Implantation of Artificial Urinary Sphincter

The artificial urinary sphincter is a device that functions like a natural urinary sphincter. Its purpose is to compress the urethra to prevent urine leakage. With the help of a manually controlled pump, the patient will be able to control their bladder by compressing and decompressing a cuff placed around the urethra.

In this way, when the patient feels the need to urinate, they can decompress the urethra by pressing the pump (located in the scrotum) to allow urination.

Despite its high success rate, this surgery is not always the first option. The implantation of the artificial urinary sphincter is recommended in cases where other surgeries or therapeutic options have failed. 

In fact, to ensure there are no contraindications for placing the artificial sphincter, a urodynamic evaluation will be essential.

The Artificial Urinary Sphincter (AUS) is a hydraulic silicone prosthesis designed to restore continence without causing harm to the patient. The prosthesis consists of three components made primarily of silicone:

• Urethral cuff: This part is placed around the urethra—or around the bladder neck in women—to control the flow of urine. When the cuff is filled with fluid, it closes, preventing the passage of urine.
• Control pump: This allows fluid to circulate into or out of the cuff. It is placed in the scrotum in men, and in the labia majora in women.
• Pressure-regulating balloon (reservoir): This component is placed under the abdominal muscles, next to the bladder, and contains the same fluid as the cuff. It regulates the pressure exerted on the cuff—when fluid moves, the urethral cuff either expands or deflates accordingly.

When the patient feels the need to urinate, they press the pump located in the scrotum (in men) or in the labia majora (in women), sending the fluid from the cuff to the reservoir next to the bladder. This allows urine to pass through, enabling the patient to urinate.

After a short period, the fluid from the reservoir returns to the cuff, compressing the urethra and preventing urine leakage.

Do you have a severe incontinence problem?

Request now a free surgical consultation with our Urology specialist to evaluate your case for an artificial urinary sphincter.

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The implantation of an artificial urinary sphincter is indicated for patients with severe urinary incontinence. In these cases, the amount of urine loss is measured daily.

Although the recommendation for this procedure depends on several factors, it is generally considered in patients with urine loss exceeding 400–600 grams per day. In some exceptional cases, the loss has reached up to 1,500 grams per day.

Approximately 90% of patients who receive an artificial urinary sphincter have previously been treated for prostate cancer.

Treatment for prostate cancer affects the prostate and can lead to severe incontinence. While many patients gradually regain continence, there is a small percentage (only about 5%) who do not recover after a year and may require surgery for urinary incontinence.

Other factors that influence the likelihood of developing urinary incontinence after a prostatectomy include the patient’s age, overall health, type of surgery performed, whether the tumor was advanced, and the number of prior interventions, among others.

Stress urinary incontinence is also a common reason for considering the artificial urinary sphincter, particularly when other treatments have failed. Although it is less common, women may also be candidates for this option if other approaches have not resolved the issue.

If you are experiencing urinary incontinence and would like to receive a surgical evaluation from a specialist, you can click on any "Request Appointment" button on our website or call our patient service number at +34 91 141 33 56. We will be happy to answer any questions you may have.

If you are considering an artificial urinary sphincter as a solution for your urinary incontinence, the first step is to schedule a surgical assessment with a urologist to determine whether it is the right option for you.

Operarme offers you a surgical consultation with a urologist who will assess your condition and determine if the artificial urinary sphincter is the appropriate treatment for your case.

If you have any questions about the surgery or the surgical process, you can contact the Operarme team via the contact form or by calling at +34 91 141 33 56.

Once the consultation is requested, one of our patient service advisors will contact you to answer any questions you may have and confirm that the date and time of the consultation suit your needs.

On the day of the consultation with the specialist, you should bring all available medical tests and diagnostic results related to your condition. 

The urologist will review your medical history, perform a physical examination (if necessary), and analyze the provided medical tests (such as ultrasounds, blood tests, etc.) in order to determine the best treatment option for you.

After your consultation, our patient service team will contact you to ask how everything went and whether you have decided to proceed with the surgery. If you choose to go ahead, they will explain the next steps, arrange your preoperative and anesthesia appointments, and answer any questions you may have throughout the process.

Do you have a severe incontinence problem?

Request now a free surgical consultation with our Urology specialist to evaluate your case for an artificial urinary sphincter.

Make an appointment

Before proceeding with the implantation of the artificial sphincter prosthesis, it is necessary to assess your overall health. For this reason, a preoperative evaluation will be carried out, which is included in the cost of the surgery.

