Inflatable artificial sphincter
Sphincters are muscles that allow your body to hold in urine. An inflatable artificial (man-made) sphincter is a medical device. This device keeps urine from leaking. It is used when your urinary sphincter no longer works well. When you need to urinate, the cuff of the artificial sphincter can be relaxed. This allows urine to flow out.
Other procedures to treat urine leakage and incontinence include:
Artificial sphincter (AUS) - urinary
This procedure may be done while you are under:
An artificial sphincter has 3 parts:
A surgical cut will be made in one of these areas so that the cuff can be put in place:
The pump can be placed in a man's scrotum. It can also be placed underneath the skin in a woman's lower belly or leg.
Once the artificial sphincter is in place, you will use the pump to empty (deflate) 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
Man-made sphincter surgery is done to treat stress incontinence. Stress incontinence is a leakage of urine. This occurs with activities such as walking, lifting, exercising, or even coughing or sneezing.
The procedure is recommended for men who have urine leakage. Leakage can occur after prostate surgery. The man-made sphincter is advised when other treatments do not work.
Women who have urine leakage most often try other treatment options before having an artificial sphincter placed.
Most of the time, your health care provider will recommend drugs and bladder retraining before surgery.
This procedure is most often safe. Ask your provider about the possible complications.
Risks related to anesthesia and surgery in general are:
Risks for this surgery may include:
Before the Procedure
Always tell your provider what medicines you are taking. Also let the provider know about the over-the-counter medicines, herbs and supplements that you bought without a prescription.
During the days before the surgery:
On the day of your surgery:
Your provider will test your urine. This will make sure you do not have a urinary infection before starting your surgery.
After the Procedure
You may return from surgery with a catheter in place. This catheter will drain urine from your bladder for a little while. It will be removed before you leave the hospital.
You will not use the artificial sphincter for a while after surgery. This means you will still have urine leakage. Your body tissues need this time to heal.
About 6 weeks after surgery, you will be taught how to use your pump to inflate your artificial sphincter.
You will need to carry a wallet card or wear medical identification. This tells providers you have a man-made sphincter. The sphincter must be turned off if you need to have a urinary catheter placed.
Women may need to change how they do some activities (such as bicycle riding), since the pump is placed in the labia.
Urinary leakage decreases for many people who have this procedure. However, there may still be some leakage. Over time, some or all of the leakage may come back.
There may be a slow wearing away of the urethra tissue under the cuff. This tissue may become spongy. This may make the device less effective. If your incontinence comes back, changes may be made to the device to correct it.
Adams MC, Joseph DB, Thomas JC. Urinary tract reconstruction in children. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 145.
American Urological Association website. What is stress urinary incontinence (SUI)? www.urologyhealth.org/urologic-conditions/stress-urinary-incontinence-(sui)/printable-version. Accessed July 6, 2018.
Chapple CR. Retropubic suspension surgery for incontinence in women. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 82.
Wessells H, Peterson A. Surgical procedures for sphincteric incontinence in the male: the artificial urinary sphincter and perineal sling procedures. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 91.
Review Date: 5/31/2018
Reviewed By: Sovrin M. Shah, MD, Assistant Professor, Department of Urology, The Icahn School of Medicine at Mount Sinai, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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