Artificial urethral sphincter implantation

Artificial urethral sphincter implantation is achieved by placing a mechanical sphincter device. Although there are many models of artificial urethral sphincter implantation, the AMS 800 is the most used and best. The working principle of AMS 800 artificial urethral sphincter implantation: The AMS 800 artificial urethral sphincter is composed of a reservoir, a control pump, a cuff and an intermediate connection. The cuff is placed in the urethra or bladder neck. When it is necessary to urinate, the pump is controlled by the one-way valve. The liquid in the sleeve flows to the reservoir, the fluid in the sleeve is emptied, and the urethra is opened. After the urination is finished, the fluid is adjusted by the pressure to adjust the elastic retraction of the balloon automatically. Flow into the sleeve until the pressure in the system reaches equilibrium. Treatment of diseases: urethral syndrome urethral trauma Indication 1. Urinary incontinence caused by congenital urethral sphincter hypoplasia. 2. Urinary incontinence caused by sphincter injury after prostatectomy or TURP. 3. Neurogenic urethral sphincter dysfunction urinary incontinence. 4. Urinary incontinence caused by other surgical or traumatic urethral sphincter dysfunction. 5. Urine flow control after various bladder reconstructions. 6. Serious female true stress urinary incontinence. Contraindications 1. Absolute contraindications for bladder-derived urinary incontinence and normal urinary sphincter function. 2. Relative contraindications Patients with urinary incontinence have indications for implantation of artificial urethral sphincter implantation, but have one of the following problems, and these problems cannot be treated with artificial urethral sphincter implantation until they are solved: 1 Muscle instability or detrusor hyperreflexia or severe low compliance bladder; 2 bladder contracture; 3 severe vesicoureteral reflux; 4 with bladder outflow obstruction; 5 poor self-care ability or mental behavior abnormalities; Water in the urinary tract and impaired kidney function. Preoperative preparation 1. Urography, including pyelography and urinary bladder urethrography. 2. Urodynamic examination, mainly including filling cystometry, urine flow rate, pressure/flow rate examination. 3. Urine culture. 4. Patients with perineal dermatitis, eczema, erosion, should be actively treated to keep the skin dry. 5. Other preoperative preparations are the same as general lower abdominal surgery. Surgical procedure 1. Male artificial urethral sphincter implantation is placed in the lithotomy position, the perineal scrotum combined with the incision, the appropriate size cuff of the distal end of the urethra is exposed through the urethra, the cuff is buckled, and the pressure-regulating balloon is inserted through the inguinal incision. Placed in the posterior pubic space, the pump is placed in the scrotum, and the corresponding catheter is connected through the skin channel. 2. Female artificial urethral sphincter implantation is placed in the supine position, the legs are slightly abducted, the inguinal incision is taken, the bladder neck is free, the cuff is wrapped around here, and the pressure-regulating balloon is placed in the posterior pubic space through the inguinal canal. The pump is placed in the labia majora and the catheters are connected.