Artificial Urinary Sphincter
The artificial urinary sphincter (AUS) is the gold standard treatment for male stress urinary incontinence. It is a safe procedure and has excellent long term results.
How does the AUS work?
There are three parts to the AUS device. An inflatable cuff that encircles and compresses the waterpipe (urethra), a balloon filled with water under pressure which keeps the cuff full and a control pump which sits in the scrotum. The compressive cuff keeps the urethra closed and stops urine leaking out. When you feel the need to empty your bladder you simply squeeze the scrotal control pump once. This empties the fluid out of the cuff and the pressure on the urethra is released. You then urinate normally. The pressure ballon will refill the cuff spontaneously after you have finished.
How is the AUS implanted?
Through a small incision just behind the scrotum the cuff is wrapped around the waterpipe. A second small incision is made in the groin through which the pressure balloon and the control pump are fitted. The artificial sphincter is implanted deactivated allowing the tissues around the urethra to heal. A catheter is placed which is removed two days after the operation. On this day you can go home and return to non-strenuous activities. Six weeks after surgery the device is activated and you should regain continence.
Who is the AUS best for?
The artificial sphincter is the gold standard treatment for men with stress urinary incontinence especially after prostate surgery. It is particularly useful in men who leak a large volume of urine (<300ml/24h). Men who have had radiotherapy may also have an artificial sphincter implanted -patient satisfaction remains very high.
What are the risks of AUS implantation?
Mechanical failure - Continuous refinement of the technology has resulted in a device that is highly reliable. Only 4% of patients will have to have a revision procedure because of malfunction.
Infection - As any implanted device can become infected we take great care to minimise this occurence. The device has a special antibiotic coating which has reduced the infection risk to 3%.
How effective is the AUS?
Over 90 percent of men who have an artificial sphincter implanted will be satisfied with the outcome. The majority of men will not need to use incontinence pads any more.