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Artificial Urinary Sphincter

Artificial Urinary Sphincter
In brief

The artificial urinary sphincter is an implant placed entirely inside the body. It is used for moderate to severe stress urinary incontinence, particularly when it develops after prostate surgery. It keeps the urethra closed in a controlled way; when you want to pass urine, you press a small pump to open the system for a short time.

After surgery for prostate cancer or benign prostatic enlargement, the sphincter muscle that holds urine in does not work well enough in some patients. Mild leakage usually improves with exercises and time. For persistent, severe incontinence, the artificial urinary sphincter is one of the effective options.

How Does the Artificial Urinary Sphincter Work?

The device is a closed hydraulic system made up of three parts. It needs no battery or electricity and cannot be seen from the outside.

  • Cuff: placed around the urethra to keep it closed.
  • Pump: in men, placed inside the scrotum. When you press the pump, the cuff relaxes and you can pass urine.
  • Pressure-regulating balloon: balances the pressure in the system. A few minutes after you have passed urine, fluid returns to the cuff and the urethra closes again.

Who Is It Suitable For?

  • Men with moderate or severe, persistent urinary incontinence after prostate surgery
  • Patients with permanent loss of function in the sphincter muscle
  • Suitable patients who have not had enough benefit from other treatments, and some selected female patients
  • People with the manual dexterity and cognitive ability to use the pump

If there is an active urinary tract infection or an untreated urethral stricture, these problems are treated first. Suitability is decided after an examination, cystoscopy and, if needed, urodynamic testing.

The Treatment Process

  • Assessment: the type and severity of incontinence are established through your symptoms, an examination and tests.
  • Surgery: performed under general or regional anaesthesia and usually takes 1–2 hours.
  • Recovery: the device is kept deactivated for the first few weeks so that the tissues can heal.
  • Activation: the device is usually activated at the practice after 4–6 weeks, and you are shown how to use it.
  • Follow-up: regular check-ups monitor how the device is working and your bladder control.

Risks

As with any operation, infection can occur. In addition, the cuff can wear into the urethra (erosion), or a mechanical fault can develop over the years; in these cases the device may need to be replaced or further surgery may be required. Possible risks and expectations are discussed in detail before surgery.

Detailed information on the artificial urinary sphincter: yapayurinersfinkter.com →

Frequently asked questions

Can the device be seen from the outside?
No. It is placed entirely inside the body and cannot be noticed under clothing.
Can it be used straight after surgery?
No. The tissues need time to heal; the device is usually activated at the practice after 4–6 weeks.
Is it a permanent solution?
It is designed to be used for many years. Even so, check-ups, maintenance or further surgery may be needed over time.
How long does artificial urinary sphincter surgery take?
It usually takes 1–2 hours. The time can vary from person to person and with the findings during surgery.
Can I have an MRI scan after an artificial urinary sphincter has been fitted?
Many devices are MRI-compatible under certain conditions, but this depends on the model. Before the scan, you need to share the device details with the MRI team.
Can a catheter be inserted while I have an artificial urinary sphincter?
Inserting a catheter while the cuff is keeping the urethra closed can damage both the urethra and the device. Always say that you have the device before a catheter or any procedure on the urinary tract; the cuff must be opened or the device deactivated beforehand.

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