Artificial urinary sphincter
This is a three-piece device that is implanted into men to control urinary leakage. In rare instances, we have also implanted these devices into women with severe, intractable urinary incontinence. The first part is the cuff that encircles the bulbar urethra (or bladder neck). The cuff applies pressure to the urethra and reforms the valve that prevents leakage. The second part is the pump. The pump is positioned in the outer scrotum and controls the entire system. The pump is deactivated at the time of surgery.
The final part is the balloon reservoir that is placed into the lower abdominal wall. Fluid from the balloon filters through the pump, which then allows the fluid to travel to the cuff. At rest or in the passive state, the cuff remains full, the urethra is compressed and there is little or no leakage. When the bladder is full and it is time to pee, the patient squeezes the pump, and fluid is transferred out of the cuff and into the balloon.
With the channel now open, the bladder can contract and empty in a very normal way. These patients also undergo the three-day prep before surgery mentioned above for penile implants. This is an ingenious device that has stood the test of time (over 40 years) and is a highly effective way to treat male urinary incontinence after prostate surgery, radiation therapy or other urethral trauma.