Korean J Urol.  2008 Jun;49(6):520-525.

Twenty Years of Experience with Artificial Urinary Sphincter Implantation

  • 1Department of Urology, Yongdong Severance Hospital, Yonsei University Health System, Seoul, Korea. mahsy@yuhs.ac


PURPOSE: The efficacy of the artificial urinary sphincter(AUS) in treating sphincteric incontinence has been clearly demonstrated. We report on 20 years of experience using artificial sphincter implantation at a single institute.
The follow-up data for 37 patients who received AUS(AMS 800(TM)) implantation between 1987 and 2006 at Yonsei University were available for this study. We investigated various components of the medical records, such as the number of pads used per day, results of pre-operative urodynamic studies, operative and post-operative complications, and revision rate.
Mean patient age was 35.6 years(range 15-64 years), and mean follow-up duration was 12.4 years(range 1.4-19.8 years). Of the 37 patients, 21 had neurogenic bladder, and 9 had traumatic injury. Other causes of incontinence included post-operative complications(4 patients) and congenital anomalies(3 patients). The cuffs were placed were in the bladder necks of 21 patients and in the bulbous urethrae of 16 patients. The average number of pads used daily decreased significantly from 6.2 to 1.2 after the operation, and 27 patients(72.9%) were able to maintain 'dry-up status' (number of pads used< or=1). A total of 32 artificial sphincters remained in place(86.4% survival rate), with 8 revisions(21.6%) required secondary to infection, mechanical failure, or urethral stone.
AUS implantation is a safe and durable treatment for urinary incontinence in patients with intrinsic sphincter deficiency from various underlying diseases.


Bladder; Urinary incontinence; Artificial urinary sphincter

MeSH Terms

Follow-Up Studies
Medical Records
Urinary Bladder
Urinary Bladder, Neurogenic
Urinary Incontinence
Urinary Sphincter, Artificial


1. Scott FB, Bradley WE, Timm GW. Treatment of urinary incontinence by implantable prosthetic sphincter. Urology. 1973; 1:252–9.
2. Ruiz E, Puigdevall J, Moldes J, Lobos P, Boer M, Ithurralde J, et al. 14 years of experience with the artificial urinary sphincter in children and adolescents without spina bifida. J Urol. 2006; 176:1821–5.
3. Gonzalez R, Merino FG, Vaughn M. Longterm results of the artificial urinary sphincter in male patients with neurogenic bladder. J Urol. 1995; 154:769–70.
4. Light JK. Longterm clinical results using the artificial urinary sphincter around bowel. Br J Urol. 1989; 64:56–60.
5. Westney OL, Bevan-Thomas R, Palmer JL, Cespedes RD, McGuire EJ. Transurethral collagen injections for male intrinsic sphincter deficiency: the University of Texas-Houston experience. J Urol. 2005; 174:994–7.
6. Chrouser KL, Fick F, Goel A, Itano NB, Sweat SD, Lightner DJ. Carbon coated zirconium beads in beta-glucan gel and bovine glutaraldehyde cross-linked collagen injections for intrinsic sphincter deficiency: continence and satisfaction after extended followup. J Urol. 2004; 171:1152–5.
7. Castle EP, Andrews PE, Itano N, Novicki DE, Swanson SK, Ferrigni RG. The male sling for post-prostatectomy incontinence: mean followup of 18 months. J Urol. 2005; 173:1657–60.
8. Kang SJ, Mah SY, Lee T. 10-year experience with artificial urethral sphincter. Korean J Urol. 1997; 38:192–7.
9. Moon YT, Lee KB, Moon WC, Soh BK, Kim CK. A case of urinary incontinence treatment using AMS 800-artificial Sphincter. Korean J Urol. 1986; 27:337–44.
10. Cho JS, Shin JS, Chang SK. A case of urinary incontinence treated with AMS 800 artificial sphincter. Korean J Urol. 1988; 29:175–8.
11. Chiaffarino F, Parazzini F, Lavezzari M, Giambanco V. Impact of urinary incontinence and overactive bladder on quality of life. Eur Urol. 2003; 43:535–8.
12. Wagner TH, Hu TW. Economic costs of urinary incontinence in 1995. Urology. 1998; 51:355–61.
13. Choo MS, Ku JH, Oh SJ, Lee KS, Paick JS, Seo JT, et al. Prevalence of urinary incontinence in Korean women: an epidemiologic survey. Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18:1309–15.
14. Stone AR, Nelson RS. Evaluation and management of male urinary incontinence. ScientificWorldJournal. 2004; 4(Suppl 1):330–45.
15. Aaronson IA. The AS 800 artificial urinary sphincter in children with myelodysplasia. Preliminary results. S Afr Med J. 1986; 69:686–8.
16. Light JK, Reynolds JC. Impact of the new cuff design on reliability of the AS800 artificial urinary sphincter. J Urol. 1992; 147:609–11.
17. O'Connor RC, Gerber GS, Avila D, Chen AA, Bales GT. Comparison of outcomes after single or DOUBLE-CUFF artificial urinary sphincter insertion. Urology. 2003; 62:723–6.
18. Lai HH, Hsu EI, Teh BS, Butler EB, Boone TB. 13 years of experience with artificial urinary sphincter implantation at Baylor College of Medicine. J Urol. 2007; 177:1021–5.
19. Petero VG Jr, Diokno AC. Comparison of the longterm outcomes between incontinent men and women treated with artificial urinary sphincter. J Urol. 2006; 175:605–9.
20. Quek ML, Ginsberg DA. Longterm urodynamics followup of bladder augmentation for neurogenic bladder. J Urol. 2003; 169:195–8.
21. Chartier-Kastler EJ, Mongiat-Artus P, Bitker MO, Chancellor MB, Richard F, Denys P. Longterm results of augmentation cystoplasty in spinal cord injury patients. Spinal Cord. 2000; 38:490–4.
22. Furness PD 3rd, Franzoni DF, Decter RM. Bladder augmentation: does it predispose to prosthetic infection of simultaneously placed artificial genitourinary sphincters or in situ ventriculoperitoneal shunts? BJU Int. 1999; 84:25–9.
23. Gousse AE, Madjar S, Lambert MM, Fishman IJ. Artificial urinary sphincter for post-radical prostatectomy urinary incontinence: longterm subjective results. J Urol. 2001; 166:1755–8.
24. Light JK, Pietro T. Alteration in detrusor behavior and the effect on renal function following insertion of the artificial urinary sphincter. J Urol. 1986; 136:632–5.
25. Murray KH, Nurse DE, Mundy AR. Detrusor behaviour following implantation of the Brantley Scott artificial urinary sphincter for neuropathic incontinence. Br J Urol. 1988; 61:122–8.
26. Lopez Pereira P, Somoza Ariba I, Martinez Urrutia MJ, Lobato Romero R, Jaureguizar Monroe E. Artificial urinary sphincter: 11-year experience in adolescents with congenital neuropathic bladder. Eur Urol. 2006; 50:1096–101.
27. Onur R, Singla A. Comparison of bone-anchored male sling and collagen implant for the treatment of male incontinence. Int J Urol. 2006; 13:1207–11.
28. Montague DK, Angermeier KW, Paolone DR. Longterm continence and patient satisfaction after artificial sphincter implantation for urinary incontinence after prostatectomy. J Urol. 2001; 166:547–9.
29. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003; 61:37–49.
30. Montague DK, Angermeier KW. Postprostatectomy urinary incontinence: the case for artificial urinary sphincter implantation. Urology. 2000; 55:2–4.
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