Surgical results with artificial urinary sphincter

From June, 1974, until January, 1977, eleven AMS 721 genitourinary sphincters were installed in 9 men and 2 females. Long term success was achieved in 2 men. Failures were encountered in 9 patients (82 per cent) with urethral erosions (3 patients), infection (1 patient), and mechanical failure (5 patients) accounting for the complications necessitating prosthetic removal. From January, 1979, until May, 1981, 15 males had the revised AMS model AS 742 (b) or (c) sphincter installed. Long term continence was achieved in 9 patients (60 per cent). Urethral erosion in 4 patients (27 per cent) and infection of the prosthesis in 2 men (13 per cent) accounted for fathers. An improved surgical technique involving the installation of the device in a defunctionalized state with secondary activation is anticipated to improve future results.