Urinary Sphincter Replacement

WHAT YOU SHOULD KNOW:

  • Urinary sphincter replacement is surgery to replace your urinary sphincter with an artificial urinary sphincter. Your urinary sphincter is a strong muscle that surrounds your urethra. Your urethra is a tube that carries urine from your bladder to outside your body. Your urinary sphincter squeezes your urethra to keep urine in your bladder until it is time to urinate. An artificial urinary sphincter (AUS) may be needed if your urinary sphincter is weak or damaged. A weak urinary sphincter may cause urinary incontinence. When you have urinary incontinence, you cannot always control when you urinate, and you may leak urine. Women may need an AUS if other treatments for urinary incontinence fail. Men may have urinary incontinence after prostate surgery and need an AUS.

  • An AUS may be needed to stop urine leakage caused by radiation therapy. You may need an AUS after a spinal cord injury if you cannot control when you urinate. An AUS device has a balloon reservoir , a cuff, and a pump that connect together. When your AUS is turned on, liquid inside the balloon flows into the cuff. When the cuff is filled, it squeezes your urethra and prevents urine from leaking out of your bladder. To urinate, you press the pump, which causes liquid to leave the cuff and fill the balloon. The cuff stops squeezing your urethra and allows urine to flow out of your body. After a few minutes, the liquid flows back into the cuff on its own, blocking urine from leaking out. Having an AUS placed may help you control when you urinate and stop your urinary incontinence.

INSTRUCTIONS:

Medicines:

  • Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.

  • Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.

  • Antibiotics: Antibiotic medicine helps prevent an infection caused by germs called bacteria. Always take your antibiotics exactly as ordered by your caregiver. Keep taking this medicine until it is completely gone. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

  • Pain medicine: You may need medicine to take away or decrease pain.

    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

  • See your caregiver 1 to 2 weeks after surgery to have your wounds checked. You will need another visit with your caregiver 6 to 8 weeks after surgery to turn your AUS on. Waiting 6 to 8 weeks gives your body time to heal after surgery. Caregivers will teach you how to use your AUS once it is turned on.

Caring for your wounds:

Keep your wounds and the areas around them clean and dry. Ask your caregiver how to care for your wounds at home.

Having sex:

Avoid having sexual intercourse for up to six weeks after your surgery. Avoiding sex gives your wounds time to heal.

Returning to exercise and activities:

Avoid exercises and activities that put pressure on your wounds for as long as your caregiver tells you to. These activities include riding bikes or horses. Talk with your caregiver before you start to exercise after your surgery. Ask your caregiver what exercises or activities are safe for you to do after surgery. Ask your caregiver when you can return to daily activities, such as work.

Turning off your artificial urinary sphincter:

Once your AUS is on, there may be certain times when your AUS should be turned off. Your caregiver will show you how to turn the AUS on and off. You may need to turn off your AUS at the following times:

  • At night: Your caregiver may tell you to turn off your AUS each night when you go to bed. Turning off the AUS helps decrease pressure on your urethra and helps prevent damage. You can wear a pad at night to help absorb any urine leakage.

  • At the end of a pregnancy: Pregnant women may need to turn off their AUS for the last three months of pregnancy. Turning off the AUS decreases the pressure on the urethra and helps prevent damage. Turning off the AUS also helps prevent AUS cuff damage from the pressure of the unborn baby's head. Talk with your caregiver if you have any questions or concerns about your AUS and pregnancy.

  • For procedures: You may need to turn off your AUS before procedures that involve your urinary tract. These procedures include urinary catheter placement or a cystoscopy (a test to see inside your bladder). Your caregiver may give you a card to carry that has information about your AUS. Show the card to caregivers to see if your AUS should be turned off during a procedure.

CONTACT A CAREGIVER IF:

  • You do not think you are emptying your bladder completely when you urinate.

  • You have a fever.

  • You have to press the pump more times than usual to open the AUS.

  • Your AUS cuff is on and closed, and you keep leaking urine.

  • You have questions or concerns about your AUS.

SEEK CARE IMMEDIATELY IF:

  • Urine is leaking from your wound.

  • You cannot find the pump to open your AUS.

  • You have blood in your urine.

  • You have pain and swelling in the area where your cuff was placed.

  • You feel pain when you urinate, or you cannot urinate.

  • Your wounds are swollen, red, or have pus draining from them.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of the Blausen Databases or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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