Urinary incontinence, also referred to as urinary leakage, might occur in men when the ureteral sphincter muscle responsible for urinary continence, contraction, and relaxation is damaged and/or weakened.
Urinary incontinence is more common in women, but it can occur in men for various reasons. If medications or alternative treatment methods fail to yield successful results, artificial urinary sphincter (AUS) surgery can be performed for mild or severe urinary incontinence, which significantly decreases quality of life. AUS implants, which have been used to treat urinary incontinence for more than 40 years with effective results, have been accepted as a safe method.
Urinary incontinence, also referred to as urinary leakage, might occur in men when the ureteral sphincter muscle responsible for urinary continence, contraction, and relaxation is damaged and/or weakened. This problem is more common among men over 50 years of age. Urinary incontinence problems might occur when the enlarged prostate is not treated on time or when the patient has undergone prostate cancer treatments.
An AUS, also known as the urinary sphincter, is a prosthetic device used to treat mild or severe stress-type urinary incontinence in men. The AUS is implanted with surgical methods and acts as an artificial muscle in place of the damaged natural sphincter muscle. The urinary flow of patients can be controlled after the sphincter is implanted.
The AUS device has three components. The first component is the pump that controls the device, which is placed inside the scrotum (the baggy structure holding the testicles). The second component, called the sleeve, wraps around the urethra and is filled with an isotonic fluid. The third component is the reservoir that holds the isotonic fluid.
AUS surgery is performed under spinal or general anesthesia. The sphincter is placed to wrap the urethra through surgical intervention. The reservoir is placed inside the abdomen, and the pump is placed inside the scrotum. Then, incisions are sutured with surgical sutures. Two different incisions are performed in this surgery. This traditional method has been applied for more than 40 years. A perineal incision is made from the groin. Additionally, the third component (reservoir) of the device is placed in the Retzius space with a second incision. The second incision is made between the connection of the penis and the testicles and is called the penoscrotal incision. It is possible to complete the entire operation with these incisions. The penoscrotal incision method is preferred because it does not leave any scars.
Patients who experience severe and/or mild urinary incontinence that decreases their quality of life or patients with severe sphincter muscle damage can undergo AUS implantation surgery. The main reason for stress-type urinary incontinence in men is prostate surgery. Therefore, the most common cases that require AUS treatment are postprostatectomy incontinence cases.
If patients experience detrusor overactivity due to spinal damage or bladder symptoms that cause reflux, these symptoms must be treated first. An AUS can be implanted after these disorders are treated.
Studies have shown that AUS surgery has long-term success. In particular, the selected patient group with severe urinary inconsistence reported an improved quality of life. There are prospective mechanical problem risks for some patients with urinary sphincter implants, but the success rate is above 80%.
Like all other surgeries, AUS surgery has certain risks. These risks are as follows:
If the procedure is properly performed by an expert surgeon with an experienced team and in a fully equipped operating theatre, the risk will be kept at a minimum level.
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Dr. Yaşar Başağa, MD, FEBUUrologist and Andrologist in Istanbul
Dr. Yaşar Başağa, MD, FEBU
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My treatment process was very good, ı hope it would be continued like that
28.02.2023I very well welcomed in Dr. Yaşar’s Clinic and my treatment proces was very good. I especially liked Mr. Furkan’s aproach to the patients he was favor. Everyone can be treated at this clinic wi
28.02.2023I am very pleased with your customer welcome, interest, and hospitality. Special thanks to Mr. Onur. The surgery was well. I hope I would be satisfied in the future. Thank you very much to all
28.02.2023I would like to thanks to Dr. Yasar and his team. They took care very friendly from beginning of the surgery to end of operation. The interest of the team before and after the surgery process w
10.02.2023The entire team was very dedicated, polite, pleasant, and well-organized. In the future, I'll definitely recommend it to my friends and family. I appreciate everything you did.
10.01.2023