Mayo clinic experience with the AS800 artificial urinary sphincter for urinary incontinence after transurethral resection of prostate or open prostatectomy

A Review of the Complications and Results of Implantation of the AMS Artificial Urinary Sphincter

“…Mundy considers this a relative contraindication of implantation [69, 121], quoting an erosion risk of 57%. Despite reports to the contrary [81, 122], the risk of urethral erosion after implantation in these circumstances appears to be increased (10% [50], 12.5% [73]). As these urethral erosion rates were compatible with the global rate (11.7%), it would seem reasonable that these patients are not deprived of this implant if meticulous technique (including primary deactivation) is adhered upon and patient selection is appropriate.…”

“…The world literature appears to include reports on 2,606 patients implanted with the AMS 800 [41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82]. The literature also includes anecdotal reports of its usage in patients with renal transplantation [58], pregnancy [60, 79]and overoptimistic reports [51]of implantation in conjunction with penile implants [51, 72].…”

“…Implantation of the AUS after radiotherapy was reported in several studies [50, 73, 81, 120, 121, 122]. Mundy considers this a relative contraindication of implantation [69, 121], quoting an erosion risk of 57%.…”

Male Stress Urinary Incontinence Following Surgical Intervention: Procedures, Technical Modifications, and Patient Considerations

“…More contemporary reports have been somewhat more favorable, however still the reports rates are around 18 % (7/38) for the development of stress urinary incontinence for patients being treated with TURP following brachytherapy [ 22 ]. Similarly, high rates of patients (23 %) requiring AUS placement following TURP or open prostatectomy were noted to have had prior radiation therapy [ 23 ]. Given these risks, surgical intervention following brachytherapy or radiation therapy for obstructive urinary symptoms should be proceeded with only after the exhaustion of medical treatments.…”

Urinary Incontinence

“…Urinary continence following AUS placement is achieved in 27-75 % of patients with postprostatectomy incontinence [240][241][242][243] . Again, the de fi nitions of continence, improvement in urinary control, model of sphincter, indications (radical vs. transurethral prostatectomy), and patient satisfaction vary widely [ 244 ] .…”