Inflatable Artificial Sphincter
Alternate Names : Artificial Sphincter - Rectal or Urinary
DefinitionThis is a surgical procedure to insert an inflatable artificial sphincter to treat either urinary sphincteric incontinence (artificial urinary sphincter will be inserted) or fecal incontinence (artificial rectal sphincter will be inserted) caused by a sphincter dysfunction or injury. The urinary and rectal sphincters are the muscles that allow you to hold your urine and feces respectively.
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Overview & Description
Since the procedure for placement of the artificial urinary sphincter and the artificial anal sphincter is similar, they will be discussed together.
An artificial sphincter consists of three parts:
- A cuff that fits around the bladder neck (or anal canal for the artificial rectal sphincter)
- A pressure regulating balloon
- A pump that inflates the cuff
To treat urinary incontinence, the cuff is placed around the urethra so that when it is inflated, the urethra will close tightly. To treat fecal incontinence, the cuff is placed around the anal canal.
The pressure-regulating balloon will be placed beneath the abdominal muscles. The balloon is filled with a liquid (occasionally, an iodine-based solution will be used so that it will be visualized when X-ray procedures are performed).
The control pump mechanism is placed in the labia for women, and in the scrotum for men. Alternatively, the pump may be placed underneath the skin of the abdominal wall or thigh.
To use the sphincter, the person will compress (squeeze) the pump to divert fluid from the urethral (or anal) cuff to the balloon. This action will allow the sphincter to relax so that the person can urinate (or defecate). The cuff will then re-inflate on its own in 3 to 5 minutes (10 minutes for the artificial rectal sphincter).
The artificial sphincter is placed during surgery using general or spinal anesthesia. People having an artificial rectal sphincter may need to be admitted to the hospital prior to surgery to receive medications that cleanse the bowel. The bowel cleansing may include a series of enemas and laxatives, followed by oral antibiotics.
If you had an artificial urinary sphincter placed, you will return form surgery with a Foley catheter in place, which will be removed prior to discharge. The artificial sphincter cuff will be not be inflated immediately after surgery to allow the tissues to heal. About 6 weeks after surgery you will be taught how to activate your pump to inflate the artificial sphincter.
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