Urinary incontinence is a pressing issue in urogynecology and the number of patients with this pathology is steadily increasing. According to the International Continence Society (ICS), 8% of the population or almost 346 million people worldwide suffer from urinary incontinence, with 1/3 of the share falling on the female population [1]. Since urinary incontinence is associated with aging, a further increase in this pathology among the population is expected. The main method of treating urinary incontinence in women is suburethral synthetic slings. Currently, there are more than 200 operations for stress urinary incontinence. One of the methods of surgical treatment of this pathology is the use of Burch colposuspension. With the development of endoscopic surgery, one of the promising methods of surgical treatment of urinary incontinence is the use of robotic operations, which have many advantages over others: tissue trauma, blood loss are reduced, and the postoperative period is shortened.

We performed 10 robot-assisted Burch procedures using alloplant in 2024. The patients were admitted to the gynecology department on a planned basis with the diagnosis of "Stress urinary incontinence". Technique: 1 optical trocar, 3 additional manipulators and 2 assistant ports are installed laparoscopically in the umbilical region. The anterior wall of the bladder is mobilized to the distal urethra, which is mobilized circularly. An Alloplant allograft for sling operations is inserted under the urethra, the anterior wall of the vagina together with the paravaginal fascia is fixed to Cooper's ligament and a bladder filling test is performed. If the test is negative, the ends of the allograft are fixed to Cooper's ligament with 3-0 prolene on both sides without tension. The method allows to achieve reliable elimination of urinary incontinence, to make more durable and reliable connection of sutured tissues, which participate in urine retention in women. All patients in the postoperative period underwent functional tests, MRI on the 7th and 30th day, and were examined 2, 4, 12 months after the operation.

The average age of patients was 41.0 [32.0; 48.0]. The number of pregnancies was 4.0 [3.0; 5.0], the number of births - 3.0 [3.0; 4.0], the time from the onset of the disease - 36.0 [30.0; 54.0] months. Among all patients, pelvic organ prolapse stage 1 according to the POP-Q classification was diagnosed in 8 cases, 2 patients did not have pelvic organ prolapse. The duration of the operation was 66.0 [54.0; 78.0] min., blood loss was small - 90.0 [60.0; 180.0] ml, the postoperative period was uneventful in all patients, the time of hospital stay was recorded as 5.0 [5.0; 6.0] days. In all patients, correction of urological disorders was carried out in full and had no negative consequences during the observation period. The postoperative period was uneventful, the Foley catheter was removed on the 1st day, after its removal spontaneous urination was restored. The sutures were removed on the 5th day, the healing of the surgical wound occurred by primary intention, urine was well retained during functional tests. MRI examination after 7 and 30 days did not reveal any inflammatory processes at the site of allograft fixation, the allograft was retained, its integrity was preserved, no pathology was detected. When examining patients at late stages after surgery (2 and 4, 12 months), the urinary continence function was preserved.

robotic colposuspension using alloplant is safe and feasible with a significant improvement in quality of life indicators. The main advantages of this operation are the absence of allograft deformation, reduced trauma to paraurethral tissues involved in urinary continence in women, and the absence of relapses of the disease during the observation of patients.

Weber-Rajek M, Straczynska A, Strojek K, Piekorz Z, Pilarska B, Podhorecka M, et al. A. Assessment of the Effectiveness of Pelvic Floor Muscle Training (PFMT) and Extracorporeal Magnetic Innervation (ExMI) in the Treatment of Stress Urinary Incontinence in Women: A Randomized Controlled Trial. BioMed Res Int 2020;2020:1019872. https://doi.org/10.1155/2020/1019872