Artificial Urinary Sphincter (AUS)
Normally, a small muscle called a urinary sphincter controls the flow of urine from your bladder. While the muscle is contracted, it closes the opening of the bladder and stops 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.
Urinary incontinence could indicate that your urinary sphincter is not functioning correctly. An artificial sphincter may help to restore function and improve your quality of life.
Book an appointment today with Urology of Greater Atlanta to see one of our experts in male urinary incontinence. All our doctors are board-certified urologists. We operate in multiple locations throughout Georgia.
What Are Artificial Urinary Sphincters?
An artificial urinary sphincter is a device that performs the same function as your natural urinary sphincter. It comprises the following 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 an Artificial Urinary Sphincter Works
The artificial urinary sphincter 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.
Who Is a Candidate for an Artificial Urinary Sphincter?
The implantation of an artificial urinary sphincter is very common among men who have urine leakage following radiation therapy for the prostate or prostate surgery. It is considered the gold standard treatment for stress urinary incontinence and can significantly improve your quality of life.
How Is the AUS Surgical Procedure Performed?
Artificial urinary sphincter surgery 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. Surgery time is very quick, and patients may only need an overnight hospital stay.
What Is the Success Rate and Are There Any Risks?
Many studies have shown that over 90% of those fitted with an AUS were satisfied with the results.
However, 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 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 need a catheter
- Difficulties holding in urine
Since the AUS device is subject to erosion, it usually needs to be replaced after 8 to 10 years.
There are other common issues that can affect the urinary tract and can cause urinary leakage, such as:
- Neurogenic bladder
- Urinary tract infection
- Bladder or kidney infections
- Certain medications
- Constipation
Recovery and Post-Operative Care
After surgery, you will require a urinary catheter for 24 hours to drain urine from your bladder. You can usually go home after this period.
Be sure to keep your wounds dry for a couple of days while it starts to heal. You may apply ice through a cloth to ease any discomfort or bruising.
You will not be able to activate the device for about 6 weeks. This means you may still experience urinary incontinence during that time. It’s also generally recommended to avoid strenuous exercise or heavy lifting for about 4 weeks.
If you are interested in restoring your ability to achieve continence, speak to one of our urologists. 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 our practice today or schedule an appointment online for expert incontinence treatments that can give you peace of mind. We operate in multiple locations throughout Georgia.
