OVERVIEW

The artificial urinary sphincter implant is the ultimate treatment for moderate or severe urinary incontinence after a radical prostatectomy in patients with prostate cancer.

The indications to place an artificial urinary sphincter are the following:

  • Urine leakage after a radical prostatectomy, which does not respond to oral treatment and affects the quality of life of the patient
  • Urine leakage from any other cause that does not respond to oral treatment

Benefits of the artificial urinary sphincter

The artificial urinary sphincter (AMS 800®) can diminish or eliminate the involuntary escape of urine from the patient who has moderate to severe incontinence, so an improvement in the quality of life is achieved.

The procedure is performed by a small incision behind the scrotum, through which an inflatable prosthesis is placed around the urethra, this prosthesis is shaped like a belt, which when inflated compresses the urethra and thus maintains the urinary continence.

The urinary sphincter remains inflated most of the time, when urinating deflates and allows the passage of urine, a few seconds later, the sphincter automatically inflates again and closes the urethra.

The mechanism of artificial urinary sphincter activation is found in the scrotum and is quite simple to use.

Risk and Complications

Possible complications that can occur during the artificial urinary sphincter implant are the same that can occur in general with any surgical procedure and are hemorrhage, damage to nearby organs, reactions to anesthesia, etc. However, these complications occur infrequently and most of the time they can be resolved during the same surgery.

Infection: it is the most serious complication of the implantation of the artificial urinary sphincter, since for its treatment it is required to remove the sphincter. Diabetic patients have more risk, so they must have strict glycemic control before performing surgery.

Severe incontinence: in some patients with severe incontinence, there may persist a slight escape of urine after placement of the artificial urinary sphincter, in these cases the placement of two sphincters is recommended to achieve a good result.

Alternatives to artificial urinary sphincter

Other treatments for urinary incontinence are:

  • Pills: when the incontinence is mild and does not affect the quality of life of the patient
  • Transobturator tape (AdVance®): when the incontinence is mild and affects the quality of life of the patient

What to expect from artificial urinary sphincter implantation?

Day of surgery:

The day of the operation will arrive in the morning to the hospital in fasting

The surgery lasts approximately 1-2 hours; however, this time is variable.

Anesthesia for this procedure is spinal block (in the back) and sedation, so you will not feel pain and will be relaxed during your procedure.

The pain after surgery is minimal and can be effectively controlled with intravenous analgesics.

Food: on the day of surgery you can eat in the afternoon, there are no food restrictions, however, a balanced diet is recommended.

Physical activity: the day of surgery you can get up to walk in the afternoon. It is expected to feel a bit fatigued after any surgery, this problem resolves spontaneously within a few weeks after the procedure.

Hospital stay: most patients operated of artificial urinary sphincter implantation remain hospitalized for 1 day.

Wounds: to place an artificial urinary sphincter, an incision of 2.5 cm (one inch) is made in the lower part of the penis, once this wound heals, it is difficult to see it.

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