A new prosthetic device for the treatment of urinary incontinence, caused by a variety of etiologies, has been used 8 times at the University of Michigan Medical Center. Since the entire device is filled with contrast medium, the radiologist plays a major role in its evaluation. A brief description of the implantable urinary sphincter and its normal and abnormal roentgenographic appearances are presented and discussed. Roentgenologic findings which could lead to early clinical detection of mechanical failure are illustrated.