AMS-800 SPHINCTER IN URINARY-INCONTINENCE AFTER PROSTATIC SURGERY, BASED ON A SERIES OF 16 PATIENTS

Objective: to present the results of a series of artificial sphincters implanted for urinary incontinence after prostatic surgery, Patients and methods: from 1987 to 1996, artificial sphincters were implanted f or urinary incontinence after prostatic surgery, consisting of one tra nsvesical prostatectomy, 11 prostatic resections and 4 radical prostat ectomies. All these patients were evaluate by urine culture, cystouret hrography and urethrocystoscopy. Eleven patients underwent urodynamic assessment. The AMS 800 artificial sphincter was used. Results: the me an interval between onset of incontinence and implantation was 18 mont hs. The mean follow-up after implantation of the sphincter was 6 years . An operative wound of the bulbar urethra did not prevent implantatio n of the sphincter, but required repair and prolonged catheterization (12 days). The mean duration of catheterization was 6 days. The overal l functional result was 81 % (13 case), and 75 % of sphincters were fu nctional at 5 years. Five revisions were necessary to maintain functio ning of the sphincter in 2 cases of rupture and 1 displacement of the balloon, 1 case of urethral atrophy and 1 rupture of the pump. Three e xplantations, 2 total and 1 partial, were performed. Two reimplantatio ns were performed after 12 months and 26 months respectively. Conclusi on: the AMS 800 artificial sphincter currently represents an effective treatment for urinary incontinence due to sphincter insufficiency aft er prostatic surgery. However, an old artificial sphincter may require revision to restore function.