Artificial Urinary Sphincter (Device)
The AMS 800 (Boston Scientific) is the established hydraulic artificial urinary sphincter (AUS) for male stress urinary incontinence. The AUA/GURS/SUFU guideline recommends that clinicians discuss AUS with patients who have mild to severe stress incontinence after prostate treatment , and that they confirm adequate physical and cognitive ability to operate the device . It also states that AUS will likely lose effectiveness over time and that reoperations are common .[1]
For implantation, selection, radiation considerations and revision options, see Artificial Urinary Sphincter (procedure).
History and Evolution
Hydraulic AUS implantation began in the early 1970s. The AMS 800 design introduced in the 1980s remains the principal reference platform, with later refinements to tubing, connectors, cuff sizes and antibiotic treatment.[2]
The origin of the device with F. Brantley Scott, William Bradley and Gerald Timm (AS 721, 1972) is traced in the History of Prosthetics; later series include the double cuff reported by John Mulcahy and colleagues (1993), long-term continence after implantation reported by Drogo Montague (2001) and the Mayo cohort of 1,082 primary implants led by Brian Linder (2015).[10]
| Model | Series | Reported outcome |
|---|---|---|
| AMS 721 | 11 implants (9 men, 2 women), 1974–1977 | Long-term success in 2 men; 9 of 11 failed (82%) from urethral erosion (3), infection (1) or mechanical failure (5).[23] |
| AS 742 (b/c) | 15 men, 1979–1981 | Long-term continence in 9 (60%); erosion in 4 (27%) and infection in 2 (13%). The authors expected implantation in a deactivated state with delayed activation to improve results.[23] |
| AS 800 | 148 patients (76% male), mean follow-up 20.8 months | Socially acceptable control in 90% of 139 with active devices; removal in 7.4%. The deactivation lock was useful for primary deactivation, catheterization or cystoscopy, and elective nocturnal decompression of bladder-neck or urethral tissue.[24] |
In the Indiana series of children and young adults (mostly neuropathic bladder), a mechanical complication occurred every 7.6 patient-years with pre-800 models and every 16 patient-years with the AMS 800 (p = 0.0001). Mechanical complications affected 64% and 30% of patients, respectively.[25]
Design and Components
The three connected components form a closed fluid circuit:[3]
| Component | Function and model details |
|---|---|
| Occlusive cuff | Applies circumferential pressure around the urethra. The cited male IFU lists 13 lengths: 3.5–8 cm in 0.5 cm steps, then 9, 10 and 11 cm, each about 1.8 cm wide when deflated (2.0 cm in the earlier operating room manual[32]). Size is selected from the measured urethral circumference at surgery, and the cuff sizer is approximate because urethral tissue thickness affects the fit. The IFU states that a 4.0–4.5 cm cuff is typically required at the bulbous urethra. |
| Pressure-regulating balloon (PRB) | Supplies the pressure driving cuff refilling. The cited male IFU lists 51–60, 61–70 and 71–80 cmH₂O ranges. The surgeon usually selects the lowest pressure that maintains closure, and the earlier operating room manual calls 61–70 cmH₂O the most commonly used range.[32] Placement and fill follow the instructions for the model implanted, and the balloon is chosen from tissue assessment. |
| Scrotal control pump | The lower bulb moves fluid out of the cuff; the upper valve block contains the resistor, valves and deactivation control. It is about 1.3 cm wide and 3.5 cm long, and holds the deactivation control, so it is more than a deflate button. |
Mechanism
The patient repeatedly squeezes and releases the pump bulb to move fluid from the cuff into the PRB. The cuff opens for voiding, then refills automatically over several minutes. The number of squeezes needed varies between patients. Deactivation locks the system after the cuff has been emptied. The control must not be pressed while the cuff is still inflated, because the cuff then stays closed and obstructs.[3]
For the teaching sequence and urethral-instrumentation workflow, see System Operation.
