What is an Artificial Urinary Sphincter Placement (AUS)
Artificial urinary sphincter is a device that is used to treat urinary incontinence. The device helps you control your urine and prevents urine leaks.
An AUS is made up of three parts:
- A fluid-filled cuff.
- A fluid-filled balloon.
- A pump.
During the procedure to place an AUS, the cuff is placed around the part of the body that drains urine from the bladder (urethra), the balloon is placed in the abdomen, and the pump is placed in the scrotum (for men) or outside of the vagina (for women).
Tell a health care provider about:
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
- Any problems you or family members have had with anesthetic medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have.
What are the risks?
Generally, this is a safe procedure. However, problems may occur, including:
- Infection.
- Bleeding.
- Allergic reactions to medicines or dyes.
- Damage to other structures or organs.
- Damage to the area around the balloon (erosion).
- Failure of the artificial sphincter to work (mechanical failure).
- Need for additional surgeries.
- Inability to drain the bladder (urinary retention).
What happens before the procedure?
Medicine
- Ask
your health care provider about:
- Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
- Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
- You will be given antibiotic medicine to help prevent infection.
Eating and drinking restrictions
Follow instructions from your health care provider about eating and drinking, which may include:
- 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
- 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
- 6 hours before the procedure – stop drinking milk or drinks that contain milk.
- 2 hours before the procedure – stop drinking clear liquids.
General instructions
- If you were asked to do a bowel prep before the procedure, follow instructions from your health care provider.
- If you were asked to shower with a germ-killing soap, follow instructions from your health care provider.
- Keep all visits with your health care provider. You may have tests done, including urine tests and imaging tests.
- Plan to have someone take you home from the hospital or clinic.
- Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
What happens during the procedure?
- To
reduce your risk of infection:
- Your health care team will wash or sanitize their hands.
- Your skin will be washed with soap.
- Hair may be removed from the surgical area.
- An IV will be inserted into one of your veins.
- You
will be given one or more of the following:
- A medicine to help you relax (sedative).
- A medicine to make you fall asleep (general anesthetic).
- You will be given an antibiotic medicine.
- A small, thin tube (catheter) will be placed into your urethra. The tube will help to drain urine during and after the procedure.
- An
incision will be made:
- If you are a man, the incision will be made in your scrotum.
- If you are a woman, the incision will be made in the area between your vagina and anus (perineum).
- The cuff will be placed around your urethra.
- An incision will be made in your abdomen.
- The balloon will be placed in your abdomen and filled with salt-water fluid (saline).
- The
pump will be put in place.
- If you are a man, the pump will be placed inside your scrotum.
- If you are a woman, the pump will be placed between the folds of skin around the opening of your vagina (labia).
- The cuff, balloon, and pump will be connected with tubes.
- The AUS will be tested to make sure it works properly.
- The incisions will be closed with stitches (sutures).
- A bandage (dressing) will be placed over the incisions.
The procedure may vary among health care providers and hospitals.
What happens after the procedure?
- Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
- A catheter will be left in your urethra to help drain your bladder during recovery. The catheter may be removed before you leave the hospital. If you have problems draining urine after the procedure, it may be left in until you can drain urine on your own.
- You will be given medicine to help with pain as needed.
- You will not use your AUS right away. It will be activated 4–6 weeks after the procedure.
- Do not drive for 24 hours if you were given a sedative.
Summary
- An artificial urinary sphincter (AUS) is a device that is used to treat urinary incontinence.
- An AUS helps to control urine flow and prevent leaking.
- The AUS is made up of three parts. These include a fluid-filled cuff, a fluid-filled balloon, and a pump that activates the AUS.
- You will not use your AUS right away. It will be activated 4–6 weeks after the procedure.
Artificial Urinary Sphincter Placement, Care After
This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.
What can I expect after the procedure?
After the procedure, it is common to have:
- Pain
or discomfort:
- In your scrotum, if you are male.
- Between your vagina and anus (perineum), if you are female.
- Discomfort in your abdomen.
Your artificial urinary sphincter (AUS) will be activated 4–6 weeks after the procedure. Until it is activated, you may continue to have symptoms of not being able to control urine (urinary incontinence).
Follow these instructions at home:
Medicines
- Take over-the-counter and prescription medicines only as told by your health care provider.
- If you were prescribed an antibiotic medicine, take it as told by your health care provider.Do notstop taking the antibiotic even if you start to feel better.
Incision care
- Follow
instructions from your health care provider about how to take care of your
incision. Make sure you:
- Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
- Change your dressing as told by your health care provider.
- Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.
Check your incision every day for signs of infection. Check for:
- Redness, swelling, or pain.
- Fluid or blood.
- Pus or a bad smell.
- Warmth.
Eating and drinking
- For 4-6 weeks, avoid foods and drinks that can irritate the bladder, such as coffee, alcohol, citrus, or spicy foods.
- Drink enough fluid to keep your urine clear or pale yellow.
- Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
Activity
- Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
- Exercise
regularly as told by your health care provider. Avoid exercises that:
- Strain your abdomen or pelvis.
