Jim,
In 2009 I considered doing the artificial sphincter, since I was using about 4-5 Depend pads per day. I live in Maine, so decided to go down to the Lahey Clinic in Burlington, MA, since a friend of mine had had good luck with an artificial sling he had gotten there. I had hoped to get the Advance Sling, but after talking with the urologist there he said I would be drier if I chose the sphincter. Because of my wife not wanting to drive in Mass. traffic, I decided to find a surgeon in Maine who could do the operation. I could only find one who does just a few of these each year (big mistake). He punctured my urethra, and one month after installing the sphincter he had to remove all 3 pieces of it. I learned my lesson: don't be afraid to travel to wherever you need to go to get a surgeon who has done a GREAT many of that kind of operation each year.
You haven't said how incontinent you are. How many pads a day do you go through? Or do you use some other system?
I believe the sphincter is a good system to have, because I have talked to local men who have gotten it from a reliable surgeon and it has worked good for years. I probably could be dry now if I had only chosen a qualified surgeon. So, do your research, and depending on how incontinent you are you could choose between the Advance Sling and the artificial sphincter. If you can go to a nationally known hospital, such as Lahey, etc. you could talk to a urologist and get good guidance. They put a camera up my penis and urethra and checked me out thoroughly before giving their advice.
Swanee