InhibiZone and Material Handling
InhibiZone supplies rifampin and minocycline on specified cuff and pump components; the PRB is not antibiotic treated. Perioperative infection prevention is still required. For an InhibiZone-treated AMS 800, check for rifampin, minocycline or other tetracycline hypersensitivity and the labeled systemic-lupus contraindication. The male IFU also calls for caution in hepatic or renal disease, prothrombin-time monitoring with warfarin, renal-toxicity monitoring with methoxyflurane, and careful consideration with thionamides, isoniazid or halothane.[3] Treated components must not be soaked in saline or other solutions, and alcohol and other specified solvents can remove the treatment.[3]
The label reports fewer infection-related revisions with treated devices in a voluntary manufacturer registry. That registry did not capture infections managed without implant surgery and could not remove deaths or losses to follow-up, and the comparison was not randomized.[3] In a Mayo cohort, erosion or infection occurred in 13 of 62 diabetic men with non-antibiotic-coated devices and 1 of 28 with coated devices (p = 0.035).[30]
Indications and Preoperative Assessment
The cited US male IFU covers incontinence from intrinsic sphincter deficiency following prostate surgery. Female bladder-neck implantation and pediatric or neurogenic implantation are separate indications with their own evidence, and require specialist selection and jurisdiction-specific labeling. The AUA/SUFU neurogenic guideline states that clinicians may offer AUS to selected patients with stress incontinence and acceptable storage parameters , and a robotic bladder-neck series in women is available.[3][4][5]
Confirm the leakage mechanism, assess bladder storage and emptying and evaluate urethral or bladder-neck pathology. The Asia-Pacific consensus recommends preoperative cystoscopy with or without multichannel urodynamics (Grade C); multichannel testing is often needed for mixed incontinence, prior pelvic fracture or neurologic disease.[6] It recommends at least six months of clinical stability for urethral stricture or bladder-neck contracture before AUS placement (Grade C).[6] Dexterity and cognition are assessed with continued long-term use in mind.[6][1]
Active infection, unresolved outlet obstruction, unsafe bladder dysfunction and inability to use the pump need to be resolved or an alternative planned. In men with SUI after primary, adjuvant or salvage prostate radiotherapy who seek surgery, the AUA/GURS/SUFU guideline recommends AUS over male slings or adjustable balloons ; prior radiotherapy raises AUS erosion risk.[1] In women with prior pelvic irradiation, the current EAU female LUTS guideline classifies SUI as complicated, lists AUS among surgical options , and reports more frequent explantation after radiotherapy.[38][3][1]
Outcomes and Device Survival
AUSCO Prospective Study
AUSCO was a prospective, single-arm study of the AMS 800 in 115 men at 17 sites. At 12 months after activation, 91/97 with pad-weight data achieved at least a 50% reduction; 61/101 reported no pad use. Nine of 115 underwent revision, with none attributed to device infection; 17/115 (15%) had serious adverse events, including 10/115 (8.7%) adjudicated device- or procedure-related.[7] The full report separately records three postoperative wound infections that resolved without erosion or explantation. Denominators are available-case, there was no randomized comparator, sites were high-volume, and follow-up was one year. See the procedure evidence summary.[7]
Pooled Continence Estimates
A 2023 synthesis of 19 studies and 1,271 patients estimated approximately 52% pad-free and 82% using 0–1 pad/day. Most evidence came from cohorts and heterogeneity remained substantial. Pad-free and 0–1 pad/day are different definitions of success.[8]
Long-Term Reintervention-Free Survival
| Cohort | Population and endpoint | Results |
|---|---|---|
| French national study, 2025 | 8,475 first implants; median follow-up 6 years; replacement/removal-free survival | 71% at 2 years, 57% at 5 years, 40% at 10 years. Removal-free survival at 10 years was 66% (a different endpoint). [9] |
| Mayo cohort, 2015 | 1,082 primary implants; median follow-up 4.1 years; freedom from any secondary surgery | 74% at 5 years, 57% at 10 years and 41% at 15 years. [10] |
