An artificial urinary sphincter can restore control for selected men with persistent stress leakage.
An artificial urinary sphincter (AUS) is an implanted device used for selected men with bothersome stress urinary incontinence, often after prostate surgery or radiation. It is not an automatic next step and it does not recreate a natural sphincter. A careful evaluation confirms the type and severity of leakage, urethral health, prior radiation or procedures, ability to operate the pump, and whether a sling or non-surgical approach remains reasonable.
The device uses a fluid-filled cuff around the urethra, a scrotal pump, and a pressure-regulating component to help control stress leakage.
A man must be able to find and operate the pump; urethral health, prior radiation, and earlier procedures affect risk.
Effectiveness can decline and revision may be needed over time, so lifetime device planning belongs in consent.
What an AUS evaluation should confirm
Type and severity of leakage
Stress leakage with activity is different from urgency, overflow, infection, or a bladder problem and may require a different treatment.
Radiation and urethral history
Radiation, scarring, stricture, erosion, and prior implants can change tissue risk and procedure selection.
Hand function and cognition
The patient must reliably locate and squeeze the scrotal pump before urinating.
Cystoscopy and bladder assessment
The urethra, bladder outlet, and bladder behavior may need evaluation before implantation.
Revision and future procedures
Mechanical failure, tissue change, infection, erosion, or recurrent leakage can lead to additional surgery.
How the device works
The AUS typically includes a cuff around the urethra, a pump in the scrotum, and a pressure-regulating component. The closed cuff helps resist leakage. To urinate, the man squeezes the pump, temporarily moving fluid away from the cuff so urine can pass; the cuff then refills.
The device is implanted surgically and is generally left inactive during initial healing. Activation and teaching occur later according to the implanting surgeon's plan. Until activation, the device does not provide its intended continence support.
Who may be considered
Guidelines support discussing an AUS with men who have persistent, bothersome stress urinary incontinence after prostate treatment. The conversation depends on severity, time since treatment, prior pelvic radiation, urethral or bladder-neck scarring, earlier continence surgery, infections, bladder function, and the patient's goals.
Radiated tissue and severe leakage may make an AUS more appropriate than a male sling for some men, but they can also increase complication risk. This is a decision for individual evaluation, not a rule that can be applied from a symptom search.
Risks and lifetime device planning
Important risks include infection, erosion into the urethra, urinary retention, pain, device malfunction, recurrent leakage, and the need for revision or removal. The AUA guideline emphasizes counseling that effectiveness can decline over time and reoperations are common.
Any clinician who places a urinary catheter or performs urethral instrumentation in the future needs to know an AUS is present. The device may need to be deactivated first to reduce urethral injury risk; patients should follow the implanting team's device instructions.
Evaluation and referral in New Jersey
An incontinence evaluation can separate stress leakage from urgency and other bladder problems, quantify pad use and bother, review conservative care, and determine whether cystoscopy or other testing is appropriate. It should also compare a sling, AUS, and non-surgical management honestly.
Innovative Urology can evaluate male leakage and clarify the next step. This page does not claim that AUS implantation will be performed by Dr. Savatta or at a particular facility; when the device is the right direction, the care plan should name the experienced implanting clinician and referral pathway.
Male stress-incontinence options
Pelvic floor and practical management
Early recovery, milder symptoms, or men who prefer non-surgical care.
May include therapy, pads, clamps used only with guidance, and monitoring.
Male sling
Selected men, often with mild-to-moderate stress leakage and favorable tissue factors.
No pump to operate, but it is not the right fit for every severity or radiation history.
Artificial urinary sphincter
Selected men with persistent bothersome stress incontinence who can operate the device.
Implant surgery with infection, erosion, mechanical, and future-revision considerations.
Treat urgency or obstruction
Men whose testing shows bladder urgency, retention, stricture, or another cause rather than isolated stress leakage.
Correct diagnosis prevents an implant from being used for the wrong mechanism.
Next step for New Jersey patients
Request a consultation if these questions match your symptoms, diagnosis, or treatment decision. Innovative Urology serves patients from Westfield, Summit, Short Hills, Millburn, Livingston, Edison, Woodbridge, Morristown, and nearby New Jersey communities.
Continue your decision path
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Artificial urinary sphincter questions
What is an artificial urinary sphincter?
It is an implanted fluid-filled device that uses a cuff around the urethra and a scrotal pump to help selected men control stress urinary leakage.
Who is a candidate after prostatectomy?
Men with persistent, bothersome stress incontinence may be considered after recovery and evaluation of severity, bladder and urethral health, radiation, earlier procedures, hand function, and goals.
Is an AUS better than a male sling?
Neither is universally better. Severity, radiation history, tissue quality, anatomy, and patient preferences influence which is appropriate. Guidelines favor AUS over a sling for many radiated men seeking surgery.
Does an artificial sphincter last forever?
No device can be promised for life. Effectiveness can decline, and infection, erosion, tissue changes, or mechanical failure can require revision or removal.
Can I urinate normally with the device?
The patient squeezes the scrotal pump to temporarily open the cuff before urinating. Training and manual ability to operate the pump are essential.
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