Treatment of urinary incontinence with AMS 800 artificial urinary sphincter.

BACKGROUND

Urinary incontinence has a significant impact on the quality of life for patients. The introduction of the AMS 800 artificial urinary sphincter by American Medical Systems (Minnetonka, MN, USA) has revolutionized the treatment of urinary incontinence due to pure sphincteric incompetence.

PATIENTS AND METHODS

From April 1989 to October 1997, a total of 52 patients (42 men and 3 women) underwent implantation of the AMS 800 artificial sphincter. Patient age ranged from 31 to 87 years (mean 69.5 years). They all were suffering from urinary incontinence caused by sphincteric damage, always of iatrogenic origin. Follow-up was 5-110 months, with a mean of 35 months.

RESULTS

The restoration of continence was complete for 35 patients and allowed them all to return to their normal life. 7 of the patients who had a successful implant died because of other problems. For 2 patients follow-up was not available. Explantation was performed 8 times: in 5 male patients the device was removed because of periprosthetic infections; in 1 female patient with ileal neobladder, because of serious urethral necrosis; and in 2 male patients because of an urethral erosion.

CONCLUSIONS

The AMS 800 artificial urinary sphincter is the most efficacious treatment currently available for urinary incontinence due to pure sphincteric incompetence. Implanted patients achieved acceptable urinary control. The implantation is associated with 2 distinct complications: surgical and mechanical.