Artificial urinary sphincter (AUS) Melbourne

Urinary incontinence is the involuntary leakage of urine whilst coughing, walking, sneezing, standing or exerting pressure.

In males, urinary leakage may be as a result of surgery to the muscle that controls the flow of urine. This muscle is called the external urethral sphincter and is sometimes weak following surgery to the prostate.

At North Eastern Urology, our Urology staff will discuss your concerns and will arrange tests to ensure the diagnosis is accurate. Once this is determined, your Urologist will discuss the most appropriate management for you.

The Artificial urinary control system is designed to stop urinary leakage. This device is placed inside your body to provide discrete urinary control. This system simulates normal sphincter control.

An inflatable cuff is secured around your urethra. A corresponding pump is implanted in the scrotum (see diagram) and a balloon reservoir is implanted in the abdomen. When the cuff is inflated, it keeps the urethra closed and therefore urine is stored in the bladder. To empty your bladder, you squeeze the pump to deflate the cuff (fluid moves from the cuff into the reservoir) and open the urethra. Once opened, you are able to void. The pump will reinflate itself in a couple of minutes. That is, fluid automatically returns from the reservoir to the cuff squeezing the urethra closed again.

Prior to this procedure you are required to have a urine culture, baseline blood tests and an ECG. If an infection is detected the Urologist will prescribe appropriate antibiotics for you. The procedure is performed under general anaesthesia. You will be in hospital for 4-5 days. You will have a urethral catheter for the first two days. This will be removed by Nursing staff and it’s at this point that you will return to urinary incontinence. The Artificial urinary control system will not be activated for 6 weeks. This is to allow you time to heal and to reduce swelling from surgery.

Following discharge

• You are required to return to the rooms 1 week following the procedure to check your groin and perineal wound.
• Avoid constipation as this puts unnecessary strain on the suture line. Ensure your diet is high in fibre with adequate fluids.
• It is strongly advisable you do no heaving lifting for 6 weeks, no squatting or bending for 4 weeks. Gentle exercise such as walking is advisable.
• No sexual intercourse for 6 weeks.
• You are required to refrain from driving for 4 weeks.
• You are required to remain at home from work for 4-6 weeks. Please discuss this further with your surgeon.
• You will also return to the rooms 6 weeks following your procedure so that your Artificial urinary control system can be activated. Once activated in the rooms you will be required to void 1-2 times to ensure you are able to effectively use the system before leaving the rooms.
• A medical certificate will be issued on request.

Following your procedure, it is advisable you call the rooms if you experience any of the following:

• Fever
• Voiding difficulties
• Redness and inflammation to wound sites
• Pain – increase in pain not relieved by medication