Functional results and complications of artificial urinary sphincter AMS 800: About 84 cases

Purpose. - To verify the effectiveness and safetiness of artificial urinary sphincter (SUA) AMS 800 (TM) in the management of urinary incontinence by sphincter incompetence. Patients and methods. - Retrospective study of patients who received SUA by the same operator between 1992 and 2006. Fifty-seven men and 27 women whose average age was 61 years (22-82) suffered from incontinence by sphincter incompetence: after radical prostatectomy (46%), primary stress or mixed incontinence (21.4%), transurethral resection of prostate (9.5%), injury and neurological malformations (9.5%), pelvic or urethral trauma (7.1%), rectal surgery (3.6%), adenomectomy (2.4%). Functional assessment was made by telephone based on a 23-item questionnaire (Appendix 2). Results. - The mean follow-up was 52.6 months (5.3-187.1): 64% had their original SUA, 50 re-interventions were necessary for 30 patients with 13.1% mechanical complications, 6.6% urethral atrophy, and 13.9% infectious complications, 2.5% failures and 9% definitive explant. The half-time survival without revision was 8.3 years. Sixty-seven percent of patients were contacted for the functional assessment: 77% success rate (<= 1 protection), 85% of patients improved, 87% satisfied or very satisfied and 94% would go again through the same operation. Conclusion. - The artificial urinary sphincter AMS 800 (TM) remains still the reference in the management of urinary incontinence by sphincter incompetence in improving the quality of life of patients implanted at the cost of a significant revision rate and frequent residual leaks. (c) 2010 Elsevier Masson SAS. All rights reserved.