These observational estimates come from different settings and definitions.[9][10] An AUS is not intended to be a lifetime implant. The IFU reports bench verification of at least 29,220 cycles, equivalent to 8 voids per day for 10 years.[3] In a matched single-center comparison of first implants for non-neurogenic SUI (107 women, 316 men), women had a lower risk of explantation or revision than men between 6 months and 8 years (HR for men 2.12, 95% CI 1.29–3.48), with no significant difference before 6 months or after 8 years.[31]
Comparative Trials
MASTER randomized 380 men to a transobturator sling or AUS. The sling met the prespecified 15-percentage-point noninferiority margin for the strict patient-reported incontinence outcome at 12 months (incontinence 87.0% with sling and 84.2% with AUS; intention-to-treat composite continence risk difference −3.6%, 95% CI −11.6 to 4.6, favoring AUS, whose recipients had the lower incontinence rate), and most participants in both groups still reported some leakage.[11] The 12-month ICIQ-UI SF mean difference was 1.4 in the 2021 article versus 1.30 (95% CI 0.11–2.49, p = 0.032) in the full HTA report — the same comparison, both favoring AUS.[11][36] Symptoms and satisfaction improved in both groups, and the statistically significant secondary differences favored AUS.[11] At 24 months (a separate, later timepoint) the sling remained noninferior (absolute risk difference −0.006, 95% CI −0.092 to 0.080), ICIQ-UI SF scores fell to 7.9 with the sling and 7.1 with the AUS (mean difference 1.4), and further surgery was needed in 11% after sling versus 2% after AUS.[35]
In a propensity-matched single-center comparison of 70 men with moderate incontinence (3–5 pads/day), 0–1 pad/day at 12 months was 94.3% with AUS and 68.6% with a retrourethral transobturator sling (p = 0.012); median follow-up was about 4 years.[26] The AUA/GURS/SUFU guideline says clinicians should not routinely implant male slings in severe stress incontinence .[1]
Complications — Device-Level Overview
- Infection, erosion and tissue compromise. These need prompt assessment and may require explantation. Risk varies with tissue quality, prior urethral procedures, radiation and comorbidity. In one Mayo cohort, diabetes was associated with erosion or infection (HR 2.26; 5-year incidence 13% vs 8%), and higher BMI with a lower risk.[30]
- Mechanical dysfunction. Fluid loss, tubing problems, pump malfunction or altered PRB performance can cause recurrent leakage or impaired emptying.
- Recurrent leakage with an apparently functioning device. Reassess bladder function, device operation, coaptation and tissue or capsule findings. The cause is not always urethral atrophy, and routine downsizing is not the default.
- Urethral instrumentation. Completely deflate the cuff and deactivate the device before catheterization or other transurethral passage. A deactivated cuff may still not admit every catheter or scope safely: the IFU states that the inside diameter of the smallest (3.5 cm) cuff, fully deflated, generally exceeds 28 Fr, and that additional clearance is needed for the urethral tissue between the instrument and the cuff.[3]
In a retrospective cohort of 200 men, cuff erosion occurred in 17/44 (39%) with catheterization longer than 48 hours versus 7/156 (4.5%) without prolonged catheterization; prolonged catheterization remained associated with erosion on multivariable analysis.[12] Involve the implant team when sustained drainage is needed.[12]
Interpreting Revision and Radiation Studies
Bentellis's 1,020-patient revision cohort excluded infection and erosion revisions. Of its 214 revisions, 121 (56.5%) were nonmechanical, a category that included recurrent or persistent SUI despite a functioning device as well as atrophy. Larger cuff size was the only predictor of overall revision and of nonmechanical revision.[13]
Mann's “fragile urethra” study included only 156 men who already had erosion. Radiation (HR 2.36) and prior urethroplasty (HR 2.12) were associated with earlier erosion; prior AUS, androgen deprivation, transcorporal placement and a 3.5 cm cuff were not.[14] Cuff size as a risk factor is inconsistent across series: a multicenter prospective study reported higher explantation with 3.5 cm cuffs, while the AUA guideline notes conflicting data.[29][1] A single-surgeon, 410-case cohort found nearly identical erosion at a median 50 months between 3.5 cm cuffs (10.8%, 18/166) and cuffs 4.0 cm or larger (10.7%, 26/244; p = 0.7); pelvic radiation, prior AUS cuff erosion, prior urethroplasty and prior IPP placement — not cuff size — predicted erosion on multivariate analysis.[37] In a 283-man cohort, prior radiation was associated with cuff removal (HR 3.30) but not revision, and an exploratory 1.74-year post-radiotherapy timing signal was not statistically significant.[15]
