AUS in Men: Illustrated Description of Surgery

Artificial Urinary Sphincter (AUS)

How the AUS Works and an Overview of the Operation

The AUS is a hydraulically-operated device that circumferentially squeezes the urethra. A doughnut-shaped silicon “cuff” squeezes the urethra and a pump (implanted below the skin in the scrotum) controls the opening of the cuff. The AUS works well for all degrees of incontinence. Dr. Elliott is among the top 1% of American urologists for this procedure.

How the AUS Works

While there are many designs of Artificial Urinary Sphincters (AUS), there is only one FDA-approved in the United States (the AMS 800). The AMS 800 AUS is shown in figure 1. It is made up of 3 parts, all of which come separately and are connected in the operating room. All 3 parts are implanted inside the body.

The pressure-regulating balloon is placed in the abdominal cavity and the pump in the scrotum. Greater than 95% of AUSs are placed in men with incontinence after prostate cancer treatment. In these men, the cuff is placed around the urethra, right behind the scrotum.

Implantation of this device takes less than an hour and men go home the same day. Satisfaction is extremely high.

Urethra

Bladder

Rectum

Prostate

Cuff

Pressure-regulating balloon

Front

Back

Pump

Figure 1.

The pressure regulating balloon is inflated to a certain pressure (usually 601-70 cm H2O). That pressure then gets equalized across the system and the cuff squeezes the urethra at 61-70cm H2O. To open the cuff and pee, one squeezes the pump 2-3 times. The fluid moves from the cuff to the balloon and then back again to close the cuff. Further details of how the AUS works are described in a video.