Treatment of Urinary Incontinence with the Artificial Sphincter

Abstract

From Dec. 1977 to Nov. 1978, 21 American Medical System 742A artificial sphinceters were implanted in 19 male and 2 female patients with a variety of etiologies for incontinence, including post-prostatectomy incontinence, female incontinence following unsuccessful bladder neck suspension and myelodysplasia. Urodynamic evaluation before sphincter placement is reviewed. Eight patients (38%) had excellent or improved results, while 5 (24%) remained unchanged and 5 (24%) suffered urethral erosion. Between Jan. and Sept. 1979, 18 patients had placement of the 742B or 742C model of the sphincter. Again a variety of etiologies for incontinence was represented, including 11 patients with postoperative male incontinence (10 after prostatectomy). Overall 9 patients (50%) had excellent or improved results, while 6 (33%) suffered urethral erosion. Of the post-prostatectomy group 50% had excellent or improved results, while 50% had erosion. Failures occurred more frequently in women, in patients with recurrent urinary tract infections or neurogenic bladders, and after failure of previous anti-incontinence surgical procedures.