Management of neurogenic urinary incontinence with AMS artificial urinary sphincter

The AMS artificial urinary sphincter was implanted in 33 patients with neurogenic urinary incontinence during a 10-year period. All sphincter types were employed, from the earliest AS 721 model to the latest AS 800. The mechanically unstable AS 721 and 761 types have all been removed and, when possible, replaced by later models. In 27 of the 33 patients the device is still in situ, and in 6 (18%) it was removed, mainly because of urethral erosion. Increasingly favourable sphincter survival rats have been obtained. The overall survival rate for model AS 742 was 55% (7 years) for first implant, while the 4-year survival rate for AS 791/792 was 90%. Successful control of voiding function, defined as complete continence or slight but not socially inconvenient incontinence, was obtained in 25 patients (76% of the series).