Artificial urinary sphincter AMS 800 for urinary incontinence after radical prostatectomy: the French experience

Post-radical prostatectomy urinary incontinence (PRP-UI) has a major negative impact on the patient's quality of life with the incidence accounting for over 30% on a patient questionnaire basis. In 1995 the French Urological Association started a prospective survey to investigate the efficacy and safety of the AMS 800 artificial urinary sphincter (AUS) in PRP-UI, and preliminary results are presented for the 103 men enrolled in the study in whom bulbar urethral cuff placement was used exclusively. Surgical revision was necessary in 22 patients (21%). Infection and erosion accounted for 12 non-mechanical revisions leading to complete removal of 6 AUS and to eventual replacement of 6 devices with new ones. Mechanical malfunction accounted for revision in l0 patients (9.7%). Fifty-nine patients (61.45%) reported no leakage for the 96 working devices. Twenty-seven patients (28%) wore no pads, 3 patients used 1 pad and 4 patients used 2 pads/day, and all these patients reported improvement, with only 3 patients (3%) having had more than 2 pads/day. Currently, no non-prosthetic procedure reliably affords such good objective results. Insertion of the AMS 800 AUS no doubt represents an attractive treatment modality available for male urinary incontinence following radical prostatectomy.