Experiences with the artificial urinary sphincter in the irradiated patient.

Abstract

The AMS800 artificial urinary sphincter was placed in 16 men who underwent previous pelvic irradiation for adenocarcinoma of the prostate. A total of 13 patients had undergone external beam irradiation and 3 had had iridium seed implants. The sphincteric cuff was placed in the bulbar urethra in all patients, with a pressure regulating balloon of 51 to 60 or 61 to 70 cm. water. Overall social continence rate was 87%. Total complication rate was 25% with a rate of erosion and/or infection of 12.5%. We advocate that with meticulous technique, use of a low pressure balloon and delayed primary cuff activation, the artificial urinary sphincter can be placed with a reasonable success rate in post-irradiated men with urinary incontinence.