Experiences with the artificial urinary sphincter in the irradiated patient

The AMS800 artificial urinary sphincter was placed in 16 men who underwent previous pelvic irradiation for adenocarcinoma of the prostate. A total of 13 patients had undergone external beam irradiation and 3 had had iridium seed implants. The sphincteric cuff was placed in the bulbar urethra in all patients, with a pressure regulating balloon of 51 to 60 or 61 to 70 cm. water. Overall social continence rate was 87%. Total complication rate was 25% with a rate of erosion and/or infection of 12.5%. We advocate that with meticulous technique, use of a low pressure balloon and delayed primary cuff activation, the artificial urinary sphincter can be placed with a reasonable success rate in post-irradiated men with urinary incontinence.