Male Urinary Sphincter Implant
Urinary incontinence refers to the involuntary loss of urine at inappropriate times and places, to such an extent that it constitutes a hygienic and social problem.
In men, this type of incontinence is rare and is generally caused by trauma and/or surgery to the sphincter apparatus and neurological diseases that compromise the innervation of the bladder and urethra. In other cases, the person feels a sudden and strong urge to urinate, is forced to rush to the toilet and sometimes “wets themselves” before reaching it. Urine leakage ranges from a few drops to actual urination and is frequent and unpredictable.
In this case, we refer to urinary incontinence due to urinary urgency. In most cases, the disorder is caused by frequent, involuntary and uncontrollable contractions of the bladder muscle. The causes are neurological diseases, urinary infections, stones and bladder tumours. This type of incontinence is frequently found in the elderly, especially those suffering from brain diseases (arteriosclerosis, Parkinson’s disease, etc.) and is aggravated by walking difficulties, balance problems and mental confusion.
The AMS 800 device is used to treat urinary incontinence due to resistance to urine flow in the urethra/bladder (intrinsic sphincter deficiency) in patients
male, female and paediatric patients.
The AMS 800 sphincter is a reliable device for treating incontinence in appropriately selected patients. The artificial sphincter is currently the best treatment for sphincter deficiency incontinence after radical prostatectomy.
The placement of an artificial sphincter for sphincter insufficiency achieves satisfactory continence in 80-90% of cases. It simulates a healthy sphincter in that it keeps the urethra closed until you want to urinate. The artificial urinary sphincter is a small device that is surgically implanted with the aim of restoring the natural process of urinary control. When the natural sphincter, i.e. the muscle responsible for controlling urination, does not function properly, as sometimes happens after prostatectomy, uncontrollable urine leakage occurs. In cases of severe incontinence, where rehabilitation techniques and physiokinesitherapy of the perineal plane are not sufficient to restore the continence mechanism, the use of an artificial sphincter may be a solution to the problem. It consists of three components: a cuff, which wraps around and closes the urethra, a pump, located in the scrotum to deflate the cuff, and a reservoir balloon. These components are connected by flexible tubes.
Where the device is implanted
Balloon (reservoir): positioned near the bladder. Tubes: connect the parts of the device, allowing fluid to move inside. Cuff: positioned around the urethra. Deactivation valve: small button located in the rigid part of the pump. Pump: this is placed in the scrotum so that it can be felt through the skin.
The lower part is soft and compressible. The cuff, filled with fluid, exerts slight pressure to keep the urethra closed and thus retains urine in the bladder.
To urinate, the pump is pressed several times. The fluid is thus transferred to the reservoir and the cuff remains open. Once emptied, the cuff exerts no pressure on the urethra and urine can flow out of the bladder. A few minutes after urination, the fluid automatically returns from the balloon to the cuff, which fills up and closes the urethra, restoring continence.
The surgical procedure to implant the artificial urinary sphincter can be performed on an outpatient basis with a single 3 cm incision below the scrotum. It is necessary to wait 30 days after the operation before starting to use it.
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