What To Expect After Surgery
The procedure typically requires an overnight hospital stay with a catheter that is removed the following day. There is a small incision in the groin area as well as an additional incision underneath the scrotum. There can be significant tenderness, bruising and swelling that dissipates over 2-3 weeks. The device is left deactivated initially after surgery. Therefore, it is expected that urine leakage will continue in the postoperative period until device activation around 6 weeks following surgery.
Ams 800 Vs Incontinence Devices
These two options may be seen as competing technologies but in fact are fully supportive of each other. The decision to have a surgical procedure depends on general health and personal financial situations so it is extremely beneficial to have a low-cost, effective alternative to use while waiting.
An incontinence cuff/clamp is a particularly useful adjunct to treatment plans aimed at placing an AMS 800 artificial urinary sphincter as management of urinary incontinence post treatment.
As stated by Bostin Scientific themselves, the AMS 800 urinary control system:
is not for patients who are determined by their doctor to be poor surgical candidates, have permanent blockage of the lower urinary tract or who have uncontrollable contraction of the bladder.
Figure 1: This shows the various components of the surgically implanted sphincter device.
i. The control pump and valve is normally placed in the scrotal sac with a reservoir placed near the bladder in the extraperitoneal space where it can function without any perceptible feeling.
ii. The incontinence cuff is applied around the urethral channel where it can apply pressure to stop urine flow.
Ectopic Placement Of Ams 800 Urinary Control System Pressure
- Author Footnotes1 S. K. Wilson is a paid consultant to, study investigator for, and holds stock in, American Medical Systems. J. R. Delk II is a paid consultant to, and study investigator for, American Medical Systems.S.K. WilsonCorrespondenceReprint requests: Steven K. Wilson, M.D., University of Arkansas School of Medicine, 4301 West Markham, #540, Little Rock, AR 72205-7199.Footnotes1 S. K. Wilson is a paid consultant to, study investigator for, and holds stock in, American Medical Systems. J. R. Delk II is a paid consultant to, and study investigator for, American Medical Systems.Affiliations
- Author Footnotes1 S. K. Wilson is a paid consultant to, study investigator for, and holds stock in, American Medical Systems. J. R. Delk II is a paid consultant to, and study investigator for, American Medical Systems.J.R. Delk IIFootnotes1 S. K. Wilson is a paid consultant to, study investigator for, and holds stock in, American Medical Systems. J. R. Delk II is a paid consultant to, and study investigator for, American Medical Systems.Affiliations
- Author Footnotes1 S. K. Wilson is a paid consultant to, study investigator for, and holds stock in, American Medical Systems. J. R. Delk II is a paid consultant to, and study investigator for, American Medical Systems.
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Artificial Urinary Sphincter Is The Most Common Surgical Procedure Performed In Men Who Leak Urine After Prostate Cancer Treatment An Inflatable Cuff Is Placed Around The Urethra Through A Small Incision Under The Scrotum
It causes physical compression to limit urine leakage. Patients briefly squeeze a small control pump underneath the skin in the scrotum to deflate the cuff and urinate before the cuff automatically re-inflates. The fluid cycles between the cuff and a small reservoir placed through a small incision in the groin. AUS is appropriate for patients with moderate-to-severe stress incontinence in patients who have the manual dexterity to operate the control pump. The cuff can be deactivated by a Urologist if subsequent temporary catheter placement is needed but every attempt should be made to avoid future catheterization as this instrumentation could damage the cuff.
About Artificial Urinary Sphincters
An AUS is a device that works like your natural urinary sphincter . An AUS is made up of 3 parts:
Figure 2. Artificial urinary sphincter
- Urethral cuff: This wraps around your urethra to control the flow of urine. When the cuff is closed , no urine can pass through. When its open , urine can pass through.
- Pump: This moves fluid into or away from the urethral cuff. Its placed in your scrotum.
- Balloon: This holds the same fluid as the cuff. This is where the fluid is moved to when the urethral cuff is open or deflated. Its placed under your abdominal muscles.
To urinate with an AUS, you must squeeze the pump in your scrotum. The pump moves fluid from the urethral cuff into the balloon, allowing the cuff to open or deflate and your urethra to open. Your cuff stays open for about 3 minutes so that you can urinate. The cuff will close automatically.
An AUS is placed during a surgery.
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What To Do To Prepare For Surgery
You will receive detailed instructions from the surgical schedulers regarding any necessary testing or appointments prior to surgery. In general, you should temporarily stop blood-thinning medications prior to surgery . Prescription blood-thinning medications should be stopped following clearance from the doctors that prescribed them though other medications that thin the blood including fish oil and pain relievers such as ibuprofen should be stopped as well.
On the day before surgery, you will receive a phone call alerting you to the time that you should arrive, and you should wash the surgical area with an antibacterial soap.
You should not eat or drink anything after midnight on the day of surgery, but you may take approved home medications in the morning before surgery with a small sip of water.
Risks Associated With Having An Aus
Although not common, the following problems can occur:
- Pain
- Long-term or permanent problems urinating
- You may have to insert a catheter into your bladder to drain your urine.
- You may also need to have another surgery to fix the problem.
Read Also: Why Do I Have Urinary Incontinence
Ams 800 Urinary Control System
The AMS 800 is a device known as an artificial urinary sphincter that is placed completely inside the patients body to provide simple, discreet urinary control. The patient controls urination by squeezing and releasing a pump.
The AMS 800 has proven to be effective in treating incontinence, and is considered the gold standard by many urologists. When using this device, most patients are dry with only minor leaks or dribbles of urine, usually with strenuous exercise or exertion.
The AMS 800 is the gold standard treatment for men who are not ideally suited for a male sling. Those men who are best managed with a sling are those men who are dry at night, can interrupt their urinary stream when voided and who leak less than around 200- 250mls in a 24 hour period. For those with more severe leakages they are best managed with an artificial urinary sphincter. This device consists of three components: a cuff which is placed around the urethra, a pressure regulated balloon and a pump which is used to control the device. The procedure is performed under a general anaesthetic and usually lasts around 1 1.5 hours. The majority of men are admitted to hospital overnight only. The device is left deactivated or in the off position for 6 weeks. Patients are then reviewed in the clinic at that time, and the device activated.
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About Your Urinary Sphincter
Your urinary sphincter is a muscle that controls the flow of urine out of your bladder . When your urinary sphincter is contracted , it blocks the opening of your bladder so urine doesnt leak out.
Figure 1. Urinary sphincter
Normally, your urinary sphincter stays contracted until you choose to relax it to urinate . When you relax your urinary sphincter, urine leaves your bladder and flows through your urethra and out of your body .
Some people have trouble controlling their urinary sphincter. This causes them to leak urine. This can happen after surgery to remove the prostate or radiation therapy to the prostate.
You may need an artificial urinary sphincter if you lose control of your urinary sphincter.
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Ams 800 Vs Incontinent Devices
Usually there are several phases of use of the incontinence device, below a few different scenarios to consider.
Having an incontinence device as backup is a strong asset for the patient to regain control during these phases of treatment.
Ams 800 Artificial Urinary Sphincter
The AMS 800 is a urinary control system that helps with incontinence and was designed to be discreet and comfortable for the user, but it is not suitable for all patients and is an invasive procedure.
The AMS 800 system consists of three parts:
These components are attached by tubes and are loaded with a sterile solution while the cuff works like a regular sphincter, squeezing the urethra closed to prevent the bladder from leaking urine.
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