The purpose of this paper was to examine the most recent data on the use of artificial urinary sphincter (AUS) in adult females. While outstanding functional results of AUS in female patients with stress urine incontinence (SUI) due to intrinsic sphincter deficiency (ISD) have been recorded for decades, its usage has remained private in most countries, owing to its difficult implantation and inherent morbidity. Laparoscopic and, more recently, robotic AUS implantation methods in female patients have been described in recent years, with good perioperative results. As a result, numerous countries have expanded their usage of AUS. The most common indications include recurrent or chronic SUI following earlier anti-incontinence treatments, as well as neurogenic SUI. AUS may be of particular relevance in female patients with detrusor underactivity due to its unique ability to restore continence while maintaining low outlet resistance throughout the voiding phase. High-level evidence from ongoing studies, as well as advancements in robotic surgery and technological enhancements of the device, may potentially give the AUS impetus as a key contribution to the female SUI armamentarium over 50 years after its inception.

While the use of AUS in female patients has been limited to a few nations and high-volume clinics, it has begun to expand again in recent years, due to the advent of minimally invasive methods that enable its insertion, and the results are promising.