Society of Urologic Prosthetic Surgeons (Society of Genitourinary Prosthetic Surgeons)
The AUS is a popular surgical treatment for men who leak urine. While the procedure is usually
simple and effective, it is important to remember that all surgical procedures have a certain
degree of risk.
You may still leak some urine after this surgery: The AUS helps manage, but does not cure,
the urinary leakage condition. Although satisfaction rates are high following placement of the
AUS, we can never promise that you’ll be completely dry or that you can stop wearing a pad for
protection against leaking. It takes anywhere from 6 to 10 weeks to completely heal from the
AUS surgery. You will continue to leak urine during that recovery time, until we turn on your
AUS device. Even when the device is active, low grade or occasional leakage is not
uncommon.
You may need more surgery in the future: Some patients may choose to have additional
surgery in the future to reposition or replace some components of their AUS system if they
migrate out of place or do not function optimally.
The AUS device may not work forever: Like any mechanical device, the AUS can stop
working for you. This may be due to a loss of pressure (like a “flat tire”) in the system from a
leak or a problem with the pump device. Additional surgery will be needed to restore your AUS
to working order again.
Erosion of the AUS through the urethra: The urethral cuff, which surrounds the urethra like a
belt, puts pressure on the urethra to keep it closed and decrease the leakage of urine. In some
patients, this constant pressure can bruise or cut through (erode) the urethra. If that occurs, the
AUS will have to be removed to allow the urethra to heal. Once the urethra heals, a new AUS
can be implanted. Men who have had radiation treatments to the prostate or rectum, have had
previous surgeries to decrease their urine leakage, have had surgical instruments inserted into
the urethra, have low male hormone levels (testosterone levels) or have had surgery to implant
a device to give them an erection (penile prosthesis), have an increased risk of having the AUS
erode through the urethra.
Infection: It’s rare for the AUS to become infected. However, if the AUS becomes infected, it
must be removed and/or replaced. After the infection clears and the body heals, a new AUS can
be installed.
Bleeding: Bleeding from the AUS surgery is rare. But, if there is bleeding and, it’s severe, you
may need a blood transfusion. Many patients notice bruising and swelling on the penis and
scrotum after the operation. This is expected and gets better over a short period of time.
Injuries from surgery: Like with any operation, an injury to the urethra, penis, bladder,
testicles, intestines, or other structures may occur, although this is extremely rare.
Bladder and urethral problems: Many patients who have the AUS surgery have other bladder
problems, like urinary frequency and urgency, trouble emptying their bladder completely or a
bladder that can’t hold a lot of urine. It’s important to know that those problems may still be
present after the AUS surgery. Any patient who has had problems with their urethra, like scar
tissue, may need to have that treated before having the AUS operation. Even so, scar tissue in
the urethra may come back.
What if you need a catheter put in your bladder after the AUS is installed? Remember that
the AUS is like a pressurized belt around the urethra. If medical personnel need to put in a
catheter or look into your urethra and bladder with a special scope, your urethra and the AUS
can be damaged. It’s important to tell all medical personnel that you have an AUS device. We
recommend wearing a medical alert necklace or bracelet stating that you have an AUS device.
That may help prevent damage to your urethra and the AUS device.
Download and sign the PDF here.