Inflatable artificial sphincter
Key points
- This is a surgical procedure to insert an inflatable artificial sphincter to treat either urinary sphincteric incontinence (artificial urinary sphincter will be inserted) or fecal incontinence (artificial rectal sphincter will be inserted) caused by a sphincter dysfunction or injury.
- To treat urinary incontinence, the cuff is placed around the urethra so that when it is inflated, the urethra will close tightly.
- An artificial urinary sphincter is used to treat stress incontinence in men that is caused by urethral dysfunction such as after prostate surgery.
- Additional risks include: Possible complications of this surgery include wound infection, urinary tract infection, urethral erosion, or mechanical failure of the device requiring its removal.
Alternative names
Artificial sphincter - rectal or urinary
Definition
This is a surgical procedure to insert an inflatable artificial sphincter to treat either urinary sphincteric incontinence (artificial urinary sphincter will be inserted) or fecal incontinence (artificial rectal sphincter will be inserted) caused by a sphincter dysfunction or injury.
The urinary and rectal sphincters are the muscles that allow your body to hold urine and feces, respectively.
Description
An artificial sphincter consists of three parts:
- A cuff that fits around the bladder neck (or anal canal for the artificial rectal sphincter)
- A pressure regulating balloon
- A pump that inflates the cuff
To treat urinary incontinence, the cuff is placed around the urethra so that when it is inflated, the urethra will close tightly. To treat fecal incontinence, the cuff is placed around the anal canal.
The pressure-regulating balloon will be placed beneath the abdominal muscles. The balloon is filled with a liquid (occasionally, an iodine-based solution will be used so that it will be visualized when X-ray procedures are performed).
The control pump mechanism is placed in the labia for women and in the scrotum for men. Alternatively, the pump may be placed underneath the skin of the abdominal wall or thigh.
To use the sphincter, the person will squeeze the pump to divert urine (or feces) from the cuff to the balloon. This action will allow the sphincter to relax so that the person can urinate (or defecate). The cuff will then reinflate on its own in 3 to 5 minutes; the artificial rectal sphincter reinflates in 10 minutes.
The procedure for placement of an artificial urinary sphincter and an artificial anal sphincter is similar and is performed during surgery using general or spinal anesthesia. People having an artificial rectal sphincter may be admitted to the hospital prior to surgery to receive medications that cleanse the bowel. The bowel cleansing may include a series of enemas and laxatives, followed by oral antibiotics.
If you had an artificial urinary sphincter placed, you will return form surgery with a Foley catheter in place, which will be removed prior to discharge. The artificial sphincter cuff will be not be inflated immediately after surgery to allow the tissues to heal. About 6 weeks after surgery you will be taught how to activate your pump to inflate the artificial sphincter.
Indications
An artificial urinary sphincter is used to treat stress incontinence in men that is caused by urethral dysfunction such as after prostate surgery. Additionally this procedure may be performed in men and women with sphincter dysfunction related to spinal cord injury or multiple sclerosis.
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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