Artificial urethral sphincters

Last revised by Craig Hacking on 10 Aug 2023

Artificial urethral sphincters, also known as inflatable artificial sphincters and urinary control systems, are devices used for the treatment of urinary stress incontinence (e.g. due to pelvic floor dysfunction in females or prostate surgery in males) and are sometimes used in combination with bladder neck stent.

A typical design includes:

  • urethral cuff at the bladder neck or proximal urethra

  • fluid balloon reservoir (placed usually under the lower abdominal muscle, connected directly with the cuff)

  • a pump that relaxes the cuff by moving fluid from the cuff to the balloon  (placed under the skin of the lower abdomen or leg, or alternatively in the scrotum in males)

  • connecting tubes

The pump can be manually used to inflate or deflate the urethral cuff by redistributing the fluid between the cuff and the balloon reservoir. Deflation of the cuff allows urine to leave the bladder and flow through the urethra. The fluid from the balloon is automatically shifted back to the cuff after approximately 2 minutes. 

  • leak around the the tubes or the reservoir, with subsequent infection

  • migration of the fluid balloon reservoir along its track and may get lodged anywhere between the muscle and the skin - similar to a buried bumper syndrome

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