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The procedures were performed several weeks ago at the medical center in Nahariya on four women between the ages of 44 and 75.
By Shula Rosen
Israeli surgeons have for the first time implanted artificial urinary sphincters in women using robotic surgery, offering a new treatment option for patients with severe incontinence who had exhausted all other therapies, Galilee Medical Center announced.
The procedures were performed several weeks ago at the medical center in Nahariya on four women between the ages of 44 and 75.
All had undergone multiple previous interventions without success and were considered candidates of last resort. While artificial urinary sphincters have long been used in men, their use in women has been limited worldwide because of anatomical complexity and surgical risk.
“This is a breakthrough,” Prof. Lior Lowenstein, director of the Obstetrics and Gynecology Department at Galilee Medical Center, told Ynet. “Where previously I had nothing more to offer these women, we can now open new therapeutic avenues. The surgery itself represents hope where none existed before.”
Stress urinary incontinence, which affects women at roughly three times the rate seen in men, is often linked to intrinsic sphincter deficiency and can result from childbirth, prior surgeries, or genetic factors, Lowenstein explained.
Initial treatment typically focuses on pelvic floor physiotherapy, followed by surgical options such as mid-urethral slings when conservative measures fail. For some patients, however, those approaches offer no relief. “We often hit a dead end,” Lowenstein said. “Many women are left to live with the condition, which severely affects their daily lives, intimacy, and social participation.”
The new procedure involves implanting a device that functions as an artificial valve at the bladder outlet, allowing patients to control urination mechanically. In women, this operation previously required open surgery, increasing the risk of complications. The use of robotic assistance has changed that calculation, improving precision and visibility around sensitive anatomy and reducing surgical trauma.
The surgeries were led by Dr. Susana Mustafa-Mikhail, head of urogynecology and pelvic floor reconstructive surgery at the medical center, in collaboration with Prof. Gilles Karsenty of Aix-Marseille University Hospital in France. Lowenstein said the Israeli team trained with Karsenty abroad before he joined them in Israel for the initial operation.
All four patients underwent imaging 24 hours after surgery to confirm correct device placement. Follow-up examinations showed no complications, and physicians expect to activate the sphincter pumps within days, allowing patients to regain urinary control.
Hospital officials said the results could open the door to wider use of the procedure in women, while emphasizing the need for specialized expertise, careful follow-up, and greater public awareness of urinary disorders that often remain unspoken despite their impact on quality of life.
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