Thursday, August 04, 2005

Artificial Urinary Sphincter

This device consists of a silicone rubber cuff that wraps around the urethra near the bladder neck and is inflated manually. Several patients that visit our clinic use this device, which is used to treat urinary incontinence.



A balloon in the pelvic area regulates the pressure of the cuff and a bulb in the scrotum controls its inflation and deflation. When the cuff is inflated, the urethra is blocked and urine does not leak and when urination is desired, the cuff is deflated allowing urine to pass.





The procedure: (I’ll try to get a video of this soon)

The patient is placed in the dorsolithotomy position (laying down with legs held up and bent at the knees) and a perineal incision (incision is made in the perineum, which is the area between the base of the scrotum and the anus) is made. Colles fascia (Inner layer of superficial fascia of perineum) is being dissected off.


The bulbocavernosus muscle has been dissected off and the bulbar urethra is exposed.


The right angle is passed behind the bulbar urethra.


The measuring tape is passed around the bulbar urethra. The bulbar urethra measures 4.5 cm, so a 4.5 cm cuff is chosen for implantation.


The cuff is placed around the bulbar urethra and snapped into place.



The tubing from the cuff is passed up to the suprapubic (just above the pubic bone) wound where it is connected to the control pump.


The perineal incision is being closed. The Colles fascia is closed. The skin is closed next.


The balloon reservoir has been placed into the subrectus (abdominis rectus muscle = “six pack” muscle) space, and the control pump has been inserted into the right hemiscrotum. The connecting tubes, meaning the cuff, pump, and reservoir, are all connected.


Reference for procedure: emedicine.com

-Diego

1 Comments:

Blogger alan said...

hello - I am a 63 year old man and I am having the AUS put in at the end of september and eager to speak with someone on the phone about this procedure. My email is ajchernick48@yahoo.com.
LEt me know if someone is available for conversation. Thanks so much
Alan

3:38 PM  

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