What Is An Inflatable Artificial Sphincter?
Urinary incontinence (UI) is a
condition that occurs quite frequently in the general population. It's not
life-threatening, but UI can significantly impact your quality of life. UI that
is classified as “stress UI (SUI)” results when your sphincter muscles, which
retain urine, stop working properly. When this occurs, your doctor may implant
a device known as an artificial sphincter.
The inflatable artificial sphincter
helps keep urine from leaking from the bladder.
Why Is the Device Used?
The inflatable artificial sphincter is
used when a patient develops SUI. You'll know you have SUI if urine is leaking
from your bladder during normal activities such as walking, coughing, lifting
objects, or exercising. The procedure may be ordered for men following prostate
surgery to help them reduce incontinence, or lack of control over their bladder.
Implantation of the inflatable
artificial sphincter is usually the last resort for treatment of SUI. Patients
are typically first treated with medication and bladder-training to help with
incontinence. If these treatments fail, surgical intervention may be the next
Preparation for the Procedure
In order to prepare for implementation
of the artificial sphincter, your doctor may ask you to fast for six to 12
hours before your surgery. That means no food or liquids taken by mouth.
If you take medications for other
health conditions, talk about them with your doctor. They'll let you know
whether or not to take them before the procedure.
You’ll also need to complete a urine
test to make sure you don't have an infection before the procedure.
How Is the Inflatable Artificial Sphincter
The placement of the inflatable
artificial sphincter is a surgical procedure. You'll receive either general or
spinal anesthesia so that you won’t feel any pain while in surgery. If you're
under general anesthesia, you'll be unconscious. Spinal anesthesia numbs your
body from the waist down, so you'll be awake but won't feel any pain.
There are three stages of the
- surgical placement of the device
- postoperative recovery
- education about how to use the device
The inflatable artificial sphincter has three
- the cuff
- the balloon
- the pump
The cuff is placed around the tube
that carries urine from the bladder out of the body, called the urethra.
Surgical placement of the cuff requires an incision. The incision will be made
in one of three places:
- the scrotum (men)
- the labia (women)
- the lower belly (men and women)
Once the cuff is in place, the balloon
is also inserted. The balloon holds the same type of liquid that is in the
cuff. The pump is not needed until the patient is able to use the device, which
is roughly six weeks following surgery.
Post-Procedure Follow-Up and Recovery
Following the procedure, you can
expect to have a Foley catheter in place in the urethra. A Foley catheter is a
soft tube, made of either rubber or plastic, which is used for draining urine
from the bladder. It can be used while healing from this surgery. Before
leaving the hospital, the Foley catheter will be removed, but you won't be able
to use the inflatable artificial sphincter for several weeks. Your body needs
time to heal and can't inflate the cuff. During this time, you'll remain
Using the Pump
Approximately six weeks following the
procedure, you’ll learn how to use the pump. The pump is used to move fluid
between the cuff and the balloon. Squeezing the pump moves fluid from the cuff
to the balloon so that the cuff is loose and urine can flow through the
urethra. The fluid from the balloon moves back to the cuff in 90 seconds. With
the cuff reinflated, urine is not able to leak out of the bladder. You'll need
the pump each time you need to empty your bladder.
What Are the Risks of the Procedure?
This procedure is considered
relatively safe, and risks are minimal. As with all surgical procedures, there
are important risks you must consider. General risks associated with surgery
- infection at the site of the incision, or other
- development of blood clots in the legs, which
can travel to the lungs
- breathing problems
There are also some risks that are
specific to this procedure. These include:
- damage to organs, including the urethra,
bladder, or vagina
- increased incontinence
- increased difficulty emptying the bladder,
requiring a catheter
- failure of the device, requiring removal
What Are the Expected Results?
The inflatable artificial sphincter
can help you control SUI. This can greatly improve the quality of life if you
suffer from severe incontinence.
Be aware that changes
in the function of the inflatable artificial sphincter may occur over time. The
tissue around the cuff may erode, or the cuff may lose its elasticity. When
this occurs, incontinence may return. You may need to have the device removed
or replaced in order to address these problems.