What Is an Artificial Urinary Sphincter?
Your urinary sphincter is a muscle that controls the urine flow from your bladder. An artificial urinary sphincter (AUS) is a device that includes:
- a fluid-filled cuff that wraps around your urethra (tube that carries urine out of your body),
- a pump in your scrotum (pouch-like sac of skin that holds your testicles), and
- a balloon in the abdomen.
The fluid inside the cuff helps keep any urine from leaking out. The cuff will remain closed and filled with fluid until you need to urinate.
How AUS Works
To open the cuff for urination, you will squeeze your scrotal pump. This will temporarily move the fluid from the cuff into the balloon in your abdomen. It will take three minutes or less for the fluid to move from the balloon back into the cuff and close after you've finished urinating.
Artificial Urinary Sphincter Success Rate
Most studies show that patient satisfaction rates are well above 90 percent. Many patients describe it as life-changing.
What to Expect at Your First Consultation
You will meet with a urologist who will determine if you are a suitable candidate for this procedure. During your consultation, we will use a small camera to look inside your bladder (cystoscopy) and run urine flow tests. If you have complex incontinence issues, we may need to run more tests to be sure that this is the right treatment for your problem.
Why Choose University of Utah Health?
Our urologic surgeons have specialized training and years of experience performing artificial urinary sphincter procedures. Our team of providers will give you the satisfactory results you need to improve your quality of life and get your urinary health back on track.
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How to Prepare for Surgery
Before you undergo surgery, we must make sure that your lab results, including your urine cultures, come back normal. If there are abnormalities or something from your medical history that potentially compromises your ability to receive anesthesia, you may need to visit your primary care provider or another specialist (such as a cardiologist or anesthesiologist) first. This is to ensure that your health is optimized for the best possible outcome.
If you’ve been cleared for surgery, you will need to shower with antibiotic soap for several days before your operation. This will be provided for you at our clinic.
Artificial Urinary Sphincter Operation
The procedure will be performed in an operating room, either in the hospital or at a surgery center. Your urologic surgeon will insert the device in one of two ways:
- a tiny incision (cut) on the upper part of your scrotum or
- two incisions (one between your scrotum and anus and one in the groin or abdomen).
This is typically an outpatient procedure but may include an overnight hospital stay. If done as outpatient, you will need to return to the clinic the next day to have your bandages removed.
Artificial Urinary Sphincter Surgery Cost
Most insurances companies, including Medicare, will cover both the artificial urinary sphincter and surgery. If you don’t have health insurance, we have financial coordinators who will work with you on costs and a payment plan.
How Long Does an Artificial Urinary Sphincter Last?
Artificial urinary sphincters (AUS) usually last seven to 10 years—some more than 20 years. However, your device will eventually need to be replaced. When an AUS fails, additional surgery will be needed to replace the device (similar to the original surgery). The device may need to be replaced in a different location if your urethra thinned under the cuff over time.
Artificial Urinary Sphincter Risks
As with any surgical procedure, there are potential risks. The most significant is infection. Infection rates with implants are quite low—around one percent. There are, however, certain conditions or events that do increase your risk of infection:
- spinal cord injury,
- diabetes (especially if your blood sugar levels are consistently high),
- chronic use of steroids such as prednisone, or
- undergoing a re-do surgery or in the setting of extensive scarring.
One of the great medical advances of artificial urinary sphincters is the use of a coating that holds in antibiotics to prevent bacteria from getting on the device. Our urologic surgeons use many meticulous techniques before and during surgery to minimize a patient's risks of infection as much as possible.
Things to Keep In Mind
It's important to tell your other health care providers that you have an artificial urinary sphincter. Implants are safe for getting an MRI, if needed. However, if you’re having a dental procedure, you’ll likely need additional antibiotics. Or if you need a urinary catheter, a urologist or experienced physician will need to deactivate the cuff to prevent any damage.
Real Sports Live
Ben McCormick, MD, talks with Nicea DeGering about artificial urinary sphincter treatment for men.