Transcorporal Cuff-Placement in Artificial Urinary Sphincter Surgery: A Systematic Review - 28/11/25

Doi : 10.1016/j.urology.2025.11.222

Ana Domínguez Gutiérrez ^a,^⁎ , Manuel Hevia Palacios ^a, David Alonso López Curtis ^a, Alfonso Muriel García ^b, Noelia Álvarez Díaz ^c, Burgos Revilla Francisco Javier ^a

^a Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain

^b Clinical Biostatistics Unit, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBERESP, University of Alcalá, Madrid, Spain

^c Library, Hospital Universitario Ramón Y Cajal (IRYCIS), Madrid, Spain

^⁎ Address correspondence to: Ana Domínguez Gutiérrez, M.D., Department of Urology Hospital Universitario Ramón y Cajal., Ctra. de Colmenar Viejo km. 9, 100 28034 Madrid, Spain. Department of Urology Hospital Universitario Ramón y Cajal. Ctra. de Colmenar Viejo km. 9 Madrid 100 28034 Spain

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 28 November 2025

ABSTRACT

Objective

To review the literature on survival and functional outcomes of the TC AUS.

Methods

A systematic review and meta-analysis (PROSPERO: CRD42023393256) was conducted searching the Medline and Embase databases until January 2024. Risk of bias was assessed with ROBINS-I for comparative non-randomized studies and the tool proposed by the EAU for single-arm studies.

Results

Of 252 screened studies, 20 met the inclusion criteria (8 comparative and 12 non-comparative). Meta-analysis of comparative studies showed a significantly higher revision rate in TC AUS (OR 2.99, 95% CI 1.16–7.75), with no significant difference in explantation (OR 1.41, 95% CI 0.27–7.24). Continence and QoL outcomes appeared comparable between both approaches. Notably, the TC AUS was associated with a significantly lower infection (OR 0.33, 95% CI 0.12–0.95) and erosion rates (OR 0.35, 95% CI 0.15–0.81). Subgroup analysis in the high-risk urethra population demonstrated similar trends.

Conclusion

TC AUS shows higher revision rates both in the general and high-risk populations. However, these rates are not associated with a higher explantation, which suggests that the TC may be a viable option in complex situations. Additionally, no greater erosion has been observed, even in patients with risk factors.

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