The artificial urinary sphincter.

Urinary incontinence (UI) is regarded as a major health issue affecting a large sector of the population. The International Continence Society defines UI as the complaint of involuntary leakage of urine that is objectively demonstrated and is a social and hygienic problem. It is caused by a wide range of factors and it has a great negative impact on the lifestyle of patients, as well as a burden on the healthcare system, since it affects an estimated 10 million patients in the USA. Approximately 50% of all nursing home residents and between 15 and 30% of women over the age of 65 years have UI. The treatment modalities vary according to the underlying causes and the results are often unsatisfactory. With the introduction of the artificial urinary sphincter there has been a dramatic change in the management of refractory cases of UI. The artificial urinary sphincter is a device, usually in the form of an inflatable silicone cuff, inserted around the bladder neck or around the bulbous urethra in adult males. It mimics the biological urinary sphincter by providing a competent bladder outlet during urinary storage and an open outlet to permit voluntary voiding. In this review we give an overview of UI and the artificial urinary sphincter as a method of treatment.