Artificial urinary sphincter cuff erosion. Experience with reimplantation in 38 patients.

Artificial urinary sphincter cuff erosion has become rare but remains a dreaded consequence of sphincter implantation. Our experience indicates that with rational and systematic management of this problem, sphincter reimplantation can restore continence in many of these patients. During a ten-year period, 412 artificial sphincters were implanted at the Mayo Clinic. Bladder neck or urethral erosion occurred in 64 patients (15.5%). Ultimately, 38 patients had reimplantation, and the outcome was successful in 32 (84%). After the advent of delayed activation, the incidence of cuff erosion decreased greatly--from a peak of 18 percent (12 of 66 cases) in 1977 to 1.3 percent (1 of 79 cases) in 1985.