Related Experiment Video
Updated: Jul 14, 2026
Transcorporal Artificial Urinary Sphincter Cuff Placement in a Case Requiring Revision for Urethral Atrophy
Published on: June 16, 2022
Robotic midurethral sling removal: surgical technique and outcomes of a single center series
Camille Haudebert1,2, Mathilde Chapuis3, Nikita Bhatt4
1Department of Urology, University of Rennes, Rennes, France. Camille.haudebert@gmail.com.
Objective:
To describe the spectrum of robotic surgical techniques used for removal of synthetic midurethral slings (MUS) in different mesh-related complications and to report perioperative and functional outcomes in a tertiary referral setting. Robotic MUS removal has recently emerged as an alternative approach; however, data regarding its indications, technical aspects and outcomes remain limited.
Materials And Methods:
We analyzed a prospectively maintained database of all female patients who underwent robotic MUS removal at a single tertiary referral center between August 2022 and July 2025. Indications for surgery included pain, mesh exposure, or patient request for complete removal. Depending on the indication and shared decision-making process, either complete removal of all remaining mesh components or partial removal of the extruded segment was planned. Patients with preoperative stress urinary incontinence (SUI) were offered concomitant robotic autologous fascial sling placement, whereas those without preoperative SUI underwent pubourethral ligament plication. Outcomes assessed included postoperative complications (Clavien-Dindo classification), pain evaluated using a visual analog scale (VAS), continence outcomes, Patient Global Impression of Improvement (PGI-I), and need for reintervention.
Results:
Seventy patients were included. The planned extent of mesh excision was achieved in all patients; complete removal of all remaining mesh components was performed in 74 cases and partial removal in 6 cases. Median operative time was 160 min, and median length of hospital stay was 3 days (range 0-21). Major complications (Clavien-Dindo ≥ III) occurred in 6 patients (8.6%). At last follow-up, 62 patients (88.6%) reported symptom improvement, including 49 (70%) with PGI-I scores of 1-2. Stress urinary incontinence remained a relevant postoperative concern, and 11 patients (15.7%) ultimately required additional continence treatment.
Conclusions:
Robotic MUS removal is a feasible approach associated with high rates of patient-reported symptom improvement. However, continence outcomes should be interpreted cautiously given the heterogeneity of the population and the frequent use of concomitant anti-incontinence procedures.
Insights
Robotic surgery effectively removes synthetic midurethral slings (MUS) with high symptom improvement rates. However, careful consideration of continence outcomes is needed due to varied patient needs and concurrent procedures.
Area of Science:
- Urogynecology
- Minimally Invasive Surgery
- Surgical Technology
Background:
- Synthetic midurethral slings (MUS) are used to treat stress urinary incontinence (SUI).
- Mesh-related complications following MUS placement can necessitate surgical intervention.
- Robotic-assisted MUS removal is an emerging technique with limited published data.
Purpose of the Study:
- To detail robotic surgical techniques for synthetic MUS removal across various mesh complications.
- To evaluate perioperative and functional outcomes of robotic MUS removal in a tertiary referral center.
- To assess the feasibility and efficacy of robotic approaches for complex mesh issues.
Main Methods:
- A prospective database of 70 female patients undergoing robotic MUS removal (August 2022-July 2025) was analyzed.
- Indications included pain, mesh exposure, or complete removal requests; complete or partial excision was performed.
- Concomitant procedures for SUI (autologous fascial sling or pubourethral ligament plication) were offered as needed.
Main Results:
- Robotic MUS removal was successfully completed in all patients, with 74% undergoing complete excision.
- Median operative time was 160 minutes, and median hospital stay was 3 days; major complications occurred in 8.6%.
- 88.6% reported symptom improvement, but 15.7% required further treatment for SUI.
Conclusions:
- Robotic MUS removal is a feasible surgical option demonstrating high patient-reported symptom relief.
- Continence outcomes require cautious interpretation due to patient heterogeneity and frequent concomitant anti-incontinence procedures.
- Robotic surgery offers a viable solution for managing complex synthetic MUS complications.
