Having an artificial urinary sphincter
From Professor Mark Cato
I was diagnosed with prostate cancer in January 1999. In May 1999 I had a radical prostatectomy. A side effect of this operation was complete incontinence and I relied on a catheter and leg bags. By using a combination of regular pelvic floor exercises and a small electrical device, I managed to be 95% continent by November 2002. Then my neurologist suggested that he could probably fix that last 5% so I had a further operation to insert bio-plastique around the sphincter muscle. Unfortunately this went wrong and I returned to being completely incontinent once more. Eventually I was referred to another neurologist who told me I could be fitted with an artificial urinary sphincter (AUS).
The AUS worked splendidly from the beginning and is very easy to operate. The control pump is in the scrotum. You hold it with your left hand and use your right hand to squeeze the tip. This opens the AUS allowing the bladder to empty. As the bladder empties, a small reservoir fills up and blocks off the device, leaving you continent again until the next time you need to empty your bladder.
All went well until I was diagnosed with motor neurone disease (MND) in early 2008. My hands were affected first and rapidly weakened, making it difficult for me to locate and operate the AUS pump. I needed to find some other way of operating this device.
I was fortunate in establishing a good relationship with the medical technicians at Addenbrookes Hospital. With their help I designed a remote-controlled electronic device, located on a thigh strap, to operate the AUS pump. However, whilst experimenting with the AUS I realised the reservoir was not refilling and the pump was now permanently open. It was a weekend and so I was not able to see my neurologist to correct the device.
I went to bed that night, having put a rubber sheet on the bed and wearing a nappy. I was pleasantly surprised in the morning to find that I had not leaked, as I thought I would. The following day I wore normal underclothes with an incontinence pad but again, no significant leakage. The subsequent medical explanation was that the AUS was acting, in conjunction with my own pelvic muscles, and retaining the urine.
As my hands are now so weak there is no way I could operate the control pump and I simply would not be able to venture far from home. So I am very grateful the AUS and my own body are working together and I can maintain my continence.
Professor Cato has a blog ‘ Dying to live with MND’ which also details his cancer diagnosis and treatment.
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