Figure 1: Urinary sphincter
This information describes an artificial urinary sphincter (AUS) and the surgery to have it placed.
What is the urinary sphincter?
The urinary sphincter is a muscle. When you relax it, urine leaves your bladder and flows through your urethra and out of your body (see Figure 1). When you contract your urinary sphincter, it closes and urine stays in your bladder without leaking until you choose to urinate.
What is an artifical urinary sphincter?
Figure 2: Artificial urinary sphincter (AUS)
An artifical urinary sphinter (AUS) is a device that works like a natural urinaryl sphincter (see Figure 2). You may need an AUS if you lose control of your urinary sphincter. This can happen after surgery to remove the prostate. An AUS is placed during a surgery.
An AUS is made up of 3 parts: a urethral cuff, a pump, and a balloon.
To urinate with an AUS, you must squeeze the pump that is placed in your scrotum. The pump moves your urine from the urethral cuff into the balloon and opens your urethra. Your urethra stays open for 3 minutes so that you can urinate. Then, it will close automatically.
Are there risks associated with having an AUS?
Although not common, the following complications can occur:
- Infection, which can require that the AUS be taken out
- Problems with any part of the AUS, which can require surgery to take it out or replace it
- Injury to the urethra
- Ongoing leakage of urine
- Long-term or permanent problems urinating
- You may have to insert a catheter into your bladder to drain your urine.
- You may also need to have another surgery to fix the problem.
- The inability to hold urine until you reach a toilet
- The AUS can wear out over time and will need to be removed
What happens during surgery?
While you are asleep, your surgeon will make 2 small incisions (surgical cuts) in your lower body. The first will be in the space between your scrotum and rectum and the second will be near your lower abdomen (belly). Your surgeon will then place your AUS. Once the surgery is done, your incisions will be closed with stitches that will dissolve on their own and will not need to be removed.
What can I expect after surgery?
You will wake up in the Post Anesthesia Care Unit (PACU). Once your healthcare providers feel you are ready, family and friends can visit you.
You will have tubes, drains, catheters, and other medical devices in place after your surgery, including:
- A urinary (Foley®) catheter that will drain urine from your bladder. It will be removed 1 to 2 days after your surgery.
- An intravenous (IV) line to give you:
- Pain medication
- Other medication as needed
- Inflatable boots on your legs, which help circulate blood through your legs and prevent blood clots.
These devices are usually removed before you leave the hospital. If you will leave the hospital with any of them in place, your nurse will teach you how to care for them.
You will be able to go home the day after your surgery.
Order MedicAlert® Jewelry
Before you leave the hospital, order a MedicAlert® bracelet or necklace. Your nurse will give you an order form. Your bracelet or necklace should state the following information:
AUS: Artificial Urinary Sphincter
Brand: AMS 800
You may be given prescriptions for the following medications before you go home:
- An antibiotic
- Pain medication
- A stool softener to prevent constipation (not being able to have a bowel movement)
When can I shower?
You can shower 48 hours after your surgery.
When can I remove my bandages?
If you have any bandages, remove them when you shower. You do not need to put more bandages on your incisions after you shower.
If your bandages fall off or get soiled in the first 48 hours after your surgery, replace them with clean bandages.
How does the pump in my AUS stay in place?
To keep the pump from shifting, your surgeon may show you how to pull your AUS down into the lowest part of your scrotum. If instructed, you will need to do this daily for 14 days after your surgery.
Do I have to wear anything to protect my AUS?
For the first week after your surgery, you must wear the scrotal support that you were given before you left the hospital. You can buy another scrotal support at any drug or surgical supply store.
My urine is leaking. Is that normal?
Your urine may leak from your AUS after your surgery. This is normal and will stop once the AUS has been activated by your doctor.
When will my AUS start to work?
You will see your doctor 6 to 8 weeks after your surgery. At this time, your AUS will be activated and start to work. Call your doctor's office to make the appointment.
When can I go back to doing my normal activities?
You can go back to doing most of your normal activities the day after your surgery. However, you should wait 4 to 6 weeks to do any strenuous activities. Strenuous activities include:
- Working out at the gym
- Playing golf
- Riding a bicycle
- Lifting objects heavier than 10 pounds
When can I resume sexual activity?
Your doctor will tell you when you can resume sexual activity.
When should I see my doctor?
You should see your doctor 14 days after your surgery. Call your doctor's office to make the appointment.
Call Your Doctor or Nurse if You Have:
- A temperature of 101° F (38.3° C) or higher
- Increased bleeding or swelling
- Pain that is not relieved by your pain medication
- Severe bladder spasms
- An inability to urinate