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June 24, 1983

New surgical techniques ease incontinence

JAMA. 1983;249(24):3284-3287. doi:10.1001/jama.1983.03330480008006

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According to reports from the recent American Urological Society national meeting in Las Vegas, still-investigational methods of improving urinary sphincter function and of replacing the muscle should it fail look promising. Furthermore, there may be more to the sphincter than was previously thought.

Several reports, for example, emphasized the growing value of the artificial sphincter in treating patients with spinal cord injuries as well as those requiring intermittent catheterization.

The artificial sphincter consists of a silicone rubber cuff, a small pump, a balloon, and a stainless steel control assembly. When surgically implanted, the cuff is placed around the neck of the bladder (or some-times, in men, around the bulbous urethrae), the balloon is positioned in the prevesical space, and the pump is inserted under the skin either in the scrotum in males or the labia minora in women. When filled with fluid, the cuff cuts off the flow of urine