Prosthetic Revision & Salvage
When leakage returns after an artificial urinary sphincter: causes, testing, and revision.
Written and reviewed by Shervin Badkhshan, MD · Last reviewed
November 2026
Part of:
Implant problems and revisions
Outpatient or 1 night
Reactivation: about 6 weeks
Fellowship-Trained Reconstructive Urology
AT A GLANCE
From symptoms to treatment
1. SYMPTOMS
• Leakage coming back • Pump won't cycle • Pain or swelling
3. TREATMENT
• Cuff or device replacement • Staged repair for erosion • Bladder treatment if urgency
Surgical options →
An artificial urinary sphincter (AUS) controls leakage with a cuff around the urethra, a pump in the scrotum, and a pressure balloon in the lower belly. It works well for years, but leakage can come back and the device can need attention.
Problems I see
Leakage returning as the tissue under the cuff thins over time (atrophy)
Mechanical failure: loss of fluid or a pump that won't cycle
Erosion or infection: pain, swelling, blood in the urine, or new urgent leakage. This needs prompt care.
How I evaluate it
An exam, a pad count, cystoscopy to look at the urethra under the cuff, and sometimes imaging to check the fluid level in the device. Your operative notes and device details help.
Treatment
Replacing the cuff with a different size or position, replacing the whole device, or, for erosion, removing the cuff, letting the urethra heal, and placing a new device later.
When leakage continues with a working sphincter
Not all leakage after an AUS comes from the device. An overactive bladder can cause urgency leakage even when the sphincter works perfectly. That's treated with medication, bladder Botox, or nerve stimulation, not another operation on the device.
Related
Implant and sphincter revision · Artificial urinary sphincter · AUS recovery and activation
Need an Expert Evaluation?
See Dr. Badkhshan in person in Garden City or by video visit.
Book a Consultation
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.