Inflatable artificial sphincter Health Article

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Reviewer Info: Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.; ADAM Health Illustrated Encyclopedia, 01/13/2009
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Definition

Sphincters are muscles that allow your body to hold in urine. An inflatable artificial (human-made) sphincter is a medical device that keeps urine from leaking when your sphincter no longer works well. When you need to urinate, the cuff of the artificial sphincter can be relaxed so urine can flow out.

See also:

Alternative Names

Artificial sphincter (AUS) - urinary

Description

You will have either general anesthesia or spinal anesthesia before the procedure. With general anesthesia, you will be unconscious and will not feel pain. With spinal anesthesia, you will be awake but numb from the waist down, and you will not feel pain.

An artificial sphincter has 3 parts:

  • The cuff fits around your urethra (the tube that carries urine from your bladder to the outside). When it is inflated (full), the cuff closes off your urethra to stop urine flow or leakage.
  • The balloon is placed under your belly muscles. It holds the same liquid as the cuff.
  • The pump is placed in the scrotum (for men) or underneath the skin in the lower belly or leg (for women). The pump inflates the cuff.

An incision (cut) will be made in 1 of these areas so that the cuff can be put in place:

  • Scrotum (men)
  • Labia (women)
  • Lower belly (men and women)

Once the artificial sphincter is in place, you will use the pump to deflate (empty) and inflate (fill up) the cuff. Squeezing the pump moves fluid from the cuff to the balloon. When the cuff is empty, your urethra opens so that you can urinate. The cuff will re-inflate on its own in 90 seconds.

Why the Procedure Is Performed

Artificial sphincter surgery is done to treat stress incontinence, a leakage of urine when you are physically active (walking, coughing, sneezing, laughing, lifting, or exercising). Men who have problems with urine leakage after prostate surgery have this procedure. Women usually first try other procedures to treat urine leakage before having an artificial sphincter placed.

Most of the time, your doctor will try drugs and bladder retraining before talking about surgery with you.

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