Imagine laughing out loud with your friends, or coughing a little because of a cold, and you accidentally pee on your clothes. This is really a big problem for many people, and they are afraid to go out in public. We call this condition 'Stress Incontinence' . Especially after undergoing surgery for prostate cancer (prostatectomy), men often face this problem. So is there no solution to this? There definitely is. Today we are talking about a technologically advanced solution that can be very useful for such people.
What is this Artificial Urinary Sphincter?
Simply put, this is a small medical device that is placed inside our body and helps control the flow of urine. This is called AUS for short. It is surgically attached around the urethra. It is like an external helper that is attached to do the job when our body's natural urinary control muscle is weak.
To understand this, let's first look at how our bodies control urination. The tube that carries urine from our bladder (the urethra) is surrounded by two muscles that act like 'valves'. We call these `urinary sphincters`.
- Internal Sphincter: This is where the bladder connects to the urethra.
- External Sphincter: This is located in the pelvic floor muscles.
Normally, these muscles are tight and block the urethra. That's why we don't notice urine coming out. When we need to urinate, these muscles relax according to a signal from the brain, and then urine comes out easily. But if these muscles are weak due to surgery or any other reason, even if there is a little pressure on the abdomen (when coughing, laughing), urine starts to leak a little. That's when this artificial urinary control (AUS) comes to our aid.
How does this device (AUS) work?
This device has three main parts. All three are implanted inside the body.
1. Urethral Cuff: This is the most important part. It is like a small 'bracelet' that is worn around the urethra. Normally, it is filled with a liquid and gently squeezes the urethra. It is like a band that is tightened around the arm when we check our blood pressure. This prevents urine from leaking out.
2. Pressure Balloon: This is a small balloon that is placed in the lower abdomen, under the muscles. This is where the fluid needed for the 'cuff' is stored under pressure.
3. Pump: This is the controller. For a man, this small pump is inserted under the skin inside the scrotum, where the testicles are. For a woman, it is inserted near the labia majora. It is placed in a way that is easy to reach.
Now let's see how this system works:
Imagine you need to pee right now. Here's what you need to do:
- The pump in your scrotum is manually squeezed two or three times.
- Then, some of the fluid in the cuff goes into the pressure gauge .
- When the cuff is deflated, it relaxes and the urethra opens. You can then urinate normally.
- You don't need to do anything. After a few minutes, the fluid in the balloon will return to the cuff, tighten it, and the urethra will automatically close.
Simply put, when you need to urinate, you squeeze the pump to open the 'valve', and when you're done, it closes automatically. This allows you to control your urine throughout the day.
What are the advantages and disadvantages of this method?
As with any medical procedure, there are benefits and risks. It is important to discuss this with your doctor.
| Advantages | Disadvantages & Risks |
|---|---|
| High success rate: Studies have shown that this is over 90% successful. | Risks of surgery: Common risks of any surgery, such as anesthesia, bleeding, and infection. |
| Improved quality of life: Freedom to socialize, exercise, and laugh without fear of urine leakage. | Device malfunction: Over time, parts of the device may break or stop working, requiring surgery to replace them. |
| Long-term solution: If used properly, this device can last for up to 10 years. | Device Erosion: Sometimes the tissue in the urethra can be damaged where the cuff is. |
| You're in control: You have complete control over when and where you urinate. | Difficulty using the pump: Some people may find it a little difficult to squeeze and use the pump. |
What should you be careful about after surgery?
This is very important. You will not be allowed to use this device immediately after surgery.
- Allowing time for healing: After surgery, the internal wounds need to heal. That's why the doctor will keep this device 'deactivated' . During this time, you may lose urinary control.
- Activating the device: Your doctor will usually see you again after 6-8 weeks , and if all wounds have healed properly, they will 'activate' the device and teach you how to use it.
- Avoidance of work: You should completely avoid heavy lifting, strenuous work, and sexual activity for at least 4-6 weeks after surgery. Rest is essential during this time.
- Cleanliness: Keeping the wound clean and dry is very important to prevent infection. Follow your doctor's instructions exactly.
When should I see a doctor?
After surgery, you will need to go for follow-up tests at regular intervals. However, if you have any of the following symptoms, call your doctor immediately.
- If there is pus-like fluid coming from the wounds, if the areas are red, swollen, and in extreme pain.
- If the wounds are bleeding.
- If you are unable to urinate for more than 6 hours .
- Fever (over 101.5°F or 38.6°C).
- If your penis or scrotum becomes more tender.
If you have the slightest doubt about anything like this, never be afraid to ask your doctor.
Incontinence can be a huge obstacle in your life. But it's not your fault, and it's not something you should hide and suffer from. If other treatments, such as medication and exercise, haven't worked, talk to your doctor about an artificial urinary continence (AUS). It can help you regain your lost confidence and independence.
Take-Home Message
- An artificial urinary incontinence (AUS) is a medical device implanted in the body to control the involuntary leakage of urine (stress incontinence) during activities such as coughing and laughing.
- It consists of three main parts (Cuff, Balloon, Pump), and when you need to urinate, you can squeeze the pump to open the urethra.
- This method is more than 90% successful and significantly improves the quality of life.
- After surgery, it is imperative to avoid strenuous activities until the device is activated (approximately 6-8 weeks) and until complete healing.
- Contact your doctor immediately if you develop signs of wound infection, high fever, or inability to urinate.
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