de Vries A H Heleen, Noordzij M A Arjen
Spaarne Ziekenhuis, afd. Urologie, Hoofddorp, the Netherlands.
Ned Tijdschr Geneeskd. 2013;157(10):A5608.
The placement of an artificial urinary sphincter prosthesis is a recognised treatment for men with urinary incontinence that is caused by insufficient sphincter action, although it is rarely used. Physicians from specialties other than urology know little about the components and mechanism of action of this prosthesis, which can lead to severe complications.
A 67-year-old patient with a history of radical prostatectomy came to the emergency department with abdominal pain after a colonoscopy. A few years prior, he had received an artificial urinary sphincter prosthesis because of urinary incontinence. An abdominal CT scan showed a cystic lesion, which was punctured under ultrasonic guidance. The patient was completely incontinent after the intervention. It appeared to have been the pressure balloon of the urinary sphincter prosthesis that was punctured. The pressure balloon was operatively replaced several weeks later. During this procedure, the pressure balloon was placed intravesically instead of in the retropubic space and a reoperation was necessary.
To prevent complications, all physicians should know how medical implants function, including the ones that are rarely used. In addition, patients need to be well informed of their use.
