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Alternative Names Return to topArtificial sphincter (AUS) - urinary
Definition Return to top
Sphincters are muscles that allow your body to hold in urine. An inflatable artificial (human-made) sphincter is a medical device that keeps urine from leaking when your sphincter no longer works well. When you need to urinate, the cuff of the artificial sphincter can be relaxed so urine can flow out.
Description Return to top
You will have either general anesthesia or spinal anesthesia before the procedure. With general anesthesia, you will be unconscious and will not feel pain. With spinal anesthesia, you will be awake but numb from the waist down, and you will not feel pain.
An artificial sphincter has 3 parts:
An incision (cut) will be made in 1 of these areas so that the cuff can be put in place:
Once the artificial sphincter is in place, you will use the pump to deflate (empty) and inflate (fill up) the cuff. Squeezing the pump moves fluid from the cuff to the balloon. When the cuff is empty, your urethra opens so that you can urinate. The cuff will re-inflate on its own in 90 seconds.
Why the Procedure is Performed Return to top
Artificial sphincter surgery is done to treat stress incontinence, a leakage of urine when you are physically active (walking, coughing, sneezing, laughing, lifting, or exercising). Men who have problems with urine leakage after prostate surgery have this procedure. Women usually first try other procedures to treat urine leakage before having an artificial sphincter placed.
Most of the time, your doctor will try drugs and bladder retraining before talking about surgery with you.
Risks Return to top
This procedure is generally safe. Ask your doctor about these possible complications.
Risks for any surgery are:
Risks for this surgery
Before the Procedure Return to top
Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription
During the days before the surgery:
On the day of your surgery:
Your doctor will test your urine make sure you do not have a urinary infection before starting your surgery.
After the Procedure Return to top
You may return from surgery with a Foley catheter (tube) in place. This catheter will drain urine from your bladder for a little while. It will be removed before you leave the hospital.
You will not be using the artificial sphincter for a while after surgery. This means you will still be incontinent. Your body tissues need this time to heal.
About 6 weeks after surgery, you will be taught how to use your pump to inflate your artificial sphincter.
You will need to carry a wallet card or wear medical identification that tells health care providers you have an artificial sphincter. The artificial sphincter must be turned off if you need to have a urinary catheter placed.
Women may need to change how they do some activities (such as bicycle riding), since the pump is placed in the labia.
Outlook (Prognosis) Return to top
Urinary leakage decreases for many people who have this procedure. But you may still have some leakage. Over time, some or all of the leakage may come back.
There may be a slow erosion (wearing away) of the urethral tissue under the cuff, and this tissue may become spongy. This may make the device less effective.
A new artificial sphincter can help control leakage.
References Return to top
Staskin DR, Comiter CV. Surgical treatment of male sphincteric urinary incontinence: the male perineal sling and artificial urinary sphincter. Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 74.Update Date: 1/13/2009 Updated by: Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.