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I receive in Florence, Prato and Milan

Matteotti Medical Group
Viale Giacomo Matteotti, 42
50132 - Florence (FI)
Telephone: 055 570224
Florence Castello
Villa Donatello
Via Attilio Ragionieri, 101
50019 - Sesto Fiorentino (FI)
Telephone: 055 50975
Studi Medici Life
Viale della Repubblica, 141
59100 - Prato (PO)
Telephone: 0574 583501
Columbus Clinic Center
Via Michelangelo Buonarroti, 48
20145 - Milan (MI)
Telephone: 02 480 801


AMS 800 artificial sphincter


Placement of AMS 800 Artificial Sphincter for post-prostatectomy urinary incontinence

The AMS 800 device is used for the treatment of urinary incontinence due to a resistance to urine outflow in the urethra/bladder (intrinsic sphincter deficiency) in male, female and pediatric patients.

Complete urinary incontinence , i.e. the involuntary loss of urine, is a problem that can affect, among others, about 2% of patients who undergo surgery on the prostate.

Urinary incontinence often seriously compromises the quality of patients in various areas: social, psychological, professional, domestic, physical, sexual, but it can be treated effectively thanks to surgery. According to data published by various authors, the placement of an artificial sphincter for sphincter insufficiency allows satisfactory continence to be obtained in most cases, considerably improving the patient’s overall quality of life.
The alternative treatment, represented by the chronic and daily use of external aids (diapers, collection systems, condoms) certainly does not guarantee a good quality of life.

Any intake of antiplatelet action drugs (Aspirinetta, Ascriptin, Ibustrin, Plavix, Ticlopidine, Tiklid, or similar) or anticoagulant drugs (Coumadin, Sintrom, or similar), must be strictly suspended before the operation under the supervision of the GP, and eventually replaced with low molecular weight heparin-based therapy.
The positioning of the AMS 800 type artificial sphincter involves a series of clinical and instrumental checks, to be performed before hospitalization, including: blood tests, urine test with urine culture, PAD test/wet diaper weight, urethrocystoscopy, complete urodynamic exam and possible ultrasound of the urinary tract and retrograde and voiding cystourethrography.

The AMS 800TM type artificial urinary sphincter is a real prosthesis, surgically implanted, with the aim of restoring the natural process of urination control. Normally, the striated sphincter muscle of the urethra, or the muscle responsible for controlling urination, performs a double function: when it contracts, it closes the urethra and holds urine in the bladder; when released, it opens the urethra and allows urination. If this muscle does not work properly, uncontrollable loss of urine occurs, i.e. complete urinary incontinence.The AMS 800TM type artificial urinary sphincter consists of 3 basic parts: – the urethral occlusion cuff, which is placed around the urethra itself; – a pump, which is placed in the scrotum superficially to the skin, so that it is felt to the touch. This, in turn, consists of two parts: the upper one, represented by the deactivation valve, and the lower one which, however, is soft and compressible – a balloon (or tank) which is placed near the bladder.The three components are connected to each other by a hydraulic system and work, overall, as a natural sphincter, activated from the outside, so as to keep the urethra closed until the moment the patient does not want to urinate. To allow for the positioning and connection of the various components, two small skin incisions are made: one in the groin, approximately 4 cm in size, and one in the scrotum, approximately 4 cm in size. The total duration of the procedure is approximately 60 minutes. It is necessary to place the bladder catheter, which is removed during the first post-operative day, with spontaneous resumption of urination.Starting from the first post-operative day, the patient resumes drinking and eating gradually. The patient is made to get out of bed on the first day and, compatibly with the natural recovery of his energies, he is mobilized to an ever greater extent. As soon as possible, the patient should start walking in the corridor to favor the recovery of normal circulation, to avoid the formation of thrombi in the veins of the lower limbs and to facilitate the recovery of intestinal activity.

It lasts an average of 10 days. Starting from discharge, normal daily activities can be gradually resumed, provided that too violent efforts or lifting objects weighing more than 2-3 kilos are avoided.

Sports activity and sexual activity
They can be resumed 30 days after the operation, and in any case, always after the follow-up visit.

The wound
The stitches of the abdominal skin wound can be removed approximately 8 days after the operation, during the first check-up visit. In some patients a skin suture can be performed with an intradermal technique and it is not necessary to remove any sutures. The stitches of the scrotal wound will reabsorb on their own, within about 15-20 days, without the need for any removal.
You can take a shower starting 2 days after the stitches are removed (bathing in the tub is allowed about 20 days after the operation).

Device infections
The symptoms can be varied. However, the most common are represented by severe pain in the abdomen and/or in the scrotum (especially in the testicles), fever, any secretions from the penis. In case you suspect a sphincter infection, it is advisable to carry out a check-up visit to the General Practitioner or go to an Emergency Department. In some cases, a new hospitalization may be necessary.

Urinary tract infections
The percentage of occurrence of urinary tract infections during convalescence is equal to about 3%, according to literature data. For this reason, in order to avoid them, an antibiotic treatment is administered for the period of convalescence. In the suspicion of a urinary tract infection, it is advisable to perform a complete urine test and a urine culture with antibiogram and ask the attending physician to set up any appropriate antibiotic therapy.

Abdominal pain
Normally, post-operative pains are minimal, related to skin wounds, and easily controllable with a common analgesic treatment.

Need for reoperation
A reoperation may be necessary in the following cases:+
– If an infection occurs at the site of the sphincter implant
– If a malfunction of the sphincter or even just one of its components becomes evident.
Reoperation has the purpose of removing the entire device or one of its components (replacing them).
In case of infection, once the sphincter has been removed, the tissues will be abundantly sprayed with antibiotic solution and any infected collections will be drained outside.
It will absolutely not be possible to implant a new device during the same surgery, in order to avoid problems of superimposed infection. A new operation will be possible once the infection has adequately resolved.


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    Florence | Matteotti Medical Group

    Viale Giacomo Matteotti, 42
    50132 – Florence (FI)
    Telephone: 055 570224

    Florence Castello | Villa Donatello

    Via Attilio Ragionieri, 101
    50019 – Sesto Fiorentino (FI)
    Telephone: 055 50975

    Prato | Studi Medici Life

    Viale della Repubblica, 141
    59100 – Prato (PO)
    Telephone: 0574 583501

    Milan | Columbus Clinic Center

    Via Michelangelo Buonarroti, 48
    20145 – Milan (MI)
    Telephone: 02 480801

    Dr. Andrea Cocci

    urologist and andrologist

    The decision to dedicate my professional life to urology and in particular to andrological and reconstructive surgery is the result of a deep passion for anatomy , the art of surgery and in general the diagnostic-therapeutic process which leads to the recovery of the patient. Oncological pathology, infertility, erectile dysfunction, penile diseases or simply prostate disorders irreparably afflict not only the individual but also the couple dimension.

    Receive in:
    Florence, Milan, Prato

    Dr. Andrea Cocci
    Urologist e andrologist

    I am fully convinced that listening to the patient, understanding their needs, evaluating their expectations is the only way to establish a successful and satisfying therapeutic program for both the doctor and the patient.