Artificial Urinary Sphincter

The implantation of an artificial urinary sphincter is very common among men who have urine leakage following a prostatectomy or radiation therapy for the prostate. It is considered the gold standard treatment for urinary incontinence and can greatly improve your quality of life.

Normally, a small muscle called a urinary sphincter will control the flow of urine from your bladder. While the muscle is contracted, it closes the opening of the bladder stopping urine from coming out. In order to urinate, the urinary sphincter relaxes, unblocking the opening in the bladder and allowing the urine to flow through the urethra (the tube that carries urine) and out of your body.

What is an artificial urinary sphincter (AUS)?

An artificial urinary sphincter is a device that performs the same function as your natural urinary sphincter. It comprises of three main components:

Urethral cuff

This part imitates the function of the sphincter. It wraps around your urethra to control the flow of urine. The cuff fills with liquid and closes the urethra, stopping urine from passing. When the cuff is empty, it opens, allowing urine to pass.

Control Pump

The pump either empties or fills the cuff with liquid. It is usually placed in your scrotum.

Pressure Regulating Balloon

The balloon acts as a reservoir for the liquid when the cuff is empty. The liquid empties and returns to the cuff after you have urinated. This is where the fluid is moved to when the urethral cuff is open or deflated. It’s inserted below the abdomen and rests behind your abdominal muscles.

How does an artificial urinary sphincter (AUS) work?

The AUS controls the flow of urine by closing and opening the urethra. Normally the cuff will remain closed. When you are ready to urinate, you have to squeeze the pump in your scrotum. The pump will move the fluid from the urethral cuff into the balloon. The cuff will then open allowing urine to pass through the urethra and it will stay open for about 3 minutes so that you can urinate. The cuff then closes automatically.
How long does artificial sphincter surgery take?

Surgery time is very quick and patients may only need an overnight hospital stay. Artificial urinary sphincter placement is performed under anesthesia. The inflatable cuff is placed around the urethra through a small incision in the perineum, the area of skin just under the scrotum. The balloon is also inserted through a small incision in the abdomen.

Risks associated with having an AUS

As with any medical procedure, there are some risks involved. Although not common, the following problems and side effects can occur:

• Pain
• Bleeding
• Infection rates are low but it could require device removal
• Device malfunction or failure, which can require revision surgery to take it out or replace it
• Damaged urethra
• Ongoing leakage of urine
• Long-term or permanent problems urinating
• You may require a catheter.
• You may also need revision surgery to fix the problem.
• Difficulties holding in your urine

The AUS device is subject to erosion. It usually needs to be replaced after 8 to 10 years.

There are other common issues that affect the urinary tract and can cause urinary leakage such as:

• Neurogenic bladder
• Urinary tract infection
• Bladder or kidney infections
• Certain medications
• Constipation

If you are interested in restoring the ability to achieve continence then speak to a urologist. It may be the case that with some lifestyle modifications and non-invasive procedures, like bladder exercises, continence could be restored.

The board-certified urologists at Urology of Greater Atlanta provide state-of-the-art testing to identify the issue causing your incontinence and personalized treatment plans to restore normal bladder function.

Call the practice or schedule an appointment online today for expert incontinence treatments