ADDITION OF A 2ND URETHRAL CUFF TO ENHANCE PERFORMANCE OF THE ARTIFICIAL URINARY SPHINCTER

Purpose: Stress urinary incontinence may persist in approximately 15% of men following implantation of a standard artificial urinary sphinct er. The ability of a second urethral cuff to provide satisfactory cont inence without additional operative complications was investigated. Ma terials and Methods: A second urethral cuff was placed to enhance perf ormance of the artificial urinary sphincter in 5 men with stress urina ry incontinence following radical prostatectomy. A stainless steel 3-w ay tubing connector allowed for addition of a second cuff to the stand ard artificial urinary sphincter without the kinking problems previous ly observed with a flexible S-way connector. In 4 consecutive men a se cond cuff was added at operative revision of an existing artificial ur inary sphincter that had failed to produce satisfactory continence. A double cuff artificial sphincter was placed initially in 1 man. Result s: Of 5 men 4 had satisfactory and 1 had improved continence with the double cuff artificial urinary sphincter. The stainless steel 3-way tu bing connector eliminated kinking complications. Conclusions: Implanta tion of a second urethral cuff can provide satisfactory urinary contin ence in men with an artificial urinary sphincter and persistent incont inence. Placement of a double cuff artificial urinary sphincter may al so represent appropriate initial intervention in men with significant stress urinary incontinence.