Artificial Urinary Sphincter Surgery for Male Urinary Incontinence
Specialized evaluation and advanced artificial urinary sphincter implantation for moderate to severe stress urinary incontinence and urinary sphincter weakness by an experienced genito-urinary reconstructive surgeon.
Reconstructive Urology Expertise
Personalized Continence Care
13+ Years of Experience
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Overview
What is an Artificial Urinary Sphincter?
An Artificial Urinary Sphincter (AUS) is an implanted medical device designed to help control urine leakage in men with significant stress urinary incontinence caused by weakness or damage to the natural urinary sphincter.
The urinary sphincter normally keeps the urethra closed until a person chooses to urinate. If this sphincter becomes weak or damaged — commonly after prostate surgery or other pelvic procedures — urine may leak during coughing, walking, lifting, exercise or everyday activities.
An artificial urinary sphincter usually consists of three components: a cuff placed around the urethra, a small control pump positioned inside the scrotum and a pressure-regulating reservoir placed internally. The cuff keeps the urethra closed and is temporarily opened when the patient activates the pump to urinate.
Important: Artificial urinary sphincter surgery is generally considered for appropriately selected patients with persistent moderate to severe stress urinary incontinence when conservative treatment has not provided adequate control.
Indications
Who May Need an Artificial Urinary Sphincter?
Incontinence After Prostate Surgery
Persistent urine leakage can occur after radical prostatectomy or other prostate procedures when the urinary sphincter becomes weakened or damaged.
Moderate to Severe Stress Incontinence
Men who experience substantial urine leakage during walking, coughing, lifting, exercising or changing position may be evaluated for AUS surgery.
Failed Conservative Treatment
Surgery may be considered when pelvic floor exercises, lifestyle measures and other non-surgical treatments have not provided satisfactory improvement.
Previous Radiation Treatment
Men with urinary incontinence following prostate or pelvic radiation may require specialized evaluation because tissue quality and surgical risks can be different.
Previous Continence Surgery
Patients with persistent or recurrent leakage after another anti-incontinence procedure may be evaluated for artificial sphincter implantation or revision.
Urinary Sphincter Damage
Incontinence caused by significant intrinsic sphincter deficiency following surgery, trauma or selected reconstructive conditions may require specialist treatment.
Symptoms
Signs You Should Seek Specialist Evaluation
- Urine leakage while coughing or sneezing
- Leakage during walking or exercise
- Urine loss while lifting objects
- Leakage when standing from a sitting position
- Continuous dependence on urinary pads
- Difficulty controlling urine during normal activities
- Significant leakage affecting work or social life
- Skin irritation caused by repeated urine leakage
Evaluation
How We Evaluate Before Artificial Sphincter Surgery
Before recommending an artificial urinary sphincter, Dr. Gautam Banga performs a detailed evaluation to identify the cause and severity of urinary incontinence and assess whether the urethra and bladder are suitable for implantation.
Evaluation may include:
- Medical & Surgical History – assessment of previous prostate, bladder, urethral or pelvic surgery.
- Incontinence Assessment – evaluation of when leakage occurs and how severely it affects daily life.
- Pad Usage – number and degree of wetness of pads may help estimate severity.
- Physical Examination – assessment of genital, neurological and pelvic factors where clinically relevant.
- Urine Test – used to identify urinary infection before surgery.
- Uroflowmetry & Post-Void Residual – evaluates urinary flow and bladder emptying.
- Cystoscopy – may be performed to assess the urethra, bladder neck and previous surgical areas.
- Urodynamic Testing – may be recommended in selected patients when bladder function is unclear.
- Previous Radiation Assessment – important because radiation can affect urethral tissue quality.
- Device Counselling – discussion of device operation, realistic expectations, complications and possible future revision.
Treatment
Treatment Options for Male Urinary Incontinence
Why Choose Us
Why Choose Dr. Gautam Banga for Artificial Urinary Sphincter Surgery?
Detailed Continence Evaluation
Treatment planning identifies whether leakage is caused by sphincter weakness, bladder dysfunction or another urinary problem.
Complex & Post-Surgical Cases
Specialized evaluation for urinary incontinence after prostate surgery, radiation, urethral reconstruction or previous continence procedures.
Personalized Device Planning
The surgical approach is selected according to leakage severity, urethral condition, previous treatment and individual anatomy.
Long-Term Follow-Up
Patients receive guidance regarding device use, urinary function and symptoms that may indicate future device-related problems.
Dr. Gautam Banga
Consultant Andrologist & Genito-Urinary Reconstructive Surgeon
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Frequently Asked Questions
An Artificial Urinary Sphincter is an implanted device that helps control urine leakage by placing controlled pressure around the urethra.
The patient temporarily opens the cuff using a small pump when they need to urinate.
It is most commonly considered for men with moderate to severe stress urinary incontinence caused by urinary sphincter weakness, particularly after prostate surgery.
Yes. Persistent stress urinary incontinence following radical prostatectomy is one of the main reasons artificial urinary sphincter surgery is considered.
The patient still requires detailed evaluation before treatment.
The device uses a fluid-filled cuff around the urethra to help prevent leakage.
When the patient wants to urinate, they squeeze a pump located in the scrotum. This temporarily releases pressure from the cuff and allows urine to flow.
Current AUA/ASRM guidance states that men with NOA undergoing sperm retrieval should undergo microdissection TESE, while EAU guidance also identifies it as the treatment of choice for sperm retrieval in NOA.
No.
The cuff, pump and reservoir are implanted inside the body. The pump can be felt within the scrotum so the patient can operate it manually.
Many patients achieve major improvement in urinary control, but complete dryness cannot be guaranteed.
Some patients may continue to use a small security pad or experience occasional leakage.
The device is usually kept deactivated during the initial healing period.
After adequate recovery, the surgeon activates the device and teaches the patient how to operate it.
The implant is designed for long-term use, but it is a mechanical device.
Over time, mechanical failure, tissue changes, infection or erosion may require revision, replacement or removal.
Yes.
Like any mechanical implant, an artificial urinary sphincter can eventually malfunction. Patients should understand that future revision surgery may be required.