An artificial urinary sphincter can help to control bladder flow.
If there aren’t any underlying issues, such as a urinary tract infection, bladder abnormalities, or kidney problems involved, a common cause of urinary incontinence (UI) is a weak or damaged urethral sphincter. When working properly, this muscle controls the flow of urine between the bladder and the urethra.
- A urologist usually makes an attempt to treat urinary sphincter problems with lifestyle changes, bladder control exercises, and medication.
- Should these efforts not improve urinary control for men, an artificial urinary sphincter (AUS) may be surgically inserted.
Enlarged Prostate, or BPH
Benign prostatic hyperplasia (BPH) is simply an enlarged prostate gland. As a man ages, his prostate will go through two phases of growth. The first phase occurs during puberty, and the prostate will double in size during this time. The second growth phase begins in the mid-twenties, continuing during his adult life. Your prostate gland may grow larger as you grow older. BPH tends to develop during the second phase of growth.
When your prostate gland grows larger, it may put pressure on your urethra. The wall of your bladder may also become thicker. At some point, your bladder may weaken to the point that it is unable to empty completely. BPH is not a cancerous condition and will not cause or lead to cancer. However, cancer and BPH can occur simultaneously.
How Does an Artificial Urinary Sphincter Work?
Surgically inserted where the bladder and urethra meet, an artificial urinary sphincter is a silicone rubber device designed to prevent involuntary urine leakage. A fluid-filled ring placed around the bladder neck keeps the artificial sphincter shut until urination is necessary. The device’s urethral cuff is inflated with a pump that’s surgically inserted in the scrotum to keep urine from getting out of the bladder. A balloon located in the pelvic area is deflated when the user needs to urinate. The AUS is controlled with a valve inserted under the skin.
Who May Benefit from This Device?
The insertion of an artificial urinary sphincter may be discussed with men who have tried other methods to control UI without success. It’s also common for men to experience UI issues following prostate surgery that includes partial or complete removal. An AUS can also become an option when urinary incontinence symptoms are seriously affecting quality of life.
What Happens During Surgery?
Following an initial evaluation and tests to rule out other possible sources of UI, an artificial urinary sphincter is inserted during a procedure performed under spinal or general anesthesia. During the procedure, one incision is made in the scrotum to insert the pump. In order to insert the balloon and artificial sphincter, another small incision is made in the lower part of the abdomen. A catheter is also inserted during surgery for urinary drainage. It’s usually removed shortly after the device is activated. The entire procedure usually takes a few hours to complete.
How Is an AUS Activated?
An artificial urinary sphincter is usually activated following an initial healing period. When first using an AUS, it can be helpful for men to manually pull the pump down to the lower part of the scrotum. Doing so can keep the pump from slipping out of place. Some men experience slight leakage problems, although urinary control usually improves shortly after the AUS is activated during a follow-up visit with a urologist. Activation usually takes place 1-2 months after surgery.
Risks associated with an artificial urinary sphincter are generally considered minimal. If there are any issues with the AUS after it’s inserted, the device can be removed with a revision procedure. Should this be the case, a urologist may suggest alternative treatments such as biofeedback, the placement of an electric stimulator under the skin to calm bladder spasms, or urethral bulking with collagen injections.