Artificial Urinary Sphincter (AUS)
Post-operative Instructions
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Learn about your AUS
Please use some of the downtime during your recovery to watch Dr. Elliott's video on how the AUS works. This will help you learn how to operate the device so that you are ready to take control of your leakage when you come for your post-operative visit.
Pain
There will be discomfort in the area of the surgery. You will go home with Norco/Vicodin which is a narcotic pain medication which should only be required for the first two to three days -- because the narcotics will cause sleepiness and constipation it is best to stop or reduce them at that time if you can. After this, using Tylenol and or ibuprofen (Advil/Motrin) as directed on the packaging should be sufficient. The pain should continue to get better on a daily basis; if it doesn't please call us. Do not exceed 4000mg of Tylenol or 2400mg of ibuprofen in a day.
Incontinence
Your AUS is deactivated at the end of the surgery because your scrotum would be too sore to squeeze the scrotal pump. You will continue to leak until we activate the AUS at your post-operative visit.
You can continue to use pads or a condom catheter (whichever you were using pre-operatively) to manage your leakage. We prefer you do not use a penile clamp because that cuts off blood flow to the surgerical area during the important healing time. Do your best to maintain personal hygeine in your groin area so that no skin infection happens after the operation (thankfully, this is rare).
Diet
You may return to your normal diet that you were taking before surgery. If you had a buccal graft used as part of your surgery, you may find soft food like yogurt and smoothies more comfortable for the first couple of days, but there are no specific restrictions.
Activity
You can return to normal activity as you are able, based upon your level of pain; but, do not exercise or lift anything heavier than 10 pounds until after your post-operative visit. We ask you to take it easy to avoid two possible complications: bleeding or a hernia in the surgical area. Most people go back to work after their post-operative visit when the AUS gets activated; if you are motivated to go back to work earlier, this is safe as long as your job does not involve lifting > 10 pounds.
Restrictions
You should not drive or drink alcoholic beverages while you are taking narcotic medications (see below). You should not shower until 48 hours after surgery. After that, daily showering is important for keeping the wounds clean.
Wound Care
Abdomen -- You will have an incision on your lower abdomen near the penis and/or an incision on your mid abdomen near the navel. The stitches are dissolvable. There will either be a dressing or surgical glue covering the incisions. If there is a dressing then it can be removed 2 days after surgery and the incision left open to air. If there is surgical glue then this will dissolve and flake off in about 2 weeks. After two days, you can shower and let the water run over the incision. You should not scrub it with soap. This area may remain numb for a few months as the nerves heal.
Perineum (if you have a perineum incision) -- The area behind the scrotum is called the perineum. The stitches are all dissolvable. You will not need any specific bandage on this area, but you may find wearing a small pad (gauze, tissue paper or a sanitary napkin / "maxi pad") in your underwear can help protect from blood staining your underwear. The blood spotting should be no more than quarter-sized per 24-hour period. If you notice more drainage or if it becomes foul-smelling, please give us a call. After two days, you can shower and let the water run over the incision. You should not scrub it with soap. This area may remain numb for a few months as the nerves heal.
Medications
1. Vicodin/Norco – this is a narcotic pain medication which you should only need for two to three days after surgery.
2. Senna-S or Colace – this is a stool softener. The surgery and pain medications can lead to constipation. You can stop this or reduce it if you are having loose stools. Other over the counter solutions such as prune juice, miralax, fiber products, senna, and dulcolax can also be used.
Follow-up
Your follow-up appointment in Dr. Elliott’s clinic is generally 3 weeks after your surgery. This appointment may be with a Physician's Assistant, Nurse Practitioner or with Dr. Elliott's fellow, rather than Dr. Elliott. They are part of his team and very experienced in the post-operative care of his patients.
At this appointment we will examine your wounds to make sure there is no infection and any post-operative swelling is resolved. If everything looks good and your pain is minimal then we can activate your AUS. This involves us squeezing the pump. We will then briefly go over how to use the pump. However, please watch/re-watch the AUS patient instruction video (click here to load) the day or or day before your appointment so that you understand the basics of how to operate your device. That way wecan spend the time in the clinic visit refining your technique.
Contact Us
University of Minnesota:
1. Nursing phone helpline at the Urology clinic (8A-5P M-F): 612-625-6401
2. Jennifer Schifsky is Dr. Elliott's nurse in the Urology clinic. Her direct line is: 612-713-9649
3. If after hours, call the clinic line at 612-625-6401 and you will be connected with the Urology resident on call. If that fails, then call 612-273-3000 and ask to speak with the Urology resident on call.