The introduction of robotic da Vinci prostate removal for prostate cancer has significantly reduced the number of incontinent patients following surgery. If incontinence still occurs, an artificial sphincter is a reliable method for men to regain control over urination. This procedure can be performed in cases of severe incontinence and should be done at the earliest one year after the prostate cancer procedure.
Short info on the insertion of an artificial sphincter
|Indication||Stress incontinence after prostate cancer surgery|
|Procedure||Insertion of a hydraulically inflatable urethral cuff|
|Surgery time||Approx. 1-2 hours|
|Clinic stay||5-7 days|
|Note||General anaesthesia recommended|
Access to the urethra is made in the perineal area, which is encircled with a cuff that can be hydraulically filled. A reservoir is placed in the lower abdomen through a small incision. A small pump in the scrotum is also placed. The pump is operated by manually putting pressure on it, emptying the urethral cuff and allowing the patient to urinate. The fluid pumped into the reservoir flows back on its own after a few minutes and fills the cuff again, so that the urethra is resealed.
In addition to the general risks of any surgical procedure, such as bleeding, inflammation, and disruptions to wound healing, there are further risks unique to this procedure. As with any implantation of a foreign body, there is a risk of infection, which can lead to the prosthesis having to be removed. The cuff can also grow into the urethra. All possible risks of the surgical intervention are discussed in a detailed explanatory discussion with the patient before the procedure.
Admission for surgery takes place on the same day as the procedure. After the operation, inpatient treatment is recommended for 5-7 days. It is recommended not to work for 1-2 weeks after discharge, to take it easy, and avoid physical exertion. After 6 weeks, the artificial sphincter can be activated, and the patient is shown how to correctly handle it. Prior to this, urine loss will persist.
The procedure usually results in satisfactory continence. It is possible that the artificial sphincter begins to fail after years.