Artificial Urinary Sphincter

An artificial sphincter is a device made of silicone rubber that is used to treat urinary incontinence. The inflatable cuff fits around the urethra near the bladder. The balloon regulates the pressure of the cuff, and a pump controls inflation and deflation of the cuff. The balloon is surgically placed within the pelvic area in the abdomen, and the control pump is placed in the scrotum.

What to expect after surgery?

  • You will have a 1 to 2 hospital stay.
  • You will be expected to do breathing exercises called incentive spirometry to prevent respiratory infections.
  • On the day after surgery it is very important to get out of bed and begin walking. This will help prevent Deep Vein Thrombosis. Please follow the DVT prevention handout.
  • You may have scrotal or penile swelling and bruising after surgery it should resolve in 7 to 10 days. Try elevating your scrotum on a small towel or washcloth while sitting to help decrease the swelling. Wear athletic supporter or snug fitting underwear for support.
  • On the morning after your surgery, your doctor will show you how to gently pull down on the artificial urinary sphincter pump in your scrotum. You will do this twice a day, every day until you see your provider at your postoperative appointment to insure that the pump heals in the correct location.
  • Your bowels may be sluggish after surgery and pain medication can increase constipation. Follow the postoperative bowel program handout.
  • You will have steri strips over your incisions and these will fall off in 5-7 days.
  • You can use a heating pad on the incision to help with muscle soreness.
  • You may shower when you go home; do not bathe or sit in a hot tub for 2 to 3 weeks.
  •  Use your pain medication as directed if needed.
  • Activity and postoperative restrictions
  • • Walking and light exercise is important in prevent DVTs
  • • You should expect to return to work in 1 to 2 weeks
  • • You should reduce your activity levels for the first week while healing
  • • Use stairs gently for the first week
  • • No heavy lifting, pulling or pushing over 10 to 15 pounds for 4 to 6 weeks
  • • No strenuous exercising for 6 weeks
  • • No sexual intercourse for 6 weeks
  • • Do not activate your artificial urinary sphincter for 6 weeks.
  • • If you have had a perineal incision (an incision between the scrotum and the anus) sitting can be difficult and uncomfortable. Do not sit directly on the incision instead sit with your weight shifted back onto your buttocks. You may need an air-filled donut or a soft cushion to sit on for the first 4 weeks after surgery.
  • • Do not put direct pressure on the incision for 4 to 6 weeks. This include activities that require you to straddle anything, such as riding a bicycle, motorcycle, ATV, horseback riding, etc.
  • • Do not drive for the first week. Do not drive while taking narcotics.

Medication

• You should resume your pre-surgery medication unless told otherwise.

• Do not take any aspirin products for the first two weeks.

• If you are taking Warfrin or Plavix this should be followed by your primary care provider postoperatively. They will discuss with you when to resume medication and dosing recommendations.

• If you are taking pain medication or iron supplements you should also be taking a stool softener to keep from becoming constipated.

• If your pain is mild you can stop taking the pain medication and switch to acetaminophen.

Medications and items to have at home before surgery

• Stool Softener

• Fiber

• Milk of Magnesia

• Acetaminophen

• Frozen peas or Ice packs

• Snug fitting jockey underwear or boxer briefs

• Air-filled donut

Diet

You may return to your normal diet. You may want to avoid acidic foods and drinks that may cause burning with urination. Drinks with caffeine may cause frequency and irritation to your bladder. If you’re not on a sugar or salt restriction diet, drink 8 to 10 glasses of water and Gatorade daily to avoid constipation and to prevent possible urinary tract infections.

If you experience any of these symptoms please call Urology Northwest 425-275-5555

• Fever over 101 Fahrenheit by mouth

• Pain not relieved by medication

• Rash, itching after taking pain medication

• Continued nausea and vomiting

• Abnormal swelling around operative site

• Increased redness, warmth, hardness around operative site

• Excessive draining from surgical site

• Excessive bleeding from operative site

• Inability to urinate

• Swelling of the calf, ankle or foot

• Increased warmth of the leg

• Pain in the leg

• Bluish discoloration of the skin or leg

Postoperative follow up

You will need a follow-up appointment to monitor your progress in 2 weeks post operatively. You will be called for a postoperative follow up 1 to 2 days after surgery. You can make your postoperative appointment at that time or by calling and speaking to a receptionist. You will also need a second appointment in 6 weeks to activate your artificial urinary sphincter.