Artificial Urinary Sphincter
The artificial urinary sphincter (AUS) is a device designed to help patients with urinary incontinence. This device is used specifically for patients with stress incontinence who do not respond to conservative treatments. Stress incontinence is defined as the loss of urine during activities such as coughing, sneezing, laughing, or lifting heavy objects that increase intra-abdominal pressure. The artificial urinary sphincter surrounds the bladder neck and urethra, providing tightness in this area and thus preventing uncontrolled urine flow.
How Does the Artificial Urinary Sphincter Work?
The artificial urinary sphincter consists of three main components:
- Cuff: A ring-shaped component that surrounds and compresses the urethra, stopping the flow of urine.
- Reservoir: A fluid-filled component that is placed in the abdomen. The tightening and loosening of the cuff is achieved by the movement of fluid in this reservoir.
- Pump: The component located in the scrotum (for men) or labia (for women) that allows the patient to control the cuff. When patients want to urinate, they squeeze the pump to loosen the cuff and empty the bladder.
Which Patients Is It Applied To?
Artificial urinary sphincter is usually applied in the following cases:
- After Prostate Surgery in Men:Men who experience stress incontinence, a common complication after radical prostatectomy for prostate cancer treatment.
- Neurogenic Bladder:People who experience loss of bladder control due to neurological conditions such as spinal cord injury or multiple sclerosis patients.
- Urethral Sphincter Insufficiency in Women: Conditions in which the urethral sphincter becomes insufficient after childbirth, pelvic surgery or radiotherapy in women.
What is the Success Rate?
The success rate of artificial urinary sphincter is quite high. In clinical studies, 70-90% of patients who received AUS achieved significant improvement and urinary control. The success rate may vary depending on the patient's general health status, surgical experience and correct placement of the device. Most patients can return to their daily activities and experience a significant increase in their quality of life after AUS implantation.
What are the Complications?
As with any surgical procedure, there are certain risks and complications associated with artificial urinary sphincter implantation:
- Infection: Infection may develop during or after device placement. Antibiotic treatment is administered before and after surgery to reduce the risk of infection.
- Erosion: Erosion of the cuff into the urethra or skin may require removal of the device.
- Mechanical Failure: A mechanical failure may occur in the components of the device. In this case, the device may need to be repaired or replaced.
- Urethral Atrophy: The urethra may become thin and weakened due to the constant compression of the cuff. This may require readjustment or replacement of the device.
- Pain and Discomfort: Some patients may experience pain and discomfort in the area where the device is placed. This usually subsides over time, but if it persists, a doctor's intervention may be necessary.
- Bladder or Urethra Damage:Damage to the bladder or urethra may occur during the placement of the device. This varies depending on the surgeon's experience and care.
Postoperative Care and Follow-up
There are some important points that patients should pay attention to after artificial urinary sphincter implantation:
- Hydration:Adequate fluid intake should be ensured after surgery. Drinking plenty of water helps prevent urinary tract infections.
- Medication Use: Antibiotics and painkillers recommended by the doctor should be used regularly.
- Physical Activity:In the early postoperative period, heavy physical activity should be avoided. It is important to rest for a certain period of time for the device to settle completely and for the healing process to be completed.
- Regular Check-ups: The surgeon schedules regular follow-up appointments to check the functionality of the device and the patient's general condition. These check-ups are important for early detection of complications and intervention when necessary.
- Hygiene:Especial attention should be paid to the hygiene of the area where the pump is placed. It is important to keep the area clean and dry to reduce the risk of infection.
Artificial urinary sphincter is an effective and reliable treatment option for patients with stress incontinence. The success rate is quite high with the right patient selection, surgical technique and postoperative care. Although there are some risks and complications, these risks can generally be managed and the vast majority of patients experience a significant recovery and increase in quality of life after surgery. Patients considering implantation of an artificial urinary sphincter are advised to consult with an experienced urologist for detailed information about the benefits and risks of this procedure.
Patient Questions and Answers
Question: What is an artificial urinary sphincter (AUS) and how does it work?
Answer: An artificial urinary sphincter is a device used to treat urinary incontinence. It consists of a cuff that surrounds the urethra and prevents uncontrolled urine flow, a fluid-filled reservoir, and a manually controlled pump. When patients want to urinate, they can squeeze the pump to loosen the cuff and empty their bladder.
Question: Who can have AUS surgery?
Answer: AUS surgery is generally suitable for men who have urinary incontinence after prostate surgery, patients who have incontinence due to neurogenic bladder, and women with urethral sphincter insufficiency.
Question: Will I feel pain during AUS surgery?
Answer: The surgery is usually performed under general or spinal anesthesia, so you will not feel pain during the procedure. There may be mild pain or discomfort after the surgery, but this can be controlled with painkillers.
Question: How long will I need to stay in the hospital after AUS surgery?
Answer: Most patients stay in the hospital for 1-2 days after AUS surgery. This period may vary depending on the complexity of the surgery and the patient's general health.
Question: How long does it take to recover after AUS surgery?
Answer: The recovery period varies from person to person, but patients can generally return to their normal activities within 4-6 weeks. It is recommended to avoid strenuous physical activities during this period.
Question: Will urinary incontinence completely stop after AUS surgery?
Answer: The vast majority of patients experience a significant improvement in urinary control after AUS surgery. However, some patients may continue to have minimal incontinence. The success of the surgery depends on the patient's condition and the correct placement of the device.
Question: What is the risk of infection after AUS device placement?
Answer: As with any surgical procedure, there is a risk of infection after AUS placement. This risk can be reduced by administering antibiotic treatment before and after surgery. If signs of infection are noticed, a doctor should be consulted immediately.
Question: How will I control my normal urination function after the AUS device is inserted?
Answer: The AUS device is controlled by a pump located in the scrotum (for men) or labia (for women) when you want to urinate. By squeezing the pump, you loosen the cuff and allow the bladder to empty. The cuff automatically tightens after urination, preventing urinary incontinence.
Question: How will my sexual life be affected after the AUS device is inserted?
Answer: The AUS device generally does not affect sexual function. However, some patients may initially experience discomfort during sexual activity due to sensitivity or discomfort in the area where the device is inserted. This usually improves over time. If any problems occur, it is important to consult your doctor.
These questions and answers can help patients learn more about artificial urinary sphincter treatment. It is always important to consult a specialist for more detailed and personalized information.