Use of the artificial urinary sphincter in the management of severe incontinence in females.

AS 792 and AS 800 sphincters were implanted in 31 female patients with incontinence due to various causes including neurologic dysfunction, recurrent stress incontinence, spinal cord trauma and pelvic trauma. Continued continence has been achieved in 21 of these patients. Erosions required removal of the device in the ten other patients. The AS 800 model has significant modifications that allow activation and deactivation without additional operative procedures. Satisfactory continence can be achieved in properly selected patients. The integrity of the vesicovaginal surgical plane is the key to success. Patients with multiple operations are the most difficult to manage and delayed activation is mandatory. Intermittent catheterization can be safely done and mechanical reliability is good.