Introduction
An Artificial Urinary Sphincter is a device for men who have urinary incontinence. It takes the place of the damaged sphincter to restore control of the flow of urine. It is a fluid filled device that opens and closes the urethra to give you control of your bladder.
The device consists of a cuff, a pump and a reservoir balloon. The cuff is placed around the urethra (water pipe). The pump is put in the scrotum. This pump is the part the patient squeezes to activate and deactivate the device. The reservoir balloon is placed in the lower abdomen and is filled with a sterile saline solution. This inflates the cuff, preventing urine from flowing and deflates the cuff allowing the urine to flow.
Outcome
We expect 75-90% of men to be continent, requiring only a “security pad”.
About 10-15% of men will get improvement but with some persistent leakage.
When To Use
- Post-prostatectomy incontinence
- Severe SUI
- Intrinsic sphincter deficiency
- Neuropathic bladders
- Congenital anomalies
- Failed procedures
Cuff Inflated
Cuff Deflated
AMS 800
Complications
Infection
- Possible complications
- This happens in less than 1% of patients and requires removal of the AUS device.
Malfunction
- This is uncommon early. 50% of AUS lose function well over 10 years after implantation.
- If malfunction occurs it leads to recurrent incontinence. Surgery is usually required to fix it.
Persistent leakage
- About 10% of men need to wear more than 1 pad/day.
Retention
- Retention (inability to pass urine) is very uncommon
Mid-urethral Sling
Urethral sling surgery, also called mid-urethral sling surgery, is done to treat urinary incontinence. A sling is placed around the urethra to lift it back into a normal position and to exert pressure on the urethra to aid urine retention.
Indication
Female Stress urinary incontinence
Complication
- Voiding dysfunction
- Overactive bladder
- Recurrent UTI
- Dyspareunia
- Chronic pelvic pain
