensitivity by leave-one-out analysis. Eight studies involving 328 patients were included. Among three comparative cohorts (n = 224), operative time did not differ between robotic and open AUS (WMD = 7.62, 95% CI [-57.94, 73.17], I²=97.4).The robotic group showed significantly more blood loss (WMD = 293.5, 95% CI [81.4, 505.75], I²=95.2), more perioperative complications (OR = 3.9, 95% CI [1.75, 8.66], I²=35.5), and more hospital stay (WMD = 4.71, 95% CI [2.26, 7.16], I²=87.5). Pooled analysis of robotic cases indicated a mean operative time of 197.06 min(95% CI [177.82, 216.29], I²=86.9), mean blood loss of 19.8 mL (95% CI [14.05, 25.55], I²=0.3), hospital stay of 4.85(95% CI [4.12, 5.57], I²=88) days, and an overall complication rate of 37%(95% CI [0.27, 0.5], I²=16.6). Robot-assisted AUS implantation is a safe and effective option for treating urodynamic stress incontinence, with benefits such as reduced blood loss and faster recovery. However, the moderate risk of bias and high heterogeneity among studies limit the reliability of the findings. Larger, high-quality trials are needed to confirm its long-term efficacy.
PMID:41243039 | DOI:10.1007/s11701-025-02975-1
