Please read these instructions carefully. They are designed to help you heal safely and prepare for the activation of your device.

1. Your device is currently OFF — and you will still leak

• Your artificial sphincter was placed in the deactivated, open position. This is deliberate: it lets the urethra heal without pressure on it.

• Expect leakage. Because the device is open, you will keep leaking urine exactly as you did before surgery. This is normal and expected. It does not mean the surgery failed.

• Activation: The device stays off until your 6-week appointment. Continue using pads or protective underwear until then.

2. Pain management

Stay ahead of the pain rather than chasing it. For the first two weeks:

• Alternate ibuprofen and Tylenol (acetaminophen) every 3 hours while awake. Each medication works out to every 6 hours.

  • 9:00 AM — Ibuprofen

  • 12:00 PM — Tylenol

  • 3:00 PM — Ibuprofen

  • 6:00 PM — Tylenol

• These two medications do not interact and are safe to take on this schedule.

• Breakthrough pain only: If you were prescribed oxycodone, it is intended only for pain the ibuprofen and Tylenol schedule does not control. It is a narcotic. Do not drive while taking it.

3. Scrotal care and swelling

Swelling and bruising are expected. Proper support is the single most effective thing you can do for the pain.

• Support: You must wear tight-fitting underwear — supportive briefs or a jockstrap. This minimizes swelling and pain.

• Ice: Apply an ice pack or a bag of frozen vegetables to the scrotum. Never against bare skin — put a thin towel in between. 30 minutes at a time, every 3 to 4 hours.

• The pump: You will feel the pump in your scrotum. Do not squeeze or manipulate it while you are healing. You will be shown how to handle it at your 2-week follow-up.

4. Incision care and hygiene

• Showering: You may shower with soap and water daily starting the day after surgery. Let the soapy water run over the incisions — do not scrub. Pat dry gently with a clean towel afterward.

• Baths: Do not sit in standing water — bath, pool, lake, or hot tub — for the first 2 weeks.

• Surgical glue: Your incisions are covered with a specialized glue that will flake and fall off on its own in 2 to 4 weeks. Do not pick at it. The stitches underneath dissolve and do not need to be removed.

5. Medications and bowel care

• Blood thinners: You may restart all prescribed blood thinners 72 hours (3 days) after surgery, unless you were told otherwise.

• Preventing constipation: Pain medication and anesthesia cause constipation, and straining to have a bowel movement puts real pressure on your repair. Take the prescribed stool softener every day for as long as you are taking pain medication.

6. Activity restrictions

• Lifting: Nothing heavier than 10–15 lbs — about a gallon of milk — for 4 weeks.

• No straddle activities: Avoid anything that puts direct pressure on the perineum, the area between the scrotum and the anus. No bicycles, motorcycles, horseback riding, or lawn tractors for 6 weeks.

• Driving: Not while taking oxycodone. You may drive once you are off narcotics and can stomp on a brake pedal without hesitating.

7. Long-term safety — this matters for the rest of your life

• If you ever need a urinary catheter — another surgery, an ER visit, anything — you must tell the medical staff you have an artificial urinary sphincter.

• A catheter should generally not be inserted unless the cuff is fully open. Forcing a catheter can damage both your urethra and the device.

When to contact the office

Call immediately if you experience:

• Inability to urinate — a full bladder you cannot empty

• Fever over 101.5°F

• Signs of infection: spreading redness, warmth, or pus-like drainage from an incision

• Severe swelling or rapidly increasing bruising

• Uncontrolled pain despite following the medication schedule

• Any part of the tubing or the metal or plastic components becoming visible through the skin