The preoperative tests for the artificial urinary sphincter include:

• Complete blood work: This includes a full blood count, basic coagulation study, and kidney function test. A urine analysis will also be performed to rule out infection.
• Electrocardiogram (ECG): To evaluate your cardiac health.
• Chest X-ray: This test will only be performed if the doctor considers it necessary. It helps detect any pulmonary conditions and ensures the trachea is properly aligned.
• Consultation with the anesthesiologist: After completing the preoperative tests, you will have a consultation with the anesthesiologist to review the results and discuss relevant information such as allergies, current medications, previous surgeries, etc. Based on this, the anesthesiologist will determine the most appropriate type of anesthesia for the procedure.

Once the preoperative process is complete, the doctor will propose a surgery date—if it has not already been scheduled—and all that remains is to attend the hospital for the implantation of the artificial sphincter.

The implantation procedure for the artificial urinary sphincter is usually performed under general anesthesia so that you are asleep and feel no discomfort during the surgery. 

Once the anesthesiologist administers the necessary medication, the implantation process involves the following steps:

1. First, the doctor will insert a catheter to ensure that the bladder remains empty during the procedure.
2. To place the device, an incision will be made in the perineum and another in the suprapubic area.
3. Next, the cuff will be placed around the urethra.
4. The reservoir will then be positioned under the abdominal muscles.
5. Finally, the control pump will be placed in the scrotum (in men) or in the labia (in women) and connected to the other components of the device.

The urethral cuff will be left open and deactivated for a few weeks to allow the tissues to heal properly.

The surgical time for the implantation of the artificial urinary sphincter is approximately 90 minutes.

Once the procedure is complete, the medical team will transfer you to the recovery room to recover from the effects of the anesthesia. After the medication has fully worn off, you will be moved to a hospital room, where you will remain for 24 hours to ensure everything is progressing well.

After 24 hours, you will be discharged from the hospital, but you will not begin using the artificial sphincter immediately after surgery. As mentioned previously, it is important for the tissues to heal properly, so the device will remain inactive until healing has occurred.

For this reason, it is likely that you will continue to experience urine leakage during the first few weeks, as the device will not yet be functioning. The doctor will schedule an appointment to activate the artificial urinary sphincter approximately 4 to 6 weeks after surgery.

You will be able to return to your normal routine after discharge, although you should wait 4 to 6 weeks before engaging in strenuous activities. 

Additionally, your doctor may prescribe antibiotics to help prevent infection, as well as medication to relieve any minor discomfort you may experience.

Caring for the artificial urinary sphincter

To support healing and recovery, your doctor may recommend the following care instructions:

• Drink 1 to 2 liters of water per day.
• Do not lift heavy objects (over 5 kg / 11 lbs).
• Avoid intense physical exercise.
• Take showers instead of baths, and avoid thermal baths or saunas.
• Follow a diet that helps prevent constipation.
• Avoid vaginal penetration until your doctor advises otherwise.

Your doctor may also recommend that you wear scrotal support, which will be provided at the hospital, during the first week.

Surgery for the implantation of the artificial urinary sphincter carries very few associated risks. However, as with any surgical procedure, intraoperative and postoperative complications cannot be entirely ruled out.

It is important to be aware of the potential risks that may arise during or after the procedure:

• Pain
• Bleeding
• Infection, which may require reoperation to remove the artificial sphincter
• Problems with any component of the device, which may necessitate surgery to remove or replace it
• Damage to the urethra, bladder, or vagina
• Failure to stop urine leakage

If you experience any of the following symptoms, it is essential to consult with your doctor immediately:

• Fever
• Difficulty urinating
• Pain that does not subside with painkillers
• Blood in the urine
• The surgical wound begins to bleed or discharge clear fluid, or it becomes painful

Operarme offers the implantation surgery of the artificial urinary sphincter for 17.590 €, so you can finally resolve your urinary incontinence issue. 

The price of the procedure includes everything necessary to ensure the success of the surgery, along with several benefits exclusive to the company, including:

• Fixed price with everything included. The price you see on the website is the final price, with no last-minute surprises.
  
  
• Fully personalized care from Operarme’s patient service team. Our department will manage all your appointments, answer any questions you may have, and guide you through the entire process whenever you need it.
  
  
• Specialists in Urological Surgery. Operarme has a wide network of experienced and highly qualified urology specialists.
  
  
• The implantation of the artificial urinary sphincter, like all inpatient surgeries, includes a complication insurance policy that covers any unforeseen events, such as the need to stay an extra day in the hospital. To learn more about the medical complications insurance, contact our patient service team.

If you are considering a safe and fast solution to your urinary incontinence problem, under the care of expert urologists, you can request a free surgical assessment consultation by clicking the image below:

Do you have a severe incontinence problem?

Request now a free surgical consultation with our Urology specialist to evaluate your case for an artificial urinary sphincter.

Make an appointment