Placement of Artificial Urinary Sphincter (AUS) via Various Surgical Approaches

R. Rowaiee, A. Al Homsi, O. Almidani, O. A Raheem

Artificial urinary sphincter, Penoscrotal approach, Perineal approach, Transcorporal approach, Prosthetic revision surgery, Urinary incontinence surgery

This instructional video demonstrates the surgical placement of an artificial urinary sphincter (AUS) using different operative approaches. It compares the perineal, transscrotal, and transcorporal techniques, focusing on anatomical landmarks, device positioning, and cuff placement around the bulbar urethra. Step-by-step footage highlights variations in exposure, dissection, and implantation workflow for each approach. Emphasis is placed on optimizing visualization, minimizing urethral trauma, and achieving precise device alignment to ensure continence and reduce postoperative complications. The video serves as a guide for urologists seeking proficiency in selecting and performing the appropriate AUS placement method tailored to patient anatomy and surgical context.

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1. Scott FB, Bradley WE, Timm GW. Treatment of urinary incontinence by implantable prosthetic sphincter. Urology. 1973;1(3):252–259.

(Seminal paper describing the original AUS concept and implantation.)

2. Linder BJ, Elliott DS. Artificial urinary sphincter for male stress urinary incontinence: current perspectives. Med Devices (Auckl). 2015;8:379–390.

(Comprehensive review of AUS indications, surgical approaches, and outcomes.)

3. Henry GD, Graham SM, Cleves MA, Simmons CJ. Perineal versus penoscrotal approach for artificial urinary sphincter placement: comparison of operative outcomes. J Urol. 2009;182(6):2748–2751.

(Direct comparison of surgical approaches and outcomes.)

4. Wilson SK, Delk JR. Artificial urinary sphincter cuff placement using the transcorporal technique: indications and outcomes. J Urol. 2002;167(5):2075–2078.

(Foundational description of the transcorporal approach.)

5. Wiedemann L, Cornu JN, Haab F, Peyronnet B. Surgical techniques and outcomes of artificial urinary sphincter implantation: current practice and future directions. Nat Rev Urol. 2013;10(12):698–707.