Application of the AS-800 artificial sphincter for intractable urinary incontinence in females

Intractable incontinence is a challenging problem, especially in females who have been operated upon frequently for the correction of this problem. Twenty-four such females (age 11 to 78 years) received an artificial sphincter (AS-800). The mean follow-up time was 41 months (range of eight to 66 months). Detubularized augmentation cystoplasty was performed upon six patients, simultaneously with sphincter implantation in three patients and in two stages in the others. Seventeen patients reported "good" continence, and three reported continence as "fair, improved." The four failures occurred in patients in whom the sphincter had been extracted because of erosion and infection of the bladder neck cuff. A total of 12 revisions were necessary, nine during the first two years after sphincter implantation (0.5 revisions per patient). Two patients who had successful pregnancies underwent deactivation of the sphincter in the third trimester. Strict attention to surgical principles, postoperative care and careful selection of patients have made the AS-800 artificial sphincter a reliable option in treating intractable sphincteric incontinence in females.