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Artificial Urethral Sphincter (AUS)

The AUS is a more complex device than a male sling. A water filled cuff is placed around the urethra (water pipe) so that pressure of the cuff squeezes the urethra closed. Fine tubing inside the body connects the cuff to a pressurised reservoir and a small control pump. The control pump is placed inside the scrotum.
 
The control pump allows you to empty the cuff and allow the urine to come out when you need to pass urine. You squeeze the pump to empty the cuff and after a minute or so the cuff will automatically refill.
 
The AUS operation is a slightly bigger procedure than the sling and manipulating the pump can need a bit of dexterity. Also, because the AUS is a mechanical device with a number of complex components, it may malfunction over time and need replacing. The risk of device failure is only about 1% per year, but after 10-15 years the risk of failure is much higher. If the AUS fails, then a further operation can be performed to replace it wirth a new one and that usually works just as well as before.
 
There is a small risk (1%) of getting infections around the device, which would mean it may have to be removed and could only be replaced after a few months. There is a small risk (1%) of the cuff eroding into the water pipe and causing damage as well. These problems are uncommon, and most patients have a good result from this operation.
 
For further information, follow this link to the BAUS patient information leaflet on AUS insertion.
 

How well does it work?

The AUS is more effective than other treatments for Post Prostatectomy Incontinence, particularly when the degree of leaking is more severe (eg more than 4 pads per day). 95% of men find their incontinence is significantly better and they can get by with at most 1 small pad per day. About 70% of men are completely dry.
 
The AUS is still considered to be the Gold Standard treatment for Post-Prostatectomy Incontinence.