This Spring Festival 2014 is the happiest year for the old Qin couple in the past two years, because they can finally visit friends and relatives and travel again as in the past. What is this all about? The story begins six months ago. The first time I saw the couple was at the clinic of Professor Wang Zhong, when the two old men were talking about their misfortunes with sad faces: In August 2012, the old man had a minimally invasive surgery for prostate enlargement at a local hospital for convenience, thinking that after the surgery he would no longer have to suffer from urination problems and would have the opportunity to travel around and see the beautiful mountains, but unexpectedly after the surgery he had no control over urination at all and urine often came out involuntarily. After the surgery, he thought he would no longer have to suffer from urination problems and would have the opportunity to travel around and see beautiful mountains. At first, both Qin and the surgeon thought that this might be postoperative transient incontinence that could be recovered slowly. Who knows that this urine leakage is more than a year, the body all day a bad smell, like to go out and activities of the old Qin had to be “trapped” at home, life lost the fun of the past. The couple sought medical advice everywhere, the diagnosis is clear – true incontinence, but no hospital in the vicinity has the exact treatment. The thought of their later life is therefore destroyed, the old Qin can not help but feel desperate. By chance, the couple learned that Professor Wang Zhong, director of urology at the Ninth People’s Hospital of Shanghai Jiaotong University School of Medicine, has extensive experience in the treatment of urinary incontinence and may be able to treat Lao Qin’s disease, so they could not help but rekindle their hope. After studying the patient’s condition, Professor Wang Zhong confidently told Lao Qin, “Don’t worry, I promise to return you to a happy old age!” In October last year, Old Qin underwent an artificial urethral sphincter implantation in the Department of Urology at the Ninth Hospital, and the surgery went well, with significant urinary control after initiating the artificial urethral sphincter six weeks after the surgery. I, as Prof. Wang’s assistant, contacted Lao Qin by phone several times before New Year’s for routine post-operative follow-up, but no one answered at home the first two times, and it was only on the third time that he finally got through. He explained to me that the first two times he probably happened to be out for a walk, so he didn’t get the call. He told us that now he could go to the park again to play tai chi and take a walk, and he no longer had to worry about urine leaking out like before, and he also told us that he was planning a long trip, so he might have to wait for a long time if he couldn’t get the phone this time. Listening to his happy tone on the phone, I couldn’t help but feel happy for him. I hope that more patients with urinary incontinence can improve their quality of life with this procedure. When you look at this, one wonders what the artificial urethral sphincter is all about. What is this miraculous effect? To understand this question, we must first understand the role of the urethral sphincter. Let’s say that if the bladder is compared to a reservoir, then the urethral sphincter is the gate of the reservoir, once this “gate” is damaged, the water in the “reservoir” will keep flowing outward, we will call this urethral sphincter insufficiency true incontinence This is called true urinary incontinence. The causes of urethral sphincter impairment in men are as follows: congenital dysplasia, post-radical prostate cancer surgery, post-prostate enlargement surgery (minimally invasive or open approach), and pelvic fractures that damage the urethral sphincter. There are four main treatments for true urinary incontinence: (1) conservative treatment, (2) reconstruction of the urethral sphincter, (3) increasing urethral resistance, and (4) artificial urethral sphincter implantation. The first method is often ineffective; the second method uses adjacent muscle flaps to reconstruct the urethral sphincter, but the results have proven to be unsatisfactory and more invasive; the third method controls urination by increasing urethral resistance, commonly done by male slinging, but the efficacy is unstable. Only the artificial urethral sphincter can simulate the working principle of the normal human urethral sphincter, and put an artificial “gate” for the bladder, which can help the bladder to store urine normally and “open the gate and let go” when the patient feels the urge to urinate. Therefore, artificial urethral sphincter implantation has gradually become the gold standard for the treatment of true urinary incontinence. The artificial urethral sphincter, which is widely used at home and abroad, consists of three parts: a pressure-regulating ball, a control pump and a cuff. The mechanism of action is as follows: during the period of urine storage, the cuff is filled, compressing the urethra and thus preventing the flow of urine, and when the urge to urinate is felt, the fluid in the cuff is transferred to the pressure regulating ball by squeezing the control pump. After a few minutes, the cuff automatically returns to the filled state, and the urethra is closed by pressure and enters the urinary storage period again, and so on and so forth. Artificial urethral sphincter is so amazing, so is it possible to use this method to treat urinary incontinence as long as it is? Of course not. Bladder-derived incontinence with a normal urethral sphincter is an absolute contraindication to surgery; in addition, if the indication for surgery is present, but there is also instability of the detrusor muscle or hyperreflexia of the detrusor muscle or severe hypo-compliance bladder, bladder contracture, severe vesicoureteral reflux, obstruction of the bladder outflow tract, poor self-care ability or abnormal mental behavior, upper urinary tract fluid and impaired renal function, the above should be addressed first The above problems should be solved before surgery. It is important to mention that although the artificial urethral sphincter can solve the problems of the majority of people, there are still certain risks, such as rejection, mechanical failure, etc. In addition, the expensive cost also discourages a large proportion of patients. However, for the time being, it is the most definitive treatment modality in terms of efficacy. Not many hospitals in China are able to perform artificial urethral sphincters, and the number of such patients themselves is small. However, my teacher, Professor Wang Zhong, has performed more than 200 penile prosthesis implantations in the past 10 years, so he is familiar with this type of surgery, and we have even performed both penile support and artificial urethral sphincter implantations for some patients with satisfactory results. With the continuous development of society and the increasing improvement of people’s living standards, such procedures as artificial urethral sphincter are gradually becoming more acceptable to the general public, and we believe that in the near future, such techniques will appear more often in clinical treatment, bringing good news to patients.