Prosthesis, urinary sphincter (implantable)
HCPCS code
Name of the Procedure:
Prosthesis, Urinary Sphincter (Implantable)
Medical Term: Artificial Urinary Sphincter (AUS) Implantation
Summary
An artificial urinary sphincter (AUS) is a medical device implanted to treat issues with the urinary sphincter. This procedure involves placing a device that can be controlled to open and close the urinary passage, helping patients regain control over their urination.
Purpose
The procedure primarily addresses urinary incontinence, often resulting from prostate surgery or nerve damage. The goal is to restore the patient's ability to control urine flow, significantly improving their quality of life and eliminating the constant worry of leakage.
Indications
- Severe urinary incontinence unresponsive to other treatments
- Male patients, often post-prostatectomy
- Certain types of nerve damage or trauma affecting sphincter control
Preparation
- Pre-procedure fasting as advised by the physician
- Adjustments to regular medications, particularly blood thinners
- Comprehensive evaluation including urodynamic tests, imaging, and sometimes cystoscopy to assess suitability
Procedure Description
- Anesthesia: General or regional anesthesia is administered.
- Incision: A small incision is made in the perineal area or lower abdomen.
- Placement: The AUS system components – a cuff that wraps around the urethra, a pump placed in the scrotum, and a pressure-regulating balloon – are implanted.
- Connection: The components are connected and tested before closing the incision.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
It is usually performed in a hospital or specialized surgical center.
Personnel
- Urologist or specialized surgeon
- Anesthesiologist
- Surgical nurses
Risks and Complications
- Infection
- Device malfunction or erosion
- Pain or discomfort
- Bleeding
- Temporary urinary retention
Benefits
- Improved control over urination
- Reduced or eliminated incontinence
- Enhanced quality of life Benefits are typically noticed within a few weeks post-recovery.
Recovery
- Hospital stay of 1 to 2 days
- Initial rest period followed by gradual resumption of activities
- Avoidance of heavy lifting or strenuous activities for several weeks
- Follow-up visits to monitor progress and device function
Alternatives
- Behavioral therapy and bladder training
- Medications
- Non-implantable devices like urethral inserts or clamps
- Surgery for sling procedures or bulking agents
- Each alternative has varying effectiveness and suitability depending on individual patient conditions.
Patient Experience
Patients may feel slight discomfort or pain immediately after the procedure, which is managed with medication. There is a short learning curve to operate the device, but most patients adapt well and experience a significant improvement in symptoms. Regular follow-ups ensure the device functions correctly and allows adjustments if necessary.