Radiation. Radiation has the strongest evidence of any risk factor for erosion and device failure in the AUA/GURS/SUFU review.[1] Among 247 men with a first replacement AUS, prior radiation was associated with all-cause failure (HR 2.12) and with erosion or infection (HR 7.57), but not with atrophy or mechanical failure.[27] In 158 postprostatectomy men from one surgeon, adjuvant radiation was associated with all-cause failure (HR 4.32) and with erosion or infection (HR 4.48); among men with both adjuvant radiation and urethral comorbidity (bladder neck contracture, prior sling or stricture), revision-free survival at 3 years was 22.4%.[28]
Capsulotomy with reassessment and possible same-size cuff replacement is a revision strategy described in an expert review. The revision is chosen from the failure mechanism and tissue findings.[16]
Alternative and Emerging Devices
| Device | Distinguishing feature | Evidence boundary |
|---|---|---|
| Victo — Promedon | Preconnected cuff, control pump and separate PRB; pressure adjusted through a port in the pump. The manufacturer specifies deactivation by removing 7 mL through that port with a 25G non-coring needle after skin disinfection, followed by reinjection of 7 mL to reactivate.[17] | A prospective single-arm cohort of 96 men with moderate-to-severe incontinence after prostate surgery (55 Victo and 41 Victo Plus recipients; median follow-up 3 years) reported a median 24-hour pad-weight reduction of 79% among 48 men assessed at 3 years and 13/96 device failures (14%) during follow-up.[18] |
| ZSI 375 — Zephyr | Cuff connected to a scrotal pump/pressure-regulating unit; no separate abdominal reservoir | Preliminary observational series. |
| Electronic AUS, including UroActive | Electronic control and patient remote rather than ordinary manual hydraulic cycling | A 2026 first-in-human study of 6 men reported pad-weight reduction of at least 50% in all six at 365 days and no revisions or explants; nine device deficiencies involved the remote control. [21] |
Availability and labeling are country-specific and are confirmed for the exact device.[17][18][19][20][21]
Combined AUS and Penile Prosthesis
Simultaneous or staged implantation is used for concurrent SUI and ED. A systematic review of 21 mostly retrospective studies of simultaneous penile prosthesis implantation with AUS or other anti-incontinence devices (cohorts of 2–65 patients) reported social continence of 72–100%, inflatable prosthesis satisfaction of 84–100%, and no increase in complications detected in the included cohorts.[22] A US administrative-claims study included 659 dual IPP–AUS recipients (357 synchronous, 302 staged); dual versus solitary implantation was associated with infection (HR 1.43, 95% CI 1.13–1.80), while synchronous versus staged dual implantation had a reoperation HR of 1.50 (95% CI 0.87–2.58).[39] Endpoints varied too much to pool. See Inflatable Penile Prosthesis.[22]
Imaging and Lifelong Device Care
The AMS 800 is MR Conditional, not universally MRI-safe. The cited male IFU permits scanning at 1.5 or 3 T in a horizontal cylindrical scanner, at a maximum spatial gradient of 40 T/m, in normal operating mode with a whole-body SAR of 2 W/kg for 60 minutes of continuous RF; the image artifact extends about 36 mm from the device. MRI staff identify the implant and apply the IFU conditions. Earlier editions of the male labeling state different limits (1.5 T with a gradient of 450 G/cm or less and SAR 1.5 W/kg, and 3 T with 720 G/cm or less and SAR 2.9 W/kg, for 15 minutes of scanning). Other AUS models have their own labeling.[3][33][34]
Give the patient the implant identification card, teach deactivation and instrumentation precautions and reassess device function at least annually. New retention, pain, redness, drainage, recurrent leakage or loss of ability to operate the pump warrants earlier review.[3]
Videos
References
1. AUA/GURS/SUFU. Incontinence After Prostate Treatment Guideline, amended 2024, statements 15 and 17–24. Guideline.
2. Chung E. Narrative Review: Evolution in Device Technology and Advances in Surgical Techniques on AMS 800 Device in the Last 50 Years. Translational Andrology and Urology. 2024;13(8):1657-1665. doi:10.21037/tau-23-10
3. Boston Scientific. AMS 800 Artificial Urinary Sphincter for Male Patients — Instructions for Use. 51266569-01A, English section. Manufacturer IFU. Accessed September 12, 2026; use the IFU supplied with the actual implant.
