Current use of the artificial urinary sphincter and its long-term durability: A nationwide survey in Japan

Yoichi Arai, Mineo Takei, Katsuya Nonomura, Shiro Baba, Tomonori Habuchi, Tadashi Matsuda, Satoru Takahashi, Mikio Igawa, Yasuhiro Kaiho, Haruo Nakagawa

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Objectives: Although the artificial urinary sphincter (AUS) is one of the most effective surgical treatments for severe urinary incontinence, little is known about its use in Japan. A nationwide survey was done to determine contemporary trends in AUS use and its long-term durability. Methods: Data on AUS units sold in Japan were provided directly by Takai Hospital Supply Co., Ltd., Tokyo, Japan, and a survey form was sent to all 44 institutes where AUS implantation had been carried out. The survey included various demographic and preoperative variables, surgical variables, and postoperative outcomes. Results: Between 1994 and 2007, a total of 100 AUS devices had been provided in Japan. Of the 44 institutes, 24 responded to the survey, and a total of 64 patients were enrolled in the study. Post-urological surgery incontinence accounted for 81.3% of the indications. During the mean follow-up of 50 months, mechanical failure occurred in four (6.2%), and the device was removed in 13 (20.3%) due to infection (14.0%), erosion (4.7%), or urination difficulty (1.5%). Of the 58 patients evaluated, 91.4% reported social continence. Five- and 10-year failure-free rates were 74.8% and 70.1%, respectively. On multivariate analysis, operative time was an independent predictor of treatment failure (P = 0.0334). Conclusions: Considering recent trends in prostate surgery, the AUS may be significantly underused in Japan. Although excellent long-term durability has been achieved, a learning effect appears to be evident. The Japanese urological community needs to provide appropriate patients with this treatment option.

Original languageEnglish
Pages (from-to)101-104
Number of pages4
JournalInternational Journal of Urology
Issue number1
Publication statusPublished - 2009 Jan


  • Artificial urinary sphincter
  • Prostatectomy
  • Urinary incontinence

ASJC Scopus subject areas

  • Urology


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