Radiology, Vol 168, 403-408, Copyright © 1988 by Radiological Society of North America
Artificial urinary sphincters: plain radiography of malfunction and complications
SC Rose, ME Hansen, GD Webster, C Zakrzewski, RH Cohan and NR Dunnick
Department of Radiology, Duke University Medical Center, Durham, NC.
Inflatable artificial urinary sphincters provide excellent voluntary
continence. Eighty-four consecutive patients underwent implantation of
artificial urinary sphincters for intractable urinary incontinence; 33
patients had 58 episodes of sphincter malfunction, and eight patients had
eight complications involving a functional prosthetic sphincter.
Retrospective analysis was performed to determine the value of plain
radiography of the pelvis in patients with sphincter malfunction or
complication. The cause of malfunction in the majority of patients was a
system leak and subsequent loss of hydraulic fluid (31 occurrences; 53%).
Plain radiography permitted correct identification of all instances of
fluid leakage in patients with opacified prostheses. Plain radiographs were
of no value in examining patients with nonopacified prostheses or the
complications of cuff erosion or wound infection. Due to the low cost and
noninvasive nature of plain radiography of the pelvis, we conclude that it
should be used as the initial diagnostic modality in patients with
previously opacified but currently dysfunctional artificial urinary
sphincters.
