Abstract
PURPOSE: Artificial urinary sphincter (AUS) AMS 800 has been used for many years in women in Europe for the treatment of stress urinary incontinence. However, there is a lack of studies evaluating its impact on women's sexual function. This study aimed to assess impacts of AUS implantation on women's sexual activity. MATERIALS AND METHODS: This retrospective cohort study included all women seen in clinics between February 2019 and April 2020 for follow-up after an AMS 800 AUS's implantation. The primary outcome was the modification of sexuality, comparing sexual function before and after implantation of the device using a Likert scale called PGII (Patient Global Impression of Improvement). Our secondary outcomes were the assessment of sexual function (Questionnaries FSFI and ICIQ-FLUTSsex) and continence (number of pads). Two groups were separately assessed: patients who were sexually active at the time of surgery and those who were not sexually active at the time of surgery. RESULTS: A total of 55 women were included from a single large tertiary center. The median time from the first implantation of AUS was 7.5 years (5.3-14.2). 60% of patients reported no change on sexual activity after the implantation of the AMS 800 AUS. There was a modification of sexual activity in 40% of patients: 20% showing improvement, 20% showing deterioration. In patients having sexual intercourse before AUS implantation, the rate of change in sexuality was higher (61.7%). Regarding postoperative improvement, 91% of women attributed it to the disappearance of coital incontinence. For patients experiencing deterioration in their sexuality, all reported that it was related to the presence of the AUS. CONCLUSIONS: This study suggests that AMS 800 AUS implantation can modify the sexuality of women. Talking about the subject of sexuality, assessing sexual function, and educating patients are necessary before the surgery. TRIAL REGISTRATION: The clinical trial was registered at the "Commission Nationale de l'Informatique et des Libertés" (CNIL) under the number 20201020155100.