Long-term continence and patient satisfaction after artificial sphincter implantation for urinary incontinence after prostatectomy

Purpose: We assess long-term continence and patient satisfaction after impl antation of the AMS Sphincter 800 (American Medical Systems, Minnetonka, Mi nnesota) in men who were incontinent after total and subtotal prostatectomy . Materials and Methods: Patients who had an artificial urinary sphincter imp lanted for urinary incontinence after prostatectomy and a minimum of 20 mon ths of followup were identified from a patient database. The medical record s of these 209 patients were reviewed, and a questionnaire was mailed. Tele phone contact was attempted with patients who did not respond to the questi onnaire. Of the 209 patients 11 (5%) had undergone device removal, 34 (16%) were deceased and an additional 51 (24%) could not be contacted for follow up. Our study group consisted of the 113 patients with artificial urinary s phincters who could be contacted for followup. Mean followup was 73 months (range 20 to 170). Results: There were 4 (4%) patients who were dry and continent and 68 (60%) were incontinent using 0 to 1 pad daily. An additional 35 (31%) patients r equired 2 to 3 pads daily and 5 (4%) used more than 3 daily. There were 14 (12%) patients who had undergone surgical revision of the device. Of the 11 3 patients 31 (28%) were very satisfied, 50 (45%) satisfied, 20 (18%) neutr al, 7 (6%) dissatisfied and 4 (4%) very dissatisfied. One patient was not u sing his device to control continence. Conclusions: Artificial urinary sphincter implantation offers men who are i ncontinent after prostatectomy a reasonable chance for obtaining long-term satisfactory urinary control, although complete continence is unusual.