title: The artificial urinary sphincter in patients with spinal cord lesion: description of a modified technique and clinical results.
abstract: BACKGROUND
  The artificial sphincter is the method of choice in patients with stress urinary incontinence due to neurogenic bladder dysfunction. However, long-term studies reveal a high revision rate.
  
  
  OBJECTIVE
  To determine the success and revision rates of a modified implant.
  
  
  METHODS
  In a retrospective analysis, the results of 51 consecutive patients presenting at a private paraplegic center with neurogenic bladder dysfunction (meningomyelocele: n=8; spinal cord injury: n=37; others: n=6) who underwent implantation of an artificial sphincter at the bladder neck using a port instead of a pump were evaluated.
  
  
  METHODS
  Subjective and objective cure rates were assessed by video-urodynamics and a standardized interview.
  
  
  CONCLUSIONS
  After a mean follow up of 95.9 mo, 70.6% of the patients were objectively and subjectively cured; 90.2% were completely continent in everyday life. Mean bladder capacity (465 ml) and compliance (41.7 ml/cm H(2)O) were normal. Sixteen patients underwent 18 revisions (35.3%). One implant had to be permanently removed. This is a single-centre study; thus, the results have to be confirmed.
  
  
  CONCLUSIONS
  With a long follow up of 8 yr, the modification presented by our group proved to be highly successful, reliable, safe, and even cost-effective. Therefore, it seems to be a valuable tool for the treatment of this group of patients.
authors.affiliation: Department of Neuro-Urology, Swiss Paraplegic Center, Nottwil, Switzerland.
authors.forename: Ulf
authors.initials: U
authors.lastname: Bersch
authors.forename: Konrad
authors.initials: K
authors.lastname: Göcking
authors.forename: Jürgen
authors.initials: J
authors.lastname: Pannek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000601:surgery*; D016741:Urinary Sphincter, Artificial; D013520:Urologic Surgical Procedures / Q000379:methods; D055815:Young Adult