The artificial urinary sphincter procedure has a high success rate.
One of the most common reasons for urinary incontinence (UI) is the inability of muscles called urethral sphincters to manage the flow of urine from the bladder to the tube that exits the body. Initially, a urologist may recommend bladder control exercises, medication, techniques such as biofeedback, and lifestyle changes like quitting smoking in an attempt to manage what may be an embarrassing issue for patients.
Sling procedures are often recommended for women with UI.
Men with urine leakage may benefit from an artificial urinary sphincter (AUS).
Made of a durable type of silicone rubber, an artificial urinary sphincter is a device placed where the urethra links with the bladder. The AUS has two attached parts that help control pressure in an inflatable urethral cuff: a balloon and a control pump. The balloon is placed in the pelvic area, while the pump is inserted in the scrotum. The user inflates the cuff to keep urine from leaking and deflates when it’s time to urinate.
Needs for an Artificial Sphincter
An artificial urinary sphincter may be necessary after prostate removal. A urologist may also suggest this procedure for patients experiencing ongoing leakage from the urethra that’s not able to be controlled with non-surgical remedies and not related to an underlying issue with the urinary system. Sometimes, it may be a recommended option when urinary incontinence is seriously affecting quality of life.
The surgery to insert the artificial urinary sphincter is performed under general or spinal anesthesia. Two small incisions are made to place the AUS and its related components. The first one is between the scrotum and rectum where the pump will go. The other incision is made in the lower abdomen to place the balloon and the AUS. The procedure typically takes about 2-3 hours to complete. A catheter is temporarily inserted to allow for urine drainage immediately after surgery. While the catheter is in place, patients are instructed to drink several glasses of water a day and avoid strenuous activities. A urologist will determine when it’s safe to remove the catheter.
How Is the Device Adjusted and Activated?
For the first few weeks after the AUS is inserted, patients are usually advised to pull it down to the lowest part of the scrotum to keep the pump from shifting out of place. There may be some urine leakage initially. However, this normally stops after the device is activated. This is often done about 6-8 weeks after surgery.
Most men who have an artificial urinary sphincter inserted when urinary incontinence occurs after prostate surgery are satisfied with the results. Complications and risks associated with the device are minimal. If patients do experience issues such as an infection inside of the newly inserted artificial sphincter or if the AUS doesn’t function as expected, revision surgery may be recommended.