- May cause impact or injury to your pelvis or groin.
- Do notdrive for 24 hours if you were given a medicine to help you relax (sedative) during the procedure.
- Do notlift anything that is heavier than 10 lb (4.5 kg) or the limit that your health care provider tells you until he or she says that it is safe.
Lifestyle
- Maintain a healthy weight. Ask your health care provider what a healthy weight is for you.
- Once the AUS is activated, plan periodic bathroom breaks during the day. If you are not sure if you will be able to have a bathroom break for a while, be careful about how much fluid you drink.
- Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
General instructions
- Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider when it is okay for you to shower.
- Practice Kegel exercises as told by your health care provider. These exercises help to strengthen the muscles that control your bladder.
- If you are male, follow instructions from your health care provider about how to pull down the AUS pump in your scrotum. You may need to do this for a couple of weeks after the procedure.
- Be sure to carry a card or medical bracelet that says you have an AUS.
Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You have new or worse urinary symptoms.
- You have pain when urinating.
- You have blood in your urine.
- You have a fever.
- There
are signs of infection near the incision, such as:
- Redness, swelling, or pain.
- Fluid or blood.
- Pus or a bad smell.
- Warmth.
Get help right away if:
- You have severe pain in your scrotum (male).
- You have pain, discomfort, or bloating in your abdomen.
- You have severe pain when urinating.
- You often feel a painful, urgent need to urinate.
- You have swelling in your legs, feet, or ankles.
- You have shortness of breath or chest pain.
- You have red blotches on your skin.
- You cannot urinate.
Summary
- After the procedure, it is common for men to have some pain in the scrotum, and for women to have some pain between the vagina and anus (perineum).
- You will not use your artificial urinary sphincter (AUS) right away. It will be activated 4–6 weeks after the procedure.
- Until the AUS is activated, you may still have symptoms of urinary incontinence.
- Avoid foods or drinks that may irritate the bladder, such as coffee, alcohol, citrus, or spicy foods.
- Be sure to carry a card or medical bracelet that says you have an AUS.
Artificial Urinary Sphincter Home Guide
This guide contains information about using your artificial urinary sphincter (AUS) and about caring for yourself while you have one. Your health care provider may give you additional information. Call your health care provider if you have any problems or questions.
What is an AUS?
An AUS is a device that helps you control your urine. It is made up of three parts:
- A fluid-filled cuff.
- A fluid-filled balloon.
- A pump.
The pump is the part of the AUS that is in your scrotum (if you are a man) or outside of your vagina (if you are a woman). It controls the other parts of your AUS. The balloon is in your abdomen, and the cuff is wrapped around the part of your body that drains urine from your bladder (urethra). The cuff keeps your urethra closed so that urine cannot leave your body.
How does my AUS work?
Once your AUS has been activated, urine will not be able to leave your body unless you squeeze the pump in your scrotum or between the folds of skin around the opening of your vagina (labia). Squeezing the pump causes fluid in the cuff to go into the balloon. When this happens, the urethra opens up so urine can come out. After all of your urine has come out, the fluid in the balloon goes back into the cuff and closes up the urethra.
How do I use my AUS?
When you need to urinate, follow these steps:
- Squeeze the pump.
- Let the urine drain from your bladder. This will take about 2–3 minutes.
- Wait for 1–2 minutes for the cuff to inflate.
Follow these instructions at home:
Activity
- Exercise regularly as told by your health care provider. Aim for 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week. Ask your health care provider what exercises are safe for you.
- Avoid
exercises that:
- Strain your abdomen or pelvis.
- May cause impact or injury to your pelvis or groin.
Eating and drinking
- Avoid foods and drinks that can irritate the bladder, such as coffee, alcohol, citrus, or spicy foods.
- Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
General instructions
- Practice Kegel exercises as told by your health care provider. These exercises help to strengthen the muscles that control your bladder.
- Plan periodic bathroom breaks throughout the day. If you are not sure if you will be able to have a bathroom break for a while, be careful about how much fluid you drink.
- Maintain a healthy weight. Ask your health care provider what a healthy weight is for you.
Be sure to carry a card or medical bracelet that says you have an AUS.
Contact a health care provider if:
- You continue to have symptoms of urinary incontinence.
- You have problems urinating or emptying your bladder.
- You have a weak urine stream.
- You still feel the need to urinate after you finish urinating.
- You have pain when urinating.
- You have blood in your urine.
- You have a fever.
Get help right away if:
- You have severe pain in your scrotum (male).
- You have pain, discomfort, or bloating in your abdomen.
- You have severe pain when urinating.
- You often feel a painful, urgent need to urinate.
- You cannot urinate.
- You have swelling in your legs, feet, or ankles.
- You have shortness of breath or chest pain.
- You have red blotches on your skin.
Summary
- When you need to empty your bladder, squeeze the pump located in your scrotum (if you are male) or on the outside of the vagina (if you are female).
- It will take about 2–3 minutes for the urine to drain from your bladder.
- The cuff will re-inflate on its own and close the urethra.
- If you are still experiencing problems with urinary incontinence, talk with your health care provider.
