Fascial Mild Urethral Sling or Artificial Urinary Sphincter in the Neurological Women Population, a Multicenter Study
Abstract
BACKGROUND: Achieving continence in patients with neurogenic bladder is a difficult goal especially when stress urinary incontinence (SUI) due to intrinsic sphincter deficiency is involved. Two techniques are commonly used in that setting, but they have never been directly compared: the artificial urinary sphincter (AUS) and the fascial pubovaginal sling (PVS). The present study aims to compare the outcomes of AUS and PVS in female neuropathic patients. METHODS: This retrospective international multicenter study was conducted from 2014 to 2023. We included all women with a past medical history of neurogenic bladder who underwent AUS or a PVS insertion (cadaveric or fascia lata) at three centers. The primary endpoint was the outcomes as assessed by the patient global impression of improvement (PGII) at 3 months and at the last follow-up. RESULTS: Thirty-five patients were included: 16 with AUS and 19 with PVS. The PVS patients had fewer previous anti-incontinence procedures (10.5% vs. 43.8%; p = 0.02). The maximum cystometric capacity was significantly higher in the AUS group (364.1 vs. 252.8 mL; p = 0.03). All perioperative outcomes were similar in both groups with only two major postoperative complications in each group (12.5% vs. 10.5%; p = 0.99). Many functional outcomes favored AUS, but with no statistically significant difference, except for PGII = very much improved at 3 months (68.8% vs. 31.6%; p = 0.04). CONCLUSION: AUS and PVS are two procedures yielding satisfactory outcomes in the female neurogenic SUI population, with similar morbidity. The functional outcomes may be more favorable with AUS.
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BibTeX
@article{blondeau2026fascial,
title = {{Fascial Mild Urethral Sling or Artificial Urinary Sphincter in the Neurological Women Population, a Multicenter Study}},
author = {Alicia Blondeau and Charles Mazeaud and Rose Khavari and Melody Ong and Alexandre Dubois and Alice Pitout and Pierre Lecoanet and Benoit Peyronnet},
journal = {Neurourology and Urodynamics},
year = {2026},
month = jun,
doi = {10.1002/nau.70357},
url = {https://hal.science/hal-05683827v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Fascial Mild Urethral Sling or Artificial Urinary Sphincter in the Neurological Women Population, a Multicenter Study
AU - Alicia Blondeau
AU - Charles Mazeaud
AU - Rose Khavari
AU - Melody Ong
AU - Alexandre Dubois
AU - Alice Pitout
AU - Pierre Lecoanet
AU - Benoit Peyronnet
PY - 2026
DA - 2026/06/26
JO - Neurourology and Urodynamics
DO - 10.1002/nau.70357
UR - https://hal.science/hal-05683827v1
AB - BACKGROUND: Achieving continence in patients with neurogenic bladder is a difficult goal especially when stress urinary incontinence (SUI) due to intrinsic sphincter deficiency is involved. Two techniques are commonly used in that setting, but they have never been directly compared: the artificial urinary sphincter (AUS) and the fascial pubovaginal sling (PVS). The present study aims to compare the outcomes of AUS and PVS in female neuropathic patients. METHODS: This retrospective international multicenter study was conducted from 2014 to 2023. We included all women with a past medical history of neurogenic bladder who underwent AUS or a PVS insertion (cadaveric or fascia lata) at three centers. The primary endpoint was the outcomes as assessed by the patient global impression of improvement (PGII) at 3 months and at the last follow-up. RESULTS: Thirty-five patients were included: 16 with AUS and 19 with PVS. The PVS patients had fewer previous anti-incontinence procedures (10.5% vs. 43.8%; p = 0.02). The maximum cystometric capacity was significantly higher in the AUS group (364.1 vs. 252.8 mL; p = 0.03). All perioperative outcomes were similar in both groups with only two major postoperative complications in each group (12.5% vs. 10.5%; p = 0.99). Many functional outcomes favored AUS, but with no statistically significant difference, except for PGII = very much improved at 3 months (68.8% vs. 31.6%; p = 0.04). CONCLUSION: AUS and PVS are two procedures yielding satisfactory outcomes in the female neurogenic SUI population, with similar morbidity. The functional outcomes may be more favorable with AUS.
SN - 0733-2467
SN - 1520-6777
ER -