The implantable artificial genitourinary sphincter in the management of total urinary incontinence.

The artificial genitourinary sphincter has been implanted in 31 patients with total urinary incontinence. Minor complications associated with implantation of this device were found to be mainly mechanical in origin, resulting in malfunction of the apparatus. Postoperative mechanical malfunction, however, was found to be correctable through a variety of secondary surgical procedures. Major complications, including infection around the prosthesis, vesical neck erosion, vesical-colic fistula, and urethral erosion, were generally associated with problems of cuff placement. In nearly all cases in which major complications occurred, it was ultimately necessary to remove the prosthesis. Overall results would indicate that patients with incontinence after transurethral prostatic resection in whom the inflatable cuff was placed around the vesical neck achieved the best results (70%). In this series of 31 patients, 68% had a normally functioning sphincter with complete correction of their urinary incontinence.