The artificial urinary sphincter Zephyr ZSI 375 has two components. There is the cuff around the bulbar urethra and the pump-/tank-system to be implanted into the scrotum. The technique which had been described in the information for use (IFU) of the producer was a two-incision procedure with a perineal and an inguinal access. 
The question was if it is possible to implant the system with only one perineal incision.

The bulbar urethra is accessed by a perineal incision, completely mobilised and surrounded. Here the curved cuff is placed and closed to the appropriate size. The equilibration of pressures is watched and adapted. Then a canal is digitally carved beyond the left spermatic cord returning to the middle of the scrotum. The pump-/tank system is placed in this subdartos pouch and the wound is closed.

The new implantation technique was performed in 57 patients. The average incision-suture-time was at 27 minutes. In 3 patients there was in scrotal hematoma prolonging the hospital stay but did not lead to further interventions. Tweo of these three patients had a not disconnectable thrombocytes function inhibitors therapy.
In 3 patients a adjustion of the pressure was undertaken in the follow up time between 3 and 22 months.
2 patients had urethral arrosions, 1 a scrotal skin arrosion and were explanted.
All remaining are in situ and functioning well.

The "single-incision"-implantation-technique for the Zephyr ZSI 375 artificial urinary sphincter is a quick and safe procedure and does not produce additional side affects as known from the recent techniques.

Long term results have to be expected - we will report ours.