Infla10® Pulse™Also Known As
AUS deactivation, sphincter deactivation, cuff deflation, device decompression, temporary sphincter disablement, artificial sphincter deactivation, urinary control device deactivation
Definition
Device Deactivation refers to the process of temporarily disabling an artificial urinary sphincter (AUS) by manipulating the scrotal pump to release fluid from the urethral cuff, thereby relieving pressure on the urethra.1 This procedure involves a specific sequence of actions: emptying the cuff by compressing the pump bulb multiple times, allowing partial refill for pressure equalization, and pressing the deactivation button to lock the device in an open position.2 The deactivation is confirmed when the internal pin is locked in the bottom position and a dimple remains present in the pump bulb, indicating that the urethral cuff remains deflated and no compression is being applied to the urethral tissue.3
Clinical Context
Device deactivation is a critical procedure in the management of patients with artificial urinary sphincters, primarily used in men experiencing stress urinary incontinence following prostate surgery.1 Clinically, deactivation serves several essential purposes: it is mandatory before urethral catheterization to prevent compression of urethral tissue between the catheter and cuff, which could lead to decreased blood flow and subsequent erosion of the device into the urethral lumen.3
The procedure is routinely performed during the post-surgical healing period, typically for 6-8 weeks after AUS implantation, to allow the surgical area and urethra to heal properly without compression.1 Healthcare providers may also recommend periodic deactivation during sleep to reduce continuous pressure on urethral tissue, thereby minimizing the risk of urethral atrophy or erosion over time.2
Patient selection criteria for AUS implantation, which necessitates understanding of device deactivation, includes assessment of manual dexterity and cognitive capacity to properly operate the pump mechanism.1 The surgical procedure involves placement of the three-component system (urethral cuff, pump, and pressure-regulating balloon) with the pump positioned in the scrotum for easy access and manipulation.2
Expected outcomes of proper device deactivation include prolonged device longevity, reduced complication rates (particularly erosion and infection), and improved quality of life for patients with stress urinary incontinence.3