My primary care doctor sent me abstracts on a couple studies involving
the artificial urinary sphincter.  Reporting here just for others who may be
facing this decision.

   "Comparison of artificial urinary sphincter and collagen for the
treatment of postprostatectomy incontinence", Kuznetsov DD; Kim HL; Patel
RV; Steinberg GD; Bales GT; Urology 2000 Oct 1; 56(4):600-3, University of
Chicago Hospitals.  PMID - 11018614.   Summary was:  "Patients receiving an
AUS (artificial urinary sphincter) achieved significantly higher continence
rates.  Also, the quality of life of men treated with an AUS was improved
compared with that of the men treated with collagen injection".   The
abstract also mentions the "impact score" and the "bother score" but does
not define these.  Anyone know what those terms mean?

   "Long-term continence and patient satisfaction after artificial
sphincter implantation for urinary incontinence after prostatectomy",
Montague DK; Angermeire KW; Paolone DR; J Urol 2001 Aug; 166(2):547-9,
Cleveland Clinic Foundation, PMID - 11458065.  Summary was "Artificial
urinary sphincter implantation offers men who are incontinent after
prostatectomy a reasonable chance for obtaining long-term satisfactory
urinary control, although complete continence is unusual".  Note that last
phrase.  Only 4% (4 patients) were completely dry and 60% (68 patients) were
using between 0 and 1 pad daily.  The minimum time frame for this study was
20 months post RP, with a mean of 73 months.

   "A national survey of urinary and health related quality of life
outcomes in men with an artificial urinary sphincter for post-radical
prostatectomy incontinence", Dalkin BL; Wessells H; Cui H; J Urol 2003 Jan;
169(1):237-9; Section of Urology, Department of Biostatistics, University of
Arizona, PMID 12478144.  Summary was "Our national survey revealed that
despite significant differences in urinary function and bother, men 2 and 5
years after artificial urinary sphincter implantation had similar general
health related quality of life.  The continence outcomes differed from most
single institution studies in that men after sphincter implantation reported
a high degree of urinary dysfunction and bother.  Artificial urinary
sphincter implantation may significantly improve scores in urinary function
but continued pad use is to be expected".  Again, please note the last
phrase.  They indicate in this abstract that at 2 years 16%, and at 5 years
28%, of men have revisions to the implant.  They reported that 97% of the 5
year group and 83% of the 2 year group continued to use pads.

   So, the bottom line is that one should expect to still need pads even
with the artificial sphincter implant.  I use 1-3 pads per day now, so with
the implant is it worth it?  Tough question still, at least for me.  Two
years later I am getting kind of tired of wet underwear and not being able
to get into the pool, especially now with the heat wave we are having around
here.

   Good luck to the fellow members of the leakers club.

David S.