Artificial Urinary Sphincter Implantation

An artificial urinary sphincter is a fluid-filled device with three connected parts: a cuff around the urethra, a pressure-regulating balloon beside the bladder, and a pump in the scrotum. The cuff keeps the urethra closed; squeezing the pump opens it for a few minutes so you can pass urine.

It is the most effective treatment for moderate to severe stress incontinence in men, most often after prostate removal. It is a mechanical device that you must operate by hand, and it wears out or needs revision in a fair share of men over a decade.

What Artificial Urinary Sphincter Implantation involves

A catheter is placed and a cut of about 5 cm is made in the perineum, between the scrotum and the anus, or high in the scrotum. The urethra is freed around its full circumference, measured, and a cuff of matching size is wrapped around it. Through a second small cut in the lower abdomen the balloon reservoir is placed beside the bladder and filled with saline or contrast fluid. The pump is tunnelled into the scrotum on your dominant-hand side and the three parts are joined with kink-proof tubing. The device is then locked in the open position so tissues can heal before it is activated.

Who is a good candidate for Artificial Urinary Sphincter Implantation?

Offered to men whose leakage has not improved a year or so after prostate surgery despite pelvic floor physiotherapy.

• Moderate to severe stress incontinence, using several pads a day
• Leakage persisting 6 to 12 months after prostatectomy
• Enough hand dexterity and memory to work the pump
• A stable bladder and no untreated narrowing at the bladder neck

It is usually not the right choice if:

• Men with mild leakage, who may do well with a sling instead
• Poor hand function or advanced dementia
• Untreated urethral stricture, bladder neck scarring or active urinary infection
• A small, overactive, high-pressure bladder until that is treated
• Prior pelvic radiotherapy is not a bar, but raises erosion risk and needs counselling

الخيارات التقنية

• Perineal cuff placement: The classic route, giving the best access to the thicker part of the urethra.
• Penoscrotal single incision: All parts through one upper scrotal cut; quicker, and convenient if a penile implant is placed together.
• Transcorporal cuff: The cuff is routed through the erectile bodies to protect a thin or previously operated urethra.
• Male sling: A non-mechanical alternative for mild to moderate leakage without prior radiotherapy.

ماذا يحدث خلال علاجك

Surgery lasts 60 to 120 minutes under general or spinal anaesthesia with antibiotic cover. You stay 1 to 2 nights with a catheter that is removed the next morning. You will remain incontinent until the device is activated.

الإعداد لرحلتك

Plan for 7 to 10 days, plus a return visit at 6 weeks in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

التعافي والنتائج

Scrotal swelling and perineal soreness ease over 2 weeks; sitting on a soft cushion helps. Avoid cycling, heavy lifting and sex for 6 weeks. At about 6 weeks the urologist activates the device in a short clinic visit and teaches you to use the pump. Most men then use none or one light pad a day. Always tell medical staff you have the device before any catheter is inserted.

• Back to everyday activity: 2 weeks light activity, 6 weeks before activation
• When results show: From activation at about 6 weeks
• How long they last: Often 8 to 10 years before revision

سياسة السلامة والمخاطر والتنقيح

Problems are mostly device-related and can appear years later.

• Infection of the device, which means removal and re-implantation after some months
• Erosion of the cuff into the urethra
• Thinning of the urethra under the cuff with return of leakage over years
• Mechanical failure or fluid loss; about a quarter to a third need revision within 10 years
• Difficulty passing urine or retention early on
• Scrotal bruising, haematoma or pump migration

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Artificial Urinary Sphincter Implantation in Türkiye

Clinic-Y does not publish a single price for Artificial Urinary Sphincter Implantation, because the honest figure depends on your case. What moves it:

• The implant itself, which is the largest component
• Single versus tandem cuff, or combined penile implant
• Revision surgery versus first implant
• The return visit for activation at 6 weeks

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

الأسئلة المتكررة