Artificial Urinary Male Sphincter – AUS

Why is it done?

  • Male Stress incontinence/ Incontinence
  • Usually after a TURP/TUVP, Radical Prostatectomy in 2% of cases as pre-described complication of surgery

How is it done?

  • ·This procedure is done under a spinal /general anesthetic, as decided by the anesthetist.
  • The legs will be elevated into the lithotomy position.
  • A 7cm incision is made on the perineum space between scrotum and anus).  Or penoscrotal junction. You will also have a small suprapubic incision.
  • The silicone inflatable cuff is placed around the upper end of the corpora cavernosa of the penis under the muscle.
  • The reservoir is placed behind the pubic bone
  • The access port is placed in the scrotum; make sure it is on the side of your dominant hand.
  • The cuff will only be activated 6 weeks after the surgery
  • The wounds are closed with dissolvable sutures and/or skin glue.
  • A local anesthetic is given for pain relief.
  • A urinary catheter is placed for 24hrs.
  • The catheter will be removed early the next morning.
  • Prophylactic antibiotics will be given to prevent infection.

 

Complications

  • Any anesthetic has its risks, and the anesthetist will explain all such risks.
  • Complications: hemorrhaging, requiring blood transfusion <1%.
  • Patients will wake up with a catheter in the urethra and bladder. This will remain in the bladder for 24 hrs.
  • Pelvic pain for 10-14 days may occur, making it difficult to sit.
  • You will be incontinent until the cuff is activated
  • This may be less effective in irradiated patients

NB! Each person is unique and for this reason, symptoms may vary

 

What next?

  • Patients will have a trial of void without catheter the next day. You will be incontinent until the device is activated in 6 weeks
  • Patients will be discharged as soon as they can completely empty the bladder.
  • Patients may initially suffer from urge incontinence, but this will improve within the next 6 weeks.
  • Allow 6 weeks for symptoms to stabilize.
  • Initial period of pelvic pain is expected.

 

Download Information Sheet

Wes AUS Male Sphincter

Copyright 2019 Dr Jo Schoeman

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