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Implantation of Artificial Urinary Sphincter

The implantation of an artificial urinary sphincter (AUS) is a highly specialised procedure designed to treat severe male urinary incontinence, typically in men who have lost control of their bladder due to prostate surgery or neurological conditions. The artificial sphincter is a small, fluid-filled device that mimics the function of a natural urinary sphincter, allowing patients to regain control over urination.

This procedure is commonly recommended when other treatments for incontinence, such as medication or pelvic floor exercises, have not been effective. The artificial urinary sphincter can greatly improve quality of life by providing patients with confidence and control over their bladder function.

Also known as: AUS implantation, Urinary sphincter implant

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Everything You Need to Know

An artificial urinary sphincter is a medical device that helps control urine flow by compressing the urethra until the patient is ready to urinate. This procedure, known as artificial urinary sphincter placement, is particularly beneficial for individuals who experience persistent urinary incontinence due to weakened or damaged sphincter muscles. It is commonly used to treat stress urinary incontinence, providing a reliable solution for managing this condition.

The key benefits of artificial urinary sphincter implantation include:

  • Restored Bladder Control: The device allows patients to control their urine flow, significantly reducing or eliminating leakage.
  • Improved Quality of Life: Regaining bladder control can greatly enhance self-confidence and independence in daily activities.
  • Long-Term Solution: The artificial sphincter is a durable and effective long-term solution for managing incontinence, with many patients experiencing years of relief.

The artificial urinary sphincter is particularly effective for patients who suffer from incontinence after prostate surgery or due to bladder dysfunction related to neurological conditions.

Before the Surgery

Consultation

Your first step will be a detailed consultation with a urology specialist. Intrinsic sphincter deficiency may be assessed during this session as a potential cause of your condition. During this session, your medical history, symptoms, and previous treatments for incontinence will be reviewed. You will be assessed to determine whether you are a suitable candidate for artificial urinary sphincter implantation, and the doctor will discuss the procedure in detail, including potential outcomes and risks.

Health Assessment

A full health assessment will be conducted prior to the surgery to ensure you are in good condition for the procedure. This includes evaluating the bladder neck for any strictures or conditions that may impact the surgery. This includes blood tests, a physical examination, and imaging studies if necessary. If you are taking any medications or have any existing health conditions, these will be reviewed to ensure the surgery can be carried out safely.

Pre-Procedure Instructions

In the lead-up to the surgery, you will be given specific pre-operative instructions, which may include:

  • Medication Adjustments: Your doctor will advise whether you need to stop taking any medications, such as blood thinners, in the days before surgery.
  • Fasting Instructions: You will be required to fast from midnight on the day of your surgery.
  • Lifestyle Adjustments: Stopping smoking and maintaining a healthy lifestyle can help improve your recovery following the procedure.

During the Surgery

Our skilled surgical team will perform the artificial urinary sphincter implantation using state-of-the-art techniques, ensuring a high standard of care throughout.

Anaesthesia

The procedure is typically performed under general or regional anaesthesia. General anaesthesia puts you to sleep during the surgery, while regional anaesthesia numbs the lower half of your body, allowing you to remain awake but comfortable.

Surgical Process

The surgery involves a specific surgical technique to place a small, inflatable cuff around the urethra to act as the artificial sphincter. An abdominal incision is used during the procedure to access the peritoneal cavity for the placement of the pump and other components.

Additionally, a bladder catheter is maintained during the surgery to ensure patient safety and effective results. This cuff is connected to a pump, which is implanted in the scrotum. The pump allows the patient to manually control the flow of urine by inflating or deflating the cuff. Once the cuff is inflated, it compresses the urethra to prevent urine leakage. When the patient needs to urinate, they simply squeeze the pump to release the cuff, allowing urine to pass.

The procedure usually takes 1 to 2 hours and is performed through small incisions, making it minimally invasive.

Monitoring and Recovery

After the surgery, you will be monitored in the recovery room to ensure there are no immediate complications. Device infection is a potential complication that will be closely monitored. Pain relief will be provided, and the nursing team will ensure that you are comfortable before transferring you to your hospital room for further observation. Mechanical failure is another potential complication that may require surgical revision or explantation.

After Surgery

Our commitment to your care continues after the surgery, with comprehensive post-operative care and support.

Immediate Post-Op Care

In the days following surgery, you may experience some discomfort or swelling in the groin area, but this is normal and will gradually subside. Urethral atrophy is a potential late complication that can occur when urinary incontinence recurs despite a functioning sphincter. You will be given pain relief to manage any discomfort. The artificial urinary sphincter will remain inactive for a few weeks to allow the area to heal properly. During this time, you will continue to use a catheter or pads to manage any leakage.

Follow-Up Care and Recovery

You will have a follow-up appointment several weeks after surgery to activate the artificial urinary sphincter. At this appointment, your doctor will demonstrate how to use the device and ensure that it is functioning correctly. Full recovery typically takes four to six weeks, and most patients can return to normal activities within this time. Ongoing follow-up appointments will ensure that the device remains effective and that no adjustments are needed.

Appointment and Treatment Plan

01

Initial Consultation

Your journey begins with an in-depth consultation with our urology specialists, who will assess your condition and determine if artificial urinary sphincter implantation is the best solution for you.

02

Personalised Treatment Plan

Based on your needs, a tailored treatment plan will be created, outlining the details of the procedure and what to expect during recovery.

03

Pre-Procedure Assessment

Before the surgery, a comprehensive assessment will be conducted to ensure you are fit for the procedure. This will include blood tests, imaging, and a review of any medications.

04

The Procedure

The surgical team will implant the artificial urinary sphincter using advanced techniques to ensure the best possible outcomes for bladder control.

05

Aftercare and Recovery

Following surgery, you will receive detailed aftercare instructions and attend follow-up appointments to monitor your recovery and ensure the device is functioning properly.
You will return to the outpatient clinic for activation of the AUS system a few weeks after surgery, which is a crucial step in ensuring the device functions properly and improves your condition.

Top Tips

  • Follow All Instructions: Adhere strictly to the aftercare guidelines provided by your doctor following urologic surgery to ensure a smooth recovery and avoid complications.
  • Rest and Recuperate: Allow time for the surgical site to heal by avoiding strenuous activities during your recovery period.
  • Monitor Your Health: Report any signs of infection or unusual discomfort to your doctor immediately to prevent complications.
  • Learn How to Use the Device: Familiarise yourself with the operation of the artificial sphincter as instructed by your doctor to ensure the best results.