Prosthetic Revision & Salvage
Clear guidance on artificial urinary sphincter complications including cuff erosion, pump malfunction, and infection, explaining diagnostic evaluation and surgical revision or replacement to preserve urinary continence.
Written and reviewed by Shervin Badkhshan, MD · Last reviewed
November 2026
Part of:
Implant problems and revisions
Outpatient Same-Day
Activation: 6 Weeks
Fellowship-Trained Reconstructive Urology
AT-A-GLANCE CLINICAL CARE PATHWAY
Symptom-to-Solution Overview
1. COMMON SYMPTOMS
• Sudden return of stress urinary leakage • Pump difficult to squeeze or refill slowly • Urethral erosion or localized cuff pain
2. IN-OFFICE WORKUP
• Flexible cystoscopy to examine cuff lumen • Pelvic imaging for reservoir fluid volume • Pressure-regulating balloon evaluation
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3. TREATMENT OPTIONS
• Cuff downsizing or tandem cuff placement • Pressure-regulating balloon exchange • Transcorporeal cuff revision for compromised tissue
Browse Surgical Procedures →
An Artificial Urinary Sphincter (AUS) is the gold-standard treatment for severe male urinary incontinence, but over time, complications or component changes can arise. These issues typically stem from mechanical wear of the device after years of cyclic use, urethral atrophy (where the tissue beneath the cuff naturally thins over time, leading to a recurrence of leakage), or rare instances of cuff erosion or infection. Managing an AUS issue requires specialized reconstructive care to preserve urethral tissue health while restoring complete mechanical urinary control.
Primary Symptoms
Recurrent Leakage: A gradual or sudden return of urinary incontinence after a long period of excellent device dryness, often indicating tissue thinning or a system pressure drop.
Inability to Deactivate: The scrotal pump button jams, catches, or fails to deflate the cuff to allow normal urination.
Pain or Discomfort: New soreness in the perineum or scrotum, or the presence of blood in the urine, which requires immediate specialist evaluation.
Diagnostic Approach
Flexible Cystoscopy: A critical visual check using an ultra-thin camera to directly look inside the urethra, confirming that the tissue beneath the cuff is entirely healthy and ruling out internal device erosion.
Uroflowmetry & Pressure Review: Assessing the speed of your urinary stream and reviewing the mechanical cycle of the pump to ensure fluid dynamics are performing correctly.
Recommended Surgical & Treatment Pathways
Dedicated Subspecialty Center: Prosthetic Revision & Infection Salvage Hub →
Surgical Reconstruction: Artificial Urinary Sphincter (AUS) Insertion, Revision, & Repair — Tertiary revision, cuff downsizing, tandem cuff placement, or transcorporal repositioning.
When leakage continues with a working sphincter
Some men still leak after an artificial urinary sphincter even though the device is working. Often the cause is an overactive bladder: sudden urges and leakage on the way to the bathroom (urge incontinence). This is common in men treated for prostate cancer, especially after radiation, and it is treated separately with medication, bladder Botox, or nerve stimulation.
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Your results and questions
Your actual test results, visit notes, and messages with your care team are in your patient portal, the same one you use to book visits. Send questions through the portal or call the office at (516) 535-1900. For anything urgent, call the office or go to the nearest emergency room.