Artificial urinary sphincter(AUS)

AUS and male sling are used to treat male stress incontinence or leakage of urine with activity.

What causes stress incontinence?

The most common cause is pelvic surgery or radiation in particular, in connection with the treatment for prostate cancer.

Who should get the AUS or the male sling?

The male sling is best suited for a patient with mild leakage - someone who uses 1 to 3 pads for leakage a day, can start and stop his urinary stream, and has no history of radiation. AUS can be used in any patient with urinary incontinence but is best suited for those with a history of radiation, heavy leakage of urine, or prior urethral surgery.

How do they work?

AUS works by placing a fluid-filled cuff around the urethra to block the flow of urine. When the patient needs to urinate, he squeezes a pump in the scrotum. This empties the fluid in the cuff to allow flow of urine, and as the bladder empties fluid slowly moves back into the cuff to block the urine again. Male sling provides support and moves the urethra into a position where the pateint has better control over the flow of urine.

What does the surgery involve?

AUS requires the surgical placement of a fluid-filled cuff around the urethra,  a pump in the scrotum, and a balloon in the lower abdomen. The male sling is placed using a similar incision and secured to the deep part of the urethra. Both are outpatient surgeries, and patients can go home the same day or the next morning.

What is the recovery?

Patients can go home the same day or the morning after either procedure. Normal daily activity is okay after the procedure, but a patient may not lift more than 10 pounds or engage in strenuous activity for 3 weeks after surgery. The patient will be taught how to use the AUS 6 weeks after the procedure. The male sling is functional immediately after the procedure.

Is this covered by insurance?

AUS and male sling are usually covered by insurance.

Can either be done at the same time as penile implant?

Yes, both the sling and the AUS can be performed with the penile-implant operation.