Evaluation and management of malfunctionings following implantation of the artificial urinary sphincter.

The authors report their experience of mechanical malfunctionings after placement of the AMS 800 artificial urinary sphincter. The aim of the study was to suggest outlines for the evaluation and management of these complications. From 1991 to 1998, 42 patients (39 men, 3 women with a mean age of 67.5 years) underwent artificial sphincter implantation of whom 5 patients required explantation of the prosthesis because of infection. The following mechanical malfunctionings occurred: 2 cases of air bubbles; 3 cases of pump overturning with tube kinking; 16 cases of persistent or recurrent incontinence 6-61 months postoperatively; and 1 case of cuff opened during sexual intercourse. Surgical revision of the prosthetic components was performed in the patients who presented mechanical malfunctionings. Several complications can arise after artificial sphincter placement (infection, urethral erosion, mechanical malfunction). In the last case, the authors stress the importance of an accurate diagnosis for the choice of exact treatment.