A urinary incontinence treatment apparatus comprises an adjustable restriction device (234) implanted in a patient, who suffers from urinary incontinence. The restriction device engages the urethra (244) of the patient to restrict, i.e. to close the urine passageway. An implanted adjustment device is adapted to adjust the restriction device such that the urethra is temporarily released, in order to open the urine passageway when the patient wants to urinate. An implanted powered hydraulic operation device (246) operates the adjustment device.