THE ARTIFICIAL URINARY SPHINCTER AMS-800 IN THE TREATMENT OF COMPLEX FEMALE URINARY-INCONTINENCE - INDICATIONS, RESULTS, COMPLICATIONS AND RISK-FACTORS

Indications, results and complications of 144 women who have undergone implantation of the current model AMS 800 since 1983 and remained in continuous follow-up in our department are presented. Included are 70 patients suffering from stress urinary incontinence (SUI) type III aft er 208 previously unsuccessful incontinence procedures, 54 patients wi th incontinence due to neurogenic bladder dysfunction (NBD) and 20 pat ients with congenital or acquired internal sphincter weakness of other causes. In the NBD group, apart from sphincter implantation a total o f 113 additional operations were necessary due to complex malfunctions of the urinary tract: augmentation ileocystoplasty in 51 patients, ur eterocystoneostomy in 23 patients and 43 operations at the bladder nec k. One hundred and twenty-six patients (86%) achieved total continence and 5 patients (3%) were significantly improved. In 9 females (6%) in continence persisted, and 4 patients ultimately underwent urinary dive rsion into a Kock pouch. With the implanted artificial sphincter 116 p atients (81%) are able to empty their bladder spontaneously, without r esidual urine and without the necessity of intermittent self catheteri sation. Under the aforementioned conditions implantation of the artifi cial urinary sphincter AMS 800 is the most effective therapy for compl ex female incontinence.