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[Artificial urinary sphincter]

C Chatelain1, F Richard, M O Bitker

  • 1Groupe Hospitalier Pitié-Salpêtrière, Clinique Urologique, Paris.

Bulletin De L'Academie Nationale De Medecine
|March 1, 1995
PubMed
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The artificial urinary sphincter effectively treats severe urinary incontinence in men and women, with high success rates and manageable complication risks. This implantable device restores continence, improving quality of life for patients with persistent post-surgical or neurogenic incontinence.

Area of Science:

  • Urology
  • Biomedical Engineering
  • Implantable Medical Devices

Context:

  • Urinary incontinence significantly impacts quality of life, particularly after prostatic surgery or in cases of sphincter insufficiency.
  • The artificial urinary sphincter (AUS) is a hydraulic prosthesis designed to restore urinary continence.
  • This study reviews the experience with 200 AUS implantations over 10 years at a single center.

Purpose:

  • To evaluate the efficacy and safety of the artificial urinary sphincter for treating severe urinary incontinence.
  • To analyze success rates and complication profiles in different patient populations (men post-prostatectomy, women with sphincter insufficiency).
  • To assess long-term outcomes, including explantation rates, revision rates, and patient satisfaction.

Summary:

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  • The artificial urinary sphincter consists of a cuff, reservoir, and pump, restoring continence by managing fluid dynamics.
  • Overall success rates range from 80-90%, with explantation rates below 15% and prosthesis failure around 20%.
  • In men with post-prostatectomy incontinence, 73% achieved complete continence, and in women with sphincter insufficiency, 78% had complete success.

Impact:

  • The artificial urinary sphincter offers a highly effective therapeutic option for severe urinary incontinence, significantly improving patient quality of life.
  • Understanding complication risks (erosion, infection) and revision rates is crucial for patient counseling and surgical planning.
  • The device demonstrates durable efficacy, with successful outcomes maintained over several years of follow-up.