[Artificial sphincter for urinary incontinence].
During the past 4 years 21 patients underwent implantation of the model AS-800 artificial urinary sphincter, 4 of whom underwent simultaneous implantation of an inflatable penile prosthesis. The mean age was 48 years (range 33-73). Incontinence was neurogenic in 12 (57%) and a complication of urologic surgery (mainly prostatectomy) in 9 (43%). In 8, in whom intermittent self-catheterization was planned, the sphincter cuff was implanted around the bladder neck, and in the other 13, around the bulbar urethra. The immediate postoperative course was uneventful in 18 (85%), but 2 (10%) had urinary tract infection and 1 had urinary retention. During a mean follow-up of 20 months (range 1-36), 19 (90%) were found to be continent (in 2 of them the cuff had had to be changed to a smaller size due to tissue atrophy), and 1 had suffered from urgency incontinence which disappeared with anticholinergic medication. In 2 with incontinence due to neurogenic bladder, the sphincter had became infected and had had to be removed; 1 of these 2 had undergone simultaneous augmentation cystoplasty. This experience resulted in a change in our policy: we now implant the sphincter and perform augmentation cystoplasty in 2 separate stages. We find implantation of the artificial urinary sphincter very effective treatment for urinary incontinence.
Ben-Chaim
J
J
Dept. of Urology, Chaim Sheba Medical Center, Tel Hashomer.
Raviv
G
G
Lebovitch
I
I
Ramon
J
J
Goldwasser
B
B
D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects; D001750:Urinary Bladder, Neurogenic / Q000150:complications; D014546:Urinary Catheterization; D014547:Urinary Diversion; D014549:Urinary Incontinence / Q000209:etiology / Q000628:therapy*; D016741:Urinary Sphincter, Artificial