Success of the Narrow-Backed Cuff Design of the AMS800 Artificial Urinary Sphincter: Analysis of 144 Patients

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Abstract
The narrow-backed cuff design of the AMS800 artificial urinary sphincter was introduced to improve transmission of cuff pressure to underlying tissue and, theoretically, to decrease the incidence of cuff erosion. The AMS800 urinary sphincter with this design change was implanted in 136 male and 8 female patients (mean age 57 years). Mean followup was 28 months. The cuff was placed around the bladder neck in all 8 female and in 29 male patients, and it was implanted around the bulbous urethra in the remaining 107. The 4.5 cm. cuff in combination with the 61 to 70 cm. pressure balloon was implanted in 109 patients. There were 12 device failures and 12 surgical complications. Five patients required cuff removal and none required reoperation for inadequate cuff pressure. Postoperatively, 132 patients reported satisfactory continence. The design change of the AMS800 and the use of the 4.5 cm. cuff with the 61 to 70 cm. pressure balloon decreased the incidence of cuff erosion and the need for reoperation for inadequate cuff pressure.