Artificial Urinary Sphincter Implant

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 Problems in Men

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.

What is a Urinary Sphincter?

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.

How is an Artificial Urinary Sphincter Placed?

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.


Who can get an Artificial Urinary Sphincter Implant?

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.

Which Cases are Unsuitable for this Operation?

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.

What is the Success Rate of AUS?

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%.

What are the Risks of AUS Implants?

Like all other surgeries, AUS surgery has certain risks. These risks are as follows:

  • Injury while placing the implant,
  • Various difficulties during bladder drainage,
  • Continuation of stress-type urinary incontinence,
  • Device-related infection problems,
  • Device failure (old device must be replaced with a second surgery).

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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Artificial Urinary Sphincter Implant
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