The Artificial Urinary Sphincter is a completely concealed, implantable, fluid-filled, solid silicone elastomer device that treats male SUI (stress urinary incontinence) resulting from intrinsic sphincter deficiency following prostate surgery. It mimics normal sphincter function by opening and closing the urethra at the control of the patient.
The Artificial Urinary Sphincter (AUS) is a three-part urinary control system contained completely in the body:
- The control pump is implanted in the scrotum
- The inflatable cuff is placed around the urethra
- The saline-filled balloon (PRB) is usually implanted in a natural open space next to the bladder
How it Works
The AUS simulates normal sphincter function by opening and closing the urethra, under patient control. When the cuff is closed, urine stays in the bladder. When the patient has a desire to void, they will then pump the control pump. This allows the cuff component to open.
The AUS working mechanism:
The AUS is filled with fluid and uses the fluid to open and close the cuff surrounding the urethra. To urinate, the patient
needs to squeeze and release the pump in the scrotum several times to remove fluid from the cuff and send it to the balloon. When the cuff is empty, urine can flow out of the bladder. The cuff automatically refills with fluid after a few minutes. Once the cuff is filled, it gently squeezes the urethra closed to prevent leakage.
What to Expect with the Placement of an Artificial Urinary Sphincter
Outpatient procedure:
- Small incisions, approximately 2-4 cm
- A few days to return to non-strenuous activities
- Urologists generally advise waiting 4 to 6 weeks before activating and using the implant to ensure full healing
Life with the Artificial Urinary Sphincter – Patient Satisfaction
- 94.6% of patients are satisfied with their device
- 94% of patients would recommend the device to a friend or family member
- ≈90% of the patients would have the surgery again
Established Outcomes
- Designed in 1973
- Over 50 years of clinical use, with over 250,000 systems sold worldwide
- Dry or improved rates were computed as 79%, ranging from 61% to 100%
- Overall device survival was 72% at 5 years, 56% at 10 years, 41% at 15 years, and
33% at 20 years
Future Developments
Electronic Artificial Urinary Sphincter