Artificial urinary sphincter gives Charles instant relief from incontinence caused by prostate treatment

Charles Snowbarger photo
Charles threw away his incontinence pads and got on his with his active life.

Ten years after having his cancerous prostate removed, Charles Snowbarger, of Davenport, Iowa, began to notice urine leakage when he was active. Urination was painful, and it was taking minutes to empty his bladder.

His local urologist recommended urethral injection therapy, but the symptoms returned quickly. By 2019, Charles was using up to eight incontinence pads a day.

In search of a long-term solution, Charles’ wife, Ellen, contacted University of Iowa Hospitals & Clinics and scheduled an appointment with urologist Amy Pearlman, MD. Pearlman recommended an artificial urinary sphincter to give Charles relief that would last.

After his first night with the device, Charles threw away his last incontinence pad.

“Dr. Pearlman and the team are fabulous, caring people,” Charles says. “I’ve never had better medical care.”

Expert diagnosis and treatment plan

Charles, 69, didn’t let prostate cancer slow him down, even after a recurrence in 2011 and 40 sessions of radiation. Despite the pain and incontinence, he and Ellen enjoyed a six-week European vacation in 2019.

“I was going to enjoy life, even though the pain topped out at 10 at times,” Charles says.

Significant urinary leakage can cause other problems for someone as active as Charles. The mix of sweat and urine led to rashes. Pads leaked. Intimacy was difficult.

In his first appointment with Pearlman, Charles understood how choosing a specialist with deep expertise in the latest and most effective treatments was about to change his life for the better.

“She came in and said, ‘Here’s what I think is going on. Here’s what I think we should do. These are going to be the problems when we do it. And here’s what we'll do to resolve those,’” Charles says. “And I’m thinking, ‘Thank you!’”

A two-step process for relief

Incontinence is common after prostate removal and after radiation. Removing the prostate can cause functional problems with the sphincter muscle. For Charles, radiation treatments also damaged the muscle and caused scar tissue in the urethra, which slowed urine flow.

A surgically implanted artificial urinary sphincter is the best available treatment for the kind of severe incontinence after prostate removal that Charles was having.

Pearlman had an honest discussion with Charles about the process of implanting the device.

“I had to let him know I was going to make him worse before I made him better,” she says.

For Charles, the treatment involved two steps: opening the urethra and then implanting the device. The device consists of a pump placed in the scrotum, a cuff placed around the urethra to prevent urine from leaking, and a pressure-regulating balloon in the lower abdomen.

In February 2020, Pearlman performed the first of the two steps, cutting away the scar tissue that narrowed the urethra.

“My pain vanished,” Charles says.

The urine-flow problem also vanished, which meant that Charles needed as many as 10 heavy adult pads per day.

“I understood the plan,” Charles says. “I knew it was a two-step process.”

‘Like I never had a problem’

Typically, patients heal from the first step within six weeks and are ready for surgery to implant the device. But COVID-19 shut down all elective surgeries, so Charles had to wait until late June for the second step to implant the device.

Six weeks after artificial urinary sphincter placement, Charles visited Pearlman to have the device activated. He finally had the relief he wanted.

“It was like I never had a problem,” Charles says.

The device gives Charles complete control. When he needs to urinate, he pushes the pump in the scrotum, and that opens the cuff around the urethra. The cuff then closes itself automatically.

“This procedure is one of my favorites to perform,” Pearlman says. “It has such a huge impact on quality of life.”

Charles agrees.

“I can go anywhere because I don’t have to worry about a pad and leakage on my pants,” he says. “Intimacy has improved, too. Men dealing with incontinence need to understand that technology is available that can benefit their lives.”

Davenport, Iowa