An incontinence cuff/clamp* is a very useful adjunct to treatment plans aimed at placing an AMS 800 artificial urinary sphincter (AUS) as management of urinary incontinence post treatment. These may be seen as competing technologies but in fact are fully supportive of each other. The decision to have a surgical procedure depends on general health and also personal financial situations so it is very useful to have a low-cost, effective alternative to use while waiting.
Usually there are several phases of use of the incontinence device.
- Post surgery, after catheter removal. There will be a period of 3-12 months before sphincter resumes its normal function. During this time one may use an incontinence device as directed by their surgeon to control dribbling.
- Post surgery, at the end of 12 months. At this time there will be a residual 5-15% of patients who fail to recover control with the sphincter. This group of patients must decide how they will adapt to the leakage problem. Often, surgeons will propose placement of an Artificial Urinary Sphincter (AUS) type of device like the AMS 800.
- An incontinence device could be an asset while waiting for this implant to take place. In some cases, users have found enough control of their incontinence to forego the surgery altogether!
- At times, there is need to adjust or replace the implant (up to 30 %). When leakage becomes a problem again, the incontinence device can back up the internal sphincter device and allow for a leisurely decision to be made.
- Having an incontinence device as backup is a strong asset for the patient to regain control during these phases of treatment.
Figure 1. This shows the various components of the surgically implanted sphincter device. The control pump and valve is normally placed in the scrotal sac with a reservoir placed near the bladder in the extraperitoneal space where it can function without any perceptible feeling. The incontinence cuff is applied around the urethral channel where it can apply pressure to stop urine flow.
*Examples of external incontinence devices:
Incontinence Cuff: Pacey Cuff™ urethral control device
Incontinence Clamps: Cunningham, Wiesner, Dribble Stop, Uriclak, J-Clamp, Geezer Squeezer
Urethral Insert: Contino