Evaluation and Revision of Artificial Urinary Sphincter Failure for Male Stress Urinary Incontinence

To examine preoperative diagnostic tools for evaluating artificial urinary sphincter failure and operative techniques for device revision. We focus our discussion of device revision on stepwise approaches for the replacement of individual components versus the replacement of the entire device.

Although the AUS has not changed significantly since its inception nearly 50 years ago, there have been a variety of proposed approaches to the assessment and management of failed devices, particularly in how each component is treated at the time of revision surgery.

Need for revision surgery is a well-known risk of AUS placement. Despite ongoing research regarding etiologies of device failure and surgical approaches to address such problems, there is no universally accepted standardized approach to management of component failure. Future studies should be aimed at preoperative diagnostic tests that can better elucidate the etiology of device failure and expand upon indications for single-component versus whole-device replacement.