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.