Artificial urinary sphincter for
bladder incontinence

The artificial urinary sphincter has been available since 1973 for men who experience prolonged bladder incontinence following treatment for prostate cancer.

The device (which typically consists of a cuff, a pump, and a balloon) is surgically implanted. The cuff—which is filled with a saline fluid—compresses the urethra to keep it closed, which prevents urine from leaking. When a man is ready to urinate, he squeezes the pump, which is implanted into his scrotum. This pulls the fluid from the cuff into the balloon, releasing the compression on the urethra—and allowing it to open—so he can urinate.

In some ways, it is similar to the way a blood pressure cuff works, except this cuff automatically refills with the saline fluid several minutes after it is deflated.

Not for every man

This surgical approach is generally considered when other therapies (including the male sling procedure) have failed.

Like any surgery, it carries risks that can include complications from anesthesia, heart attack, stroke, blood clots, and infection. It also requires good manual dexterity, as the man must operate the scrotal pump to urinate. Before deciding on this approach, it’s important to ask your loved one’s doctor about all the benefits and associated risks.

What the clinical studies report

While studies have reported ten-year success rates with the device, many men have had to undergo additional surgery because the device failed to work properly, eroded, or caused infection. In one study (Fulford et al) of 61 men, after 10 years, 49 men needed at least one further surgery to correct a problem. In another study of 70 men (Clemens et al), about half needed additional surgery five years after receiving their artificial urinary sphincter.

In another study of 113 men (Montague et al), a large majority of men (60%) were “socially continent” about six years after getting an artificial urinary sphincter, which means they used up to 1 pad a day. It was reported that 4% of men were completely continent and 31% of men needed to use 2-3 pads a day. Of all the men, 28% said they were “very satisfied” and 45% reported being “satisfied” with the device. Another 18% said they were “neutral”, 6% said they were “dissatisfied”, and 4% were “very dissatisfied” with their artificial urinary sphincter.

Always discuss everything you read on this web site with a qualified medical professional.

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Montague DK, Angermeier KW, Paolone DR. Long-term continence and patient satisfaction after artificial sphincter implantation for urinary incontinence after prostatectomy. J Urol. 2001;166:547-549.