Evaluation and management of malfunctionings following implantation of theartificial urinary sphincter

The authors report their experience of mechanical malfunctionings after pla cement of the AMS 800 artificial urinary sphincter. The aim of the study wa s to suggest outlines for the evaluation and management of these complicati ons. From 1991 to 1998, 42 patients (39 men, 3 women with a mean age of 67. 5 years) underwent artificial sphincter implantation of whom 5 patients req uired explantation of the prosthesis because of infection. The following me chanical malfunctionings occurred: 2 cases of air bubbles; 3 cases of pump overturning with tube kinking; 16 cases of persistent or recurrent incontin ence 6-61 months postoperatively; and 1 case of cuff opened during sexual i ntercourse. Surgical revision of the prosthetic components was performed in the patients who presented mechanical malfunctionings. Several complicatio ns can arise after artificial sphincter placement (infection, urethral eros ion, mechanical malfunction). In the last case, the authors stress the impo rtance of an accurate diagnosis for the choice of exact treatment.