A comparison of the functional durability of the AMS 800 artificial urinary sphincter between cases with and without an underlying neurogenic aetiology

• Published in: Irish journal of medical science 2003-07, Vol.172 (3), p.136-138
• Main Authors: Murphy, S, Rea, D, O'Mahony, J, McDermott, T E D, Thornhill, J, Butler, M, Grainger, R
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Equipment Design; Equipment Failure; Female; Follow-Up Studies; Humans; Hysterectomy - adverse effects; Male; Middle Aged; Prostatectomy - adverse effects; Urinary Bladder, Neurogenic - etiology; Urinary Bladder, Neurogenic - surgery; Urinary Incontinence - etiology; Urinary Incontinence - surgery; Urinary Sphincter, Artificial
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/BF02914499

To compare the efficacy and functional durability of the American Medical Systems 800 (AMS 800) artificial urinary sphincter (AUS) device for patients with neurogenic and non-neurogenic incontinence. From 1985 to 2000, 38 patients underwent implantation of an AMS 800 AUS at our institution. Thirty of these patients had complete records and follow-up data available. The mean follow-up for these two groups of patients was six years. Seventeen devices (57%) were implanted for non-neurogenic indications including incontinence after prostatectomy or hysterectomy. Thirteen devices (43%) were implanted for neurogenic conditions including spina bifida, spinal cord injury or severe pelvic trauma. The primary end point measured was continence. Secondary end points included mechanical and non-mechanical device failure, re-operation and complication rates between the two groups. In the neurogenic group, only two patients (15%) have their original device in situ without revisions. Only three patients (23%) in this group are entirely dry. In contrast, seven patients (41%) in the non-neurogenic group are completely dry with their original device in situ. A further four (23%) are entirely dry after device revision or replacement surgery. The rates of mechanical failure were not statistically different between the two groups. The rate of non-mechanical failure (NMF) was statistically greater in the neurogenic group in comparison to that in the non-neurogenic group (p < 0.05). Insertion of an AMS 800 artificial sphincter remains a durable means of regaining urinary continence. Patients who are incontinent as a result of an underlying neurological deficit should be counselled that they might have a higher risk of non-mechanical device failure, requirement for re-operation and that their overall long-term continence rates may be poor.