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. 2025 Feb 21:74:21-27.
doi: 10.1016/j.euros.2025.02.004. eCollection 2025 Apr.

Next-generation Solutions: Are Patients Ready for Electronic Artificial Urinary Sphincters for Male Incontinence?

Marc Kidess  1 , Troya Ivanova  1 , Julian Hermans  1 , Leo Stadelmeier  1 , Marina Hoffmann  1 , Nikolaos Pyrgidis  1 , Julian Marcon  1 , Michael Chaloupka  1 , Ricarda M Bauer  2 , Christian G Stief  1 , Yannic Volz  1
Affiliations

Next-generation Solutions: Are Patients Ready for Electronic Artificial Urinary Sphincters for Male Incontinence?

Marc Kidess et al. Eur Urol Open Sci. .

Abstract

Background and objective: Urology is characterized by continuous innovation. The inception of robot-assisted radical prostatectomy (RP) marked a pivotal technological advance and further advances in digital treatment options for stress urinary incontinence (SUI) are emerging. Our aim was to assess patient willingness to receive an electronic artificial urinary sphincter (eAUS) implant and identify associated concerns.

Methods: Patients who received a first AUS implant (AMS800 system) for post-RP SUI from March 2013 to December 2023 were included. An anonymous survey was used to collect data on demographics, current AUS satisfaction, daily technology use, interest in an eAUS, and concerns about potential eAUS technical malfunctions. Data were analyzed using SPSS, with significance set at p < 0.05.

Key findings and limitations: Out of 345 patients, 208 (60.2%) completed the questionnaire. The majority were aged 71-80 yr (51.7%) and had a university education (37.7%). Satisfaction with their AUS was high: 79.8% of the respondents were satisfied, 88.9% were satisfied with its handling, and 89.4% would choose an AUS implant again. Notably, 60.4% showed interest in an eAUS, with younger respondents and those who use technology on a daily basis expressing greater interest. Preferred control methods included remote-based (78.4%) and smartphone-based (60.0%) options. Concerns about system malfunction (66.4%), connection loss (65.9%), and battery issues (60.0%) were prevalent.

Conclusions and clinical implications: There was significant patient interest in an eAUS in our survey, especially among younger individuals and those who use technology daily. Despite high satisfaction with current AUS devices, addressing potential technical malfunctions and patient concerns is crucial for broader acceptance of an eAUS. Patient concerns about technological malfunctions seem to outweigh worries about medical issues.

Patient summary: Urology is becoming more advanced with technologies like robotic surgery and electronic artificial urinary sphincters (eAUS). According to our survey, most patients are happy with their current sphincters and are open to eAUS, especially younger patients who are familiar with technology. However, patients are concerned about system malfunctions and connection loss. More research is needed to address technical issues and patient concerns.

Keywords: Artificial male sphincter; Incontinence; Technology.

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Figures

Fig. 1
Fig. 1
Study flowchart. The questionnaire was sent to 345 patients who received an artificial urinary sphincter (AUS) implant between March 2013 and December 2023, of whom 208 completed the questionnaire. For one patient, the AUS was explanted, 14 patients died, and the letter was not delivered because of a change in address for another 14 patients.
Fig. 2
Fig. 2
Participant concerns regarding an electronic artificial urinary sphincter (eAUS).
See this image and copyright information in PMC

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