Artificial urinary sphincter for stress incontinence in men

This is a treatment for:

An artificial urinary sphincter is a mechanical device, which replaces the function of a deficient biological sphincter. The AUS is very effective for patients with severe stress incontinence whose previous treatments have failed.

What is it and how does it work?

The AUS is made from a special type of silicone designed to ensure the body won’t react to or reject the material. It has three main parts: a cuff, a pump and a balloon, which are all connected by silicone tubing. The AUS cuff is inserted during an operation with full anaesthetic, through an incision made in the perineum – the space between the scotum and anus. A small incision in the groin, similar to that used for a hernia operation, is used to place the balloon in the abdomen.

The AUS cuff is filled with fluid and compresses the urethra keeping it shut. When it is time to urinate, the scrotal pump is used. This has a soft curved end, which can easily (and gently) be pressed to move the water from the cuff to the balloon, opening the urethra. After a few minutes the fluid returns from the balloon to the cuff, and the urethra once again becomes tightly closed. For the first six weeks after surgery, the AUS is switched “off”, allowing all swelling to settle. Six weeks after implantation, our doctors or nurse specialist will switch “on” the device.

Is this the right treatment for me?

The first AUS were fitted in 1972, although the devices used today are much improved with higher success rates. Studies show 73 to 96 per cent of patients achieve complete continence after an AUS is implanted. Although an AUS does involve a very significant change in the way you pass urine and your lifestyle overall, many patients who have been living with the debilitating effect of severe incontinence manage this change well and feel the advantages outweigh the disadvantages.