Quality of life, functional outcome and durability of the AMS 800 artificial urinary sphincter in patients with intrinsic sphincter deficiency.
OBJECTIVE
To evaluate the quality of life, functional outcome and durability of the AMS 800 artificial urinary sphincter (AUS) in patients with urinary incontinence due to intrinsic sphincter deficiency of mixed origin.


METHODS
Between 1991 and 2000, 34 AUS were implanted in 31 patients (24 males/7 females) with mean age of 59 (range 15-75) years. Using a questionnaire, patients' urinary function and quality of life were assessed in 22 patients with an AUS in situ. To evaluate efficacy and durability of the device, the primary adequate function (P-AF) and additional procedure-assisted adequate function (APA-AF) rates were determined on the basis of a Kaplan-Meier survival analysis.


RESULTS
The social continence rate (0-1 pads/24 h) was 55% with a mean follow-up of 46 months. The revision rate was 26% and the explantation rate 35%. The 5-year P-AF and APA-AF rates were 41 and 44%, respectively. The pad score decreased from 2.95 to 1.23 after AUS implantation (p < 0.0001) leading to a high mean patient satisfaction (rated as 4.0 on a visual analog scale of 0-5). Twenty-one patients (95%) would undergo the procedure again under the same circumstances. Patients with previous anti-incontinence procedures showed a significantly higher explantation rate (p = 0.004).


CONCLUSIONS
In spite of a relatively high re-operation rate and moderate social continence state, patient satisfaction was found to be great mainly due to the relative improvement in incontinence. The AMS 800 AUS is a reliable device with few mechanical complications. Extensive preoperative counseling is mandatory.
ter Meulen
Ph H
PH
Department of Urology, University Hospital Maastricht, The Netherlands. flip.ter.meulen@12move.nl
Zambon
V
V
Kessels
A G H
AG
van Kerrebroeck
Ph E V
PE
D000293:Adolescent; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011475:Prosthesis Failure; D011788:Quality of Life; D020127:Recovery of Function; D012086:Reoperation; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000601:surgery*; D016741:Urinary Sphincter, Artificial; D013520:Urologic Surgical Procedures / Q000379:methods*