Treatment of urinary incontinence with the artificial sphincter

From December 1977 to November 1978, 21 American Medical System 742A artificial sphincters were implanted in 19 male and 2 female patients with a variety of etiologies for incontinence, including post-prostatectomy incontinence, female incontinence following unsuccessful bladder neck suspension and myelodysplasia. Urodynamic evaluation before sphincter placement is reviewed. Eight patients (38 per cent) had excellent or improved results, while 5 (24 per cent) remained unchanged and 5 (24 per cent) suffered urethral erosion. Between January and September 1979, 18 patients had placement of the 742B or 742C model of the sphincter. Again a variety of etiologies for incontinence was represented, including 11 patients with postoperative male incontinence (10 after prostatectomy). Over-all, 9 patients (50 per cent) had excellent or improved results, while 6 (33 per cent) suffered urethral erosion. Of the post-prostatectomy group 50 per cent had excellent or improved results, while 50 per cent had erosion. Failures occurred more frequently in women, in patients with recurrent urinary tract infections or neurogenic bladders, and after failure of previous anti-incontinence surgical procedures.