[The AMS 800 sphincter in urinary incontinence after prostatic surgery. Apropos of 16 patients].
OBJECTIVE
To present the results of a series of artificial sphincters implanted for urinary incontinence after prostatic surgery.


METHODS
From 1987 to 1996, artificial sphincters were implanted for urinary incontinence after prostatic surgery, consisting of one transvesical prostatectomy, 11 prostatic resections and 4 radical prostatectomies. All these patients were evaluate by urine culture, cystourethrography and urethrocystoscopy. Eleven patients underwent urodynamic assessment. The AMS 800 artificial sphincter was used.


RESULTS
The mean interval between onset of incontinence and implantation was 18 months. The mean follow-up after implantation of the sphincter was 6 years. An operative wound of the bulbar urethra did not prevent implantation of the sphincter, but required repair and prolonged catheterization (12 days). The mean duration of catheterization was 6 days. The overall functional result was 81% (13 case), and 75% of sphincters were functional at 5 years. Five revisions were necessary to maintain functioning 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 explanations, 2 total and 1 partial, were performed. Two reimplantations were performed after 12 months and 26 months respectively.


CONCLUSIONS
The AMS 800 artificial sphincter currently represents an effective treatment for urinary incontinence due to sphincter insufficiency after prostatic surgery. However, an old artificial sphincter may require revision to restore function.
Koutani
A
A
Service d'Urologie et de Transplantation Rénale, Hôpital Salvator, Marseille.
Lechevallier
E
E
Coulange
C
C
D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001437:Bacteriuria / Q000382:microbiology; D003558:Cystoscopy; D004724:Endoscopy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods / Q000534:rehabilitation; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D013997:Time Factors; D014521:Urethra / Q000000981:diagnostic imaging / Q000473:pathology; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D014546:Urinary Catheterization; D014549:Urinary Incontinence / Q000601:surgery*; D016741:Urinary Sphincter, Artificial; D014563:Urodynamics
Sphincter AMS 800 dans l'incontinence urinaire après chirurgie prostatique. A propos de 16 patients.