MAYO-CLINIC EXPERIENCE WITH THE AS800 ARTIFICIAL URINARY SPHINCTER FOR URINARY-INCONTINENCE AFTER TRANSURETHRAL RESECTION OF PROSTATE OR OPEN PROSTATECTOMY

The model AS800 artificial urinary sphincter was implanted in 56 patients with urinary incontinence after transurethral resection of the prostate and in 8 patients after open prostatectomy. Their ages ranged from fifty-three to eighty-seven years (mean, 70 years). At presentation, 92 percent had total incontinence and 8 percent had distressing stress incontinence. Fifteen patients (23 %) had had previous radiation therapy. Bulbous urethral cuffs were used in 60 (94 %) patients and vesical neck cuffs in 4 (6 %). Follow-up questionnaires were mailed to assess satisfaction rate and degree of continence. Continence was significantly improved in 90 percent, and 87 percent of the patients were satisfied with their sphincters. Surgical revisions were required in 14 patients (22 %). Cuff compression was inadequate in 9 patients, and erosion led to revision in 3 patients. At follow-up, 3 patients had had at least one component of the AS800 removed (complete device in 2 and cuff in 1).