4. Ginsberg DA, Boone TB, Cameron AP, et al. The AUA/SUFU Guideline on Adult Neurogenic Lower Urinary Tract Dysfunction: Treatment and Follow-Up. The Journal of Urology. 2021;206(5):1106-1113. doi:10.1097/JU.0000000000002239
5. Peyronnet B, Capon G, Belas O, et al. Robot-Assisted AMS-800 Artificial Urinary Sphincter Bladder Neck Implantation in Female Patients With Stress Urinary Incontinence. European Urology. 2019;75(1):169-175. doi:10.1016/j.eururo.2018.07.036
6. Chung E, Liao L, Kim JH, et al. The Asia-Pacific AMS800 Artificial Urinary Sphincter Consensus Statement. International Journal of Urology. 2023;30(2):128-138. doi:10.1111/iju.15083
7. Kaufman MR, Wood HM, Terlecki R, et al. The Artificial Urinary Sphincter Clinical Outcomes Trial: Primary Results. J Urol. 2026;215(2):194-202. Published online October 3, 2025. doi:10.1097/JU.0000000000004796
8. Li Y, Li X, Yang Q. Effectiveness of Artificial Urinary Sphincter to Treat Stress Incontinence After Prostatectomy: A Meta-Analysis and Systematic Review. PLoS One. 2023;18(9):e0290949. doi:10.1371/journal.pone.0290949
9. Lenfant L, Taillé Y, Chartier-Kastler E, et al. Artificial Urinary Sphincter Implants in Men: A National Health Care Data System-Based Study to Assess Reinterventions in France. The Journal of Urology. 2025;213(2):217-227. doi:10.1097/JU.0000000000004285
10. Linder BJ, Rivera ME, Ziegelmann MJ, Elliott DS. Long-Term Outcomes Following Artificial Urinary Sphincter Placement: An Analysis of 1082 Cases at Mayo Clinic. Urology. 2015;86(3):602-607. doi:10.1016/j.urology.2015.05.029
11. Abrams P, Constable LD, Cooper D, et al. Outcomes of a Noninferiority Randomised Controlled Trial of Surgery for Men With Urodynamic Stress Incontinence After Prostate Surgery (MASTER). European Urology. 2021;79(6):812-823. doi:10.1016/j.eururo.2021.01.024
12. Seideman CA, Zhao LC, Hudak SJ, et al. Is Prolonged Catheterization a Risk Factor for Artificial Urinary Sphincter Cuff Erosion? Urology. 2013;82(4):943-946. doi:10.1016/j.urology.2013.06.044
13. Bentellis I, El-Akri M, Cornu JN, et al. Prevalence and Risk Factors of Artificial Urinary Sphincter Revision in Nonneurological Male Patients. The Journal of Urology. 2021;206(5):1248-1257. doi:10.1097/JU.0000000000001954
14. Mann RA, Kasabwala K, Buckley JC, et al. The "Fragile" Urethra as a Predictor of Early Artificial Urinary Sphincter Erosion. Urology. 2022;169:233-236. doi:10.1016/j.urology.2022.06.023
15. Lee JH, Lee KS, Ko KJ. The Impact of Pelvic Radiation on Artificial Urinary Sphincter Cuff Survival and Optimal Timing for Implantation. World Journal of Urology. 2025;43(1):231. doi:10.1007/s00345-025-05625-1
16. Terlecki RP, Wilson SK. A New Paradigm for Surgical Revision of the Artificial Urinary Sphincter for Recurrent Stress Urinary Incontinence: Wilson's Workshop 11. International Journal of Impotence Research. 2022;34(1):37-43. doi:10.1038/s41443-020-0307-8
17. Promedon. Victo adjustable artificial urinary sphincter. Manufacturer device description and safety information. Accessed September 12, 2026.
18. Krhut J, Bartáková L, Kondé A, et al. Outcomes of the Victo Adjustable Artificial Urinary Sphincter in the Treatment of Male Incontinence. BJU International. 2025;135(1):103-109. doi:10.1111/bju.16511
19. Staerman F, G-Llorens C, Leon P, Leclerc Y. ZSI 375 Artificial Urinary Sphincter for Male Urinary Incontinence: A Preliminary Study. BJU International. 2013;111(4 Pt B):E202-E206. doi:10.1111/j.1464-410X.2012.11468.x
20. Ostrowski I, Golabek T, Ciechan J, et al. Preliminary Outcomes of the European Multicentre Experience With the ZSI 375 Artificial Urinary Sphincter for Treatment of Stress Urinary Incontinence in Men. Central European Journal of Urology. 2019;72(3):263-269. doi:10.5173/ceju.2019.1920
21. Mozer P, Beaugerie A, Perrouin-Verbe MA, et al. First-in-Human Assessment of the UroActive Electronic Artificial Urinary Sphincter for Treating Male Patients with Stress Urinary Incontinence. J Urol. 2026;216(1):108–117. doi:10.1097/JU.0000000000004945.
22. Ammirati E, Polisini G, Giammò A. Surgical Treatment Options and Outcomes for Concomitant Treatment of Post-Prostatectomy Erectile Dysfunction and Male Stress Urinary Incontinence: A Systematic Review of the Literature. International Journal of Impotence Research. 2026;38(3):193-205. doi:10.1038/s41443-025-01202-7
23. Malloy TR, Wein AJ, Carpiniello VL. Surgical Results With Artificial Urinary Sphincter. Urology. 1