Artificial urinary sphincters around intestinal segments--are they safe?
Artificial urinary sphincters (AUS) were implanted around intestinal segments to achieve urinary continence in 8 patients and faecal continence in 1. In 6 patients the cuff was placed around the lower end of the cystoplasty following bladder neck (5) or urethral (1) erosion. Four are completely dry, 1 on self-intermittent catheterisation (SIC). One has mild stress incontinence. In 1 patient the cuff eroded at 8 months. Two patients had cuffs implanted parastomally to create continent diversion. One is satisfactory on SIC and the other had her AUS explanted because of life-threatening metabolic acidosis. The rectal cuff was explanted because of faecal impaction above the cuff. As an absolute last resort, placing an AUS round a cystoplasty appears little more hazardous than round bladder neck. The use of the AUS for continent diversion has not been pursued because of reliable techniques of non-prosthetic continent diversion. The current model of the AUS is unsuitable for the treatment of faecal incontinence.
Weston
P M
PM
Department of Urology, Royal Infirmary, Cardiff.
Morgan
J D
JD
Hussain
J
J
Stephenson
T P
TP
D000293:Adolescent; D000328:Adult; D002432:Cecum / Q000601:surgery; D005242:Fecal Incontinence / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D019736:Prostheses and Implants; D001743:Urinary Bladder / Q000601:surgery; D014547:Urinary Diversion; D014549:Urinary Incontinence / Q000601:surgery*