Implantation of a new semiautomatic artificial genitourinary sphincter: experience with primary activation and deactivation in 47 patients.

AS 742 is a new semiautomatic artificial genitourinary sphincter that has been used at the clinic for the last 21/2 years in the management of urinary incontinence. Compared to the previous model the simplified design provides for much easier implantation, more reliable function related to cuff pressures and to cuff configuration, and more flexibility in the selection of the site for cuff placement. In addition, this new device has enabled the development and use of a new concept of primary and secondary activation. A total of 47 patients (41 male and 6 female subjects) has undergone implantation of the AS 742. Of the 42 patients who had primary activation 34 experienced continence without further surgical revision. The remaining 5 patients who primarily had deactivated devices subsequently had the devices activated and the patients are dry. Of the 8 patients with initial failures 2 had infection and 6 had primary cuff erosion of the urethra. In 4 of the 8 patients the cuff was replaced, and the device was deactivated and then activated after 3 to 4 months. All 4 of these patients are continent. Followup for these patients has ranged from 6 to 30 months. Over-all, 43 of the 47 patients are continent.