An artificial sphincter is a device that can be surgically implanted in men or women who suffer from persistent, severe incontinence issues. When a person's biological urinary sphincter is weakened or damaged, it is impossible to control urination. When less invasive treatments are unsuccessful, a surgeon can wrap an artificial sphincter over the weak area. The cuff is inflated with a pump controlled by the patient to tighten and relax the urethra. The procedure has a high success rate and it can greatly improve a person's quality of life.
Before considering artificial sphincter surgery, doctors usually try to treat incontinence with medications and muscle strengthening exercises. Women are more likely to need the procedure than men, especially if they are older than 50 and have had multiple pregnancies. A man's urinary sphincter can be weakened following a serious injury or prostate surgery.
When the procedure is needed, a patient is admitted to an inpatient hospital and usually placed under general anesthesia. Some surgeons and patients prefer to use a localize anesthetic that is injected into the lower spine to numb the legs and pelvis. With the area numb, a small incision is made in the lower abdomen, labia, or scrotum to give the surgeon access to the urethra. A round inflatable tube called a cuff is wrapped around the sphincter and a water-filled balloon is situated under the lower abdominal muscles.
Flexible, hollow tubes run from the balloon and the cuff to a control pump. The pump is implanted just underneath the skin in the labia or the scrotum. With all pieces of the artificial sphincter in place, the surgeon sutures the incision and takes the patient to a recovery room for careful monitoring. In most cases, patients need to stay in the hospital for several days and use catheters to give their bodies time to heal.
When a doctor decides that the urethra is sufficiently healed, he or she can explain how the artificial sphincter works. When the cuff is inflated, it squeezes the urethra shut and keeps urine trapped in the bladder. In order to void the bladder, a patient squeezes the pump in the labia or scrotum. Fluid drains from the cuff to the balloon to relax the urethra and allow urine to escape. The cuff automatically inflates again after about three minutes.
Even with an artificial sphincter, some leakage may still occur. Most patients, however, are greatly pleased with the improvement of their symptoms. Following the surgery, regular visits with a urologist or gynecologist are important to make sure that the sphincter continues to work properly.