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Incontinence

Artificial sphincter can't take the pressure

Nature Reviews Urology volume 11, page 245 (2014)Cite this article

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New research has uncovered a possible cause of occasional urinary leaks in men fitted with an artificial urethral sphincter, suggesting that simple behavioural changes can avoid compromise of the sphincter. These results could provide valuable information to designers of improved implants.

In search of an answer, Beaugerie et al. performed an ex vivo mechanistic investigation into the fluid dynamics of the AMS800® exposed to typical perineal pressures measured in seated men. Compression of the cuff caused reflux of fluid through the pump resistor into the reservoir, resulting in lower fluid pressure in the cuff on removal of compression. This effect, and the time taken to subsequently repressurize the cuff, was dependent on the duration of compression and the pressure applied. After 5 s compression at 150 cmH2O, the lowest test pressure used, 68 s was required for full repressurization, whereas after 20 s at 250 cmH2O, a full 207 s was required for normalization of cuff pressure.

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References

  1. Beaugerie, A. et al. Artificial urinary sphincter AMS800® in males: can we explain residual leaks when sitting? J. Urol. 10.1016/j.juro.2014.02.2567

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Authors
  1. Robert Phillips
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Phillips, R. Artificial sphincter can't take the pressure. Nat Rev Urol 11, 245 (2014). https://doi.org/10.1038/nrurol.2014.73

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