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Related Experiment Videos

Experience with the artificial urinary sphincter model AS800 in 148 patients.

I J Fishman1, R Shabsigh, F B Scott

  • 1Scott Department of Urology, Baylor College of Medicine, St. Luke's Episcopal Hospital, Houston, Texas.

The Journal of Urology
|February 1, 1989
PubMed
Summary

The AS800 artificial urinary sphincter effectively restored urinary control in 90% of patients. Device removal was infrequent, primarily due to infection or erosion, highlighting its safety and efficacy in managing urinary incontinence.

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Area of Science:

  • Urology
  • Medical Devices
  • Reconstructive Surgery

Background:

  • Urinary incontinence affects a significant patient population, necessitating effective treatment options.
  • Artificial urinary sphincters are a key therapeutic modality for managing severe incontinence.
  • The AS800 represents an advancement in artificial urinary sphincter technology.

Purpose of the Study:

  • To evaluate the efficacy and safety of the AS800 artificial urinary sphincter in patients with diverse etiologies of urinary incontinence.
  • To assess the device's performance, including success rates and reasons for explantation.
  • To analyze the impact of the deactivation feature on patient management.

Main Methods:

  • A prospective study involving 148 patients (112 male, 36 female) implanted with the AS800 artificial urinary sphincter.

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  • Cuff placement evaluated at the bladder neck (78 patients) or bulbar urethra (70 patients).
  • Follow-up ranged from 3 to 37 months (average 20.8 months) to assess outcomes and complications.

    • Main Results:

    • Socially acceptable urinary control was achieved in 90% of patients with active devices.
    • Sphincter removal was required in 7.4% of patients, predominantly due to infection and erosion (5.4%).
    • Higher success rates were observed in patients with post-surgical incontinence (failed anti-stress operations, TURP, or prostatectomy), while higher failure rates occurred in cases secondary to pelvic fracture or exstrophy/epispadias.

    Conclusions:

    • The AS800 artificial urinary sphincter demonstrates high efficacy and acceptable safety profiles for treating various forms of urinary incontinence.
    • The device's deactivation feature offers significant benefits for catheterization, cystoscopy, and nocturnal decompression.
    • Patient selection based on etiology is crucial for optimizing outcomes with the AS800 artificial urinary sphincter.