The AMS-800
™
artificial urinary sphincter has become the ‘gold
standard’ in the treatment of male stress urinary incontinence. In 2006, the
novel artificial urinary sphincter FlowSecure
™
containing a stress
relief balloon providing low cuff pressures at rest with conditional pressure
elevation during periods of stress has been launched. We assessed the
intraurethral pressure in the cuff area of the AMS-800 and the FlowSecure by
urethral pressure profile in four patients each. Urethral pressure profile was
performed at rest and during coughing. In addition, continence situation and
patient satisfaction after artificial urinary sphincter implantation was
assessed. At rest, median pressure in the cuff region was 74 (38–117,
FlowSecure) cm H
2
O and 102 (95–110, AMS-800) cm H
2
O.
During coughing, pressure peaks rose to 135 (54–162,
FlowSecure) cm H
2
O and 202 (128–216, AMS-800) cm H
2
O.
Median pad usage before artificial urinary sphincter implantation in the
FlowSecure and the AMS-800 group was 4 (3–4) and 4.5 (2–6) pads/24 h,
respectively. At the time of urodynamic investigation, median pad usage declined
to 1.5 (0–4) pads/24 h in the FlowSecure and to 1 (1–2) pads/24 h in the AMS-800
group. Seven of eight patients reported on a satisfactory quality of life, and
one patient remained unhappy after FlowSecure implantation. It remains unclear
if the trade-off in favour of lower cuff pressures, and consecutively lower
intraurethral pressures, holds truly long-term benefits regarding device
revision, explantation and patient satisfaction.