Implantation of an artificial urinary sphincter is considered only in patients with severe stress urinary incontinence, when the sphincter control around the urethra is insufficient to hold back the urine even during minimal efforts.
The most common causes of this degree of leakage are radical prostatectomy or radiotherapy for prostate cancer or a TURP procedure for an enlarged prostate but also patients with congenital anomalies, spinal cord injuries or who have had urethral reconstruction following pelvic fractures may also suffer from severe stress incontinence.
If significant stress incontinence persists for 6 months to 1 year after a pelvic operation, implantation of an AUS sphincter or of a male sling should be considered. AUS sphincter and sling are indicated in different type of patients and therefore an adequate assessment is necessary to identify which is the most suitable procedure for each patient. Implantation of AUS sphincter and of male sling are very successful procedures and allow the vast majority of patients to remain dry.