Urinary Sphincter Surgery

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Who is suitable for AUS insertion?

What are the advantages of having an AUS?

Prior to surgery

How is AUS placement performed?

What to expect after AUS insertion?

Procedure outcomes

INTRODUCTION

The artificial urinary sphincter (AUS) is regarded as the gold standard treatment for the correction of stress urinary incontinence in men. It is a completely internal and concealed device that works in the same way as the body’s natural urinary sphincter, preventing the leakage of urine out of the body.

The AUS has a cuff that goes around the urethra, a pump in the scrotum and a small balloon in the abdomen. When the patient wishes to empty their bladder, the pump is activated to open the cuff up and allow the patient to urinate. After urination the sphincter cuff will slowly reinflate to prevent unwanted leakage of urine.

We understand that urinary incontinence can be an embarrassing and socially debilitating condition. We have a dedicated team who will provide an empathetic and considerate approach to your care.

Who is suitable for AUS insertion?

  • Men who have urinary incontinence due to previous prostate surgery
  • Those who have tried conservative treatments for their incontinence to no avail
  • Those who want to improve their quality of life to what it was before developing stress incontinence

What are the advantages of having an AUS?

  • Long-term solution for urinary incontinence with excellent success rates
  • Eliminates the need for lifelong use of continence aids
  • Restores quality of life and social confidence

Prior to surgery

  • Optimize diabetic control
  • Ensure no urinary infection
  • Commence chlorhexidine body wash 3 days prior
  • Commence oral antibiotics day prior to surgery

How is AUS placement performed?

  • This procedure is performed under general anaesthetic
  • A small incision is made in the skin between the scrotum and the anus (perineum), and possibly another small incision in the lower abdomen
  • The components of the AUS are installed through these incisions
  • Dissolvable stitches are used to close the incisions at the completion of the procedure

What to expect after AUS insertion?

  • There may be some swelling or bruising in the perineal area and scrotum
  • The device is ‘deactivated’ at the end of the surgery in order to allow your body to heal
  • The device is activated at around 6 weeks post-surgery to allow for healing and it is at this time-point that you should achieve continence
  • You will need to continue using your continence aids until this point
  • Light activities can usually be resumed the following day or as soon as you feel able. Complete recovery can take up to 6 weeks, in which time strenuous activity should be avoided

Procedure outcomes

  • Most studies show more than 90% satisfaction in patients that have had an AUS inserted
  • AUS devices are designed to last are 10 years before they require replacement, however some last longer

Written by Dr. Shekib Shahbaz and Dr. Tony de Sousa

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