Successful Outcome of Artificial Urinary Sphincters in Men with Post-Prostatectomy Urinary Incontinence Despite Adverse Implantation Features

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Abstract
A total of 75 men with post-prostatectomy urinary incontinence underwent artificial urinary sphincter implantation with a mean followup of 3.7 years. Average patient age at implantation was 67 years, with 30 men being 70 years old or older. In only 15 men (20%) was there no adverse implantation feature, while the remainder had adverse features, such as detrusor hyperactivity (44), bladder neck or urethral stricture disease (27), previous radiation therapy (11) and metastatic prostate cancer (11). Although men with ideal implantation characteristics, men with normal detrusors and men who underwent prostatectomy for benign disease had slightly better outcome in terms of urinary continence, in general each group of men with and without adverse features had satisfactory urinary continence. Other than men with a benign prostate, who fared better, each group of men with and without adverse features had equal need for device revisions. In conclusion, men with post-prostatectomy urinary incontinence should not be excluded from consideration for artificial urinary sphincter implantation based on the failure to meet ideal implantation criteria provided such adverse features are recognized and appropriately addressed.