Objective assessment of urinary incontinence after successful implantation of the ams artificial urethral sphincter

Abstract

AbstractWe selected 34 patients who had been fitted with the AMS artificial sphincter (models 742, 791, 792) in 1978–1982, who claimed to have a satisfactory result and compared their subjective feeling of continence to the objectively measured urine loss by a 1‐hour padweighing test. Furthermore, we related the measured urine loss to the position and size of the cuff and the balloon pressure; 19 patients claimed to be completely dry, ten patients experienced varying degrees of incontinence with physical activity, and five patients did wear some kind of protection, but all patients were satisfied with the operation. The results of the pad‐weighing test showed that 22 patients were completely dry and 12 patients had some measurable urine loss. Patients with an artificial sphincter at the bladder neck had better continence than patients with the sphincter at the bulbous urethra, possibly because of a better transmission of pressure to the cuff from the abdominal cavity. The level of the closure pressure in the balloon in patients with sphincters at the bladder neck was not significantly related to the amount of urine loss. We conclude that patients might be subjectively satisfied with an artificial sphincter operation despite some objectively measured urine loss and that the subjective feeling of continence correlates fairly well with the objective pad‐weighing test. When regarding postimplant continence in isolation the bladder neck position of the prosthesis is superior to the bulbous urethra position.