Artificial sphincter

Question 1

components

Answer 1

3 Components: Cuff, Reservoir, Pump

The device functions by keeping fluid in the urethral cuff, which acts to close the urethra with 60-70 cm of water pressure (good enough for daily activity).

When the patient wishes to urinate, he presses on the pump 3-4 times which moves the fluid from the cuff to the reservoir so that urination can proceed.

After about two minutes, the fluid automatically re-fills the cuff

Question 2

CI to sphincter

Answer 2

Patient unfit for surgery

Not able to handle the pump

Irreversibly blocked lower urinary tract

Unresolved Detrusor Hyper-reflexia or bladder instability

Infection eg infected wounds / pressure areas (esp. MRSA)

Question 3

How will you re-activate AMS 800? Also need to be able to deactivate eg for flexi

Answer 3

grasp tubing
press top part of pump on sides for pumpt to refill
short firm press of pump
will be cuff reactivated and closed

Question 4

complications sphincter

Answer 4

Erosion
Infection
Malfunction
Incontinence
Upper tract damage
(1st three of these require surgical revision)

Question 5

revision rate

incontinence rate

Answer 5

Continence rate 70 – 93%

Re-operation rate 35 – 54%