The Artificial Urinary Sphincter (AUS) is a device used to control urinary leakage. It is generally used in those who have more severe degrees of sphincter damage.
It consists of an inflatable silicone cuff which encircles the urethra, a reservoir balloon, and a pump which resides in the scrotum. The seperate components are linked with silicone tubing.
A perineal shave and thorough antibiotic scrub is carried out when you are asleep. An incision is made in the perineum and the urethra is carefully mobilised. An apropriately sized cuff is placed, the other components are connected and the device is checked to make sure it is working properly. In some cases a seperate incision is required in the lower abdomen, often the entire procedure can be completed via the one perineal wound. The pump is then deactivated. The wound is closed using dissolvable sutures. No catheter is required.
1. Infection - if the device gets infected then it will need to be removed and you will need to wait 3 months before another can be implanted. Everything possible is done to avoid this risk and in practice it is a rare event.
2. Erosion - This is where the cuff erodes into the lumen of the urethra. The risk is increased in those who have had previous radiotherapy but again it is a rare event. If you do have an erosion, then by definition the device is infected and will need to be removed.
3. Atrophy - With time the urethra can become narrowed at the site of the cuff and it doesn't work as well. The risk of this is around 50% at 10 years. if this happens then a smaller cuff, or a second cuff, connected to the existing tubing, can be placed.
4. Device failure - This is now very uncommon, it is due to a leak in the system somewhere. We have never yet seen a case.
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