When urinary leakage continues despite recovery time and appropriate conservative treatment, it can feel as though pads are the only long-term option. For selected men with stress incontinence, an artificial urinary sphincter may offer better control and less dependence on pads.
Choosing an implant requires more than deciding that leakage is bothersome. A consultation with Dr. Amin Mir Sadeghi can establish whether the device matches the cause of your leakage, explain how you would use it and discuss surgery, recovery and future care.
What an artificial urinary sphincter does
The natural urinary sphincter helps keep urine in the bladder until you choose to pass it. An artificial urinary sphincter, or AUS, adds a controlled closing mechanism around the urethra when natural sphincter control is insufficient.
A commonly used system has a fluid-filled cuff around the urethra, a small pump in the scrotum and a reservoir placed inside the body. The reservoir is separate from the inside of the bladder. After activation and training, squeezing the pump transfers fluid away from the cuff so urine can pass; the cuff then refills to restore closure.
The device is internal. Learning to locate and operate the pump is an important part of treatment, not an optional detail after surgery.
Who may be considered for the procedure
AUS surgery is commonly discussed for selected men with persistent, troublesome stress leakage, including after prostate treatment. The assessment looks at leakage severity, prior operations or radiotherapy, the condition of the urethra and bladder, and other health factors.
Urgency leakage alone is a different problem. If the main issue is a sudden, difficult-to-control urge, the bladder may need treatment rather than an implant that closes the urethra. Men with mixed symptoms may need a plan for both components.
Can you operate the pump comfortably
Hand strength, coordination, understanding and the ability to use the pump each time you urinate are important. The consultation should include an explanation or demonstration of the mechanism and a discussion of any practical limitations.
An active infection or an unresolved narrowing may need treatment before implant surgery. Previous urethral problems do not have a single answer; they require specialist assessment of the risks and available options.
The assessment before surgery
Bring the reports from your previous prostate or urinary operations, details of radiotherapy, a medicine list and a record of pad use. Urine testing, an examination of the urethra with a camera and selected bladder function tests may be part of the work-up.
The surgeon should explain why an AUS is preferred over alternatives such as a male sling or continued conservative management. Discuss how much improvement is realistic for your situation, whether urgency may remain and what the long-term care would involve.
Surgery and the first weeks of recovery
The device is implanted during an operation under anaesthesia. Incisions are needed to position the components, and hospital arrangements depend on the procedure and your health. This is different from an injection or a treatment performed simply by freezing the skin in a consultation room.
The device is generally left deactivated initially while tissues heal. You may therefore continue to leak during the early recovery period. Activation is arranged by the surgical team after the appropriate healing interval, together with instruction on using the pump.
Follow the plan for wound care, activity, pain relief and review. Fever, increasing redness, discharge from the wound, worsening pain or difficulty passing urine need prompt contact with the treating team.
Living with the device
Once activated, the aim is to improve control during daily activities. Some men still use a pad for reassurance or residual leakage. Outcomes depend on the underlying problem and the tissues around the cuff.
Tell any healthcare professional that you have an AUS before catheterisation or instrumentation of the urethra. The device needs appropriate management, including deactivation when required, to avoid injury. Keep the device information and your surgical team’s contact details available.
An AUS is a mechanical implant and may need revision or replacement over time. Infection, cuff erosion into the urethra, mechanical failure and recurrent leakage are among the risks to discuss. Long-term follow-up and knowing whom to contact are part of owning the device.
Questions about cost and planning
Ask for a written explanation of what the proposed treatment includes: the implant, hospital and anaesthetic care, activation, follow-up and any additional assessment. Do not assume that a quotation for another implant or another country applies to your case.
If you live outside Dubai, discuss travel timing and how wound review, activation and later problems would be managed. A practical aftercare plan matters as much as selecting a date for surgery.
Frequently asked questions
Will the implant treat every kind of incontinence
No. It is primarily used for selected sphincter-related stress leakage. Bladder overactivity, retention and other causes need their own assessment.
Will it work immediately after the operation
It is normally left deactivated while healing occurs. The treating team arranges activation and teaches you how to use it.
Is it a permanent cure with no further maintenance
No such guarantee should be expected. It can provide useful long-term control, but revision or replacement may be needed and follow-up remains important.
Discuss whether an AUS fits your needs
If persistent leakage is limiting your independence, book a consultation with Dr. Amin Mir Sadeghi. The assessment can clarify suitability, alternatives and the practical steps from surgery to activation and ongoing care.
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