Artificial Urinary Sphincter Complications: A Narrative Review

Abstract

Stress urinary incontinence is a financially burdensome and socially isolating problem and can be experienced by men as a result of radical prostatectomy, radiation therapy, or other urologic surgery. Artificial urinary sphincter (AUS) placement for stress urinary incontinence is considered the ‘gold standard’ for male stress urinary incontinence. While initially only placed by specialized prosthetic surgeons, changes in urologic training have made implantation of the device by general urologists more widespread. Additionally, even though a minority of urologists place the majority of implants, many urologists may find themselves caring for patients with these devices even if they have never placed them themselves. For this reason, it is paramount that the urologic surgeon implanting the device and those caring for patients with prostheses are familiar with the various perioperative and postoperative complications of AUS implantation. This review discusses the most commonly reported complications of AUS implantation as well as those that are rarely described. Knowledge of these potential complications is necessary in order to care for patients with urologic implants.

Complications of Prostate Cancer Treatment: Open Issues

“…The artificial urinary sphincter (AUS) has been the typical solution for this group of patients, especially when urine loss is large and pelvic-floor rehabilitation techniques have provided insufficient postoperative improvement. This alternative was proposed in the 1970s [ 3 ]; however, it is also not free of complications that include urethral erosion, urethral atrophy and device malfunction. Taking this into account and with an improved knowledge of continence damage after prostate surgery, male retro-urethral slings have been developed in the last three decades as a less invasive alternative to treat a very high proportion of patients with less severe male incontinence after prostatectomy.…”