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The placement of an artificial urinary sphincter prosthesis is a recognised treatment for men with urinary incontinence that is caused by insufficient sphincter action, although it is rarely used. Physicians from specialties other than urology know little about the components and mechanism of action of this prosthesis, which can lead to severe complications.A 67-year-old patient with a history of radical prostatectomy came to the emergency department with abdominal pain after a colonoscopy. A few years prior, he had received an artificial urinary sphincter prosthesis because of urinary incontinence. An abdominal CT scan showed a cystic lesion, which was punctured under ultrasonic guidance. The patient was completely incontinent after the intervention. It appeared to have been the pressure balloon of the urinary sphincter prosthesis that was punctured. The pressure balloon was operatively replaced several weeks later. During this procedure, the pressure balloon was placed intravesically instead of in the retropubic space and a reoperation was necessary.To prevent complications, all physicians should know how medical implants function, including the ones that are rarely used. In addition, patients need to be well informed of their use.

*Urinary incontinence in males is gaining increasingly more attention. *Male urinary incontinence can be classified as storage incontinence due to overactive bladder syndrome or stress incontinence due to urethral sphincter dysfunction. *Most patients benefit from the currently available treatment options for overactive bladder, which include physiotherapy, medication, botulinum A toxin injections and neuromodulation techniques. *The number of radical prostatectomies performed for prostate cancer is increasing; this intervention can lead to stress incontinence due to sphincter weakness. *Various treatment options are available for stress incontinence due to sphincter weakness. *In addition to physiotherapy, treatment options also include the artificial urinary sphincter, which has been available for decades. *New treatments include para-urethral balloons and male slings. The value of these approaches must be proven in the coming years.

Evaluation of the results of treatment with an artificial urinary sphincter in 86 patients with urinary incontinence due to intrinsic sphincter deficiency.Retrospective.In the period 1982-1997 an artificial urinary sphincter (American Medical Systems, Minnetonka, Minnesota, USA) was inserted in the Academic Hospital Rotterdam-Dijkzigt, Department of Urology, the Netherlands, in 86 patients (15 women and 71 men) aged 8-84 years. All patients suffered from urinary incontinence due to intrinsic sphincter deficiency. A 'good' result was defined as being completely dry or using a maximum of one pad per day. During follow-up visits, the pad counts were registered and the pumping characteristics of the prosthesis were checked. In case of deterioration of the continence status a re-evaluation was started using imaging modalities and urodynamic studies.After an average follow-up of 41 months 76% of the patients were either completely dry or used a maximum of one incontinence pad per day. Urinary continence had markedly improved in another 7% of the patients. One or more reoperations due to mechanical or non-mechanical problems with the prosthesis had to be performed in 37 patients (43%).The artificial urinary sphincter can give excellent results as far as urinary continence is concerned, if the price of a relatively large number of revisions is accepted, in a population of patients to whom, in most cases, no other treatment options apply.