Incontinence, intermittent self-catheterization and the artificial genitourinary sphincter

Although the artificial genitourinary sphincter is ideally suited for incontinent patients who can empty the bladder completely, we have observed 22 patients with artificial sphincters who also perform intermittent self-catheterization to augment bladder emptying. No cuff erosions have occurred to date, with 11 patients on intermittent catheterization for more than 30 months. In patients who will require intermittent self-catheterization after sphincter implantation the cuff should be placed around the bladder neck. We believe that patients with sphincteric incontinence and decreased bladder contractility resulting in excessive residual urine volume are reasonable candidates for use of the artificial sphincter with intermittent self-catheterization.