What is it?
An Artificial Urinary Sphincter (AUS) is a surgically implanted device used to treat severe urinary incontinence, most commonly in men after prostate surgery (such as radical prostatectomy or TURP). It is considered the gold standard treatment when other options (medications, slings, or behavioural measures) are not effective.
How does it work?
The AUS mimics the function of a natural urinary sphincter:
- A fluid-filled cuff is placed around the urethra to keep it closed and prevent leakage.
- A small pump is implanted in the scrotum. When you want to urinate, you squeeze the pump to temporarily deflate the cuff, allowing urine to pass.
- After a short time, the cuff automatically refills, closing the urethra again.
Why is it done?
- Severe stress urinary incontinence (leakage with coughing, laughing, or exertion)
- Incontinence after prostate surgery (radical prostatectomy, TURP)
- Rarely, used in women or children with sphincter damage
Benefits:
- Highly effective—restores continence in the majority of men
- Improves quality of life significantly
- Long-term solution compared with pads or external devices
Risks & Considerations:
- Infection or erosion of the device (rare, but may require removal)
- Mechanical failure over time (device may need replacement after 7–10 years)
- Temporary difficulty using the pump until familiar
- Not suitable for men who cannot operate the pump with their hands
The Procedure:
- Performed under general or spinal anaesthesia
- Takes about 1–2 hours
- Usually requires 1–2 days in hospital
- Device is left deactivated for several weeks to allow healing before use
Recovery:
- Return to light activities within 1–2 weeks, normal activities after 4–6 weeks
- Device activation occurs about 6 weeks post-surgery in clinic
- Patients require instruction and practice to use the pump confidently
Why seek advice?
For men with severe urinary incontinence, the AUS can be life-changing, offering freedom from pads and confidence in daily life. If other treatments have not worked, a urologist can assess whether an AUS is the right option for you.