SYNCHRONOUS MANAGEMENT OF ANASTOMOTIC CONTRACTURE AND STRESS URINARY-INCONTINENCE FOLLOWING RADICAL PROSTATECTOMY

Of 77 patients presenting for artificial urinary sphincter implantatio n due to incontinence following radical prostatectomy 26 had a signifi cant associated urethrovesical anastomotic contracture. Synchronous en doscopic contracture incision with electrocautery and implantation of an artificial urinary sphincter (AMS800)dagger were performed in all c ases. A total of 25 patients void with a good subjective flow, with an average followup of 32 months. In 1 patient symptomatic stenosis recu rred 6 months after incision and reincision was successful at the time of sphincter revision. No infection or erosion developed and 24 patie nts are socially continent (0 to 1 thin pad per day). During this time 5 patients underwent 8 revisions of the artificial sphincter. Synchro nous contracture incision with electrocautery and artificial urinary s phincter implantation are safe and provide satisfying results in patie nts with complex post-prostatectomy incontinence.