ARTIFICIAL urinary sphincter placement for men suffering from urinary incontinence is available at one of Bahrain’s well-known hospitals, giving patients suffering from the condition a new lease of life.
Royal Bahrain Hospital (RBH) is arguably the only facility in the kingdom conducting the procedure.
Urinary incontinence (UI) is the loss of bladder control, or being unable to control urination. It is a common condition, the severity of which can range from being a minor problem to something that greatly affects your daily life.
“Urinary incontinence in males can happen after prostate surgery due to cancer,” RBH urologist Dr Erfai Emtair told the GDN.
“The sphincter which controls the urine might get affected during surgery, leading to an inability to control the flow of urine especially when the person sneezes, coughs or even moves. Amount of urine loss can vary from 50 cubic centimetre per day to as much as 400cc per day, indicating complete damage of the sphincter.
“In addition to the physical inconvenience, those suffering also experience embarrassment and mental trauma because they are unable to go out without the fear of urine escaping. They have to use pads, sometimes changing as many as six to eight a day, which can affect social life,” added Dr Emtair.
The good news is that UI can get better with proper treatment. At RBH, after diagnosing the intensity of the condition, an artificial sphincter or male sling is recommended. The former is used in more severe cases and the difference between them is that an artificial sphincter needs to be operated by the patient.
An artificial sphincter consists of a cuff around the urethra – the tube through which the urine leaves the body – which is connected to a pump that’s placed in the scrotal area. Gently squeezing the pump moves the fluid from cuff to a pressure balloon thus expanding the cuff and letting urine pass. After two-and-a-half minutes, the fluid moves back to the cuff, closing it and stopping urine flow.
“At RBH, we have all the facilities to diagnose cases and provide proper treatment like any other advanced hospital in advanced countries. When a patient comes to us, we do a complete clinical check-up, followed by an ultrasound to check the kidneys, bladder and area of surgery especially if it’s after endoscopic removal of prostate.
“Then, we do an uroflowmetry test to determine how much urine can be contained inside the bladder. It’s mandatory for us to do a cystoscopy to know how the sphincter is functioning, i.e. if it’s completely or partly damaged. Lastly, we conduct an urodynamic test to study the behaviour of the bladder.
“After these steps, we discuss with the patient and according to the grade of incontinence either we go for the artificial sphincter or male sling, both of which are available at RBH,” he explained.
Dr Emtair highlighted that the diagnosis takes about two to three days, followed by surgery and a day in the hospital after which the patient is free to go home. It takes about two weeks to completely heal after which the sphincter is activated. RBH ensures regular follow-ups and a complete rehabilitation for six months after surgery, even guiding patients on how to operate the sphincter.
“I’ve seen patients using six to eight pads a day transform their lives after surgery. At RBH, we change lives completely,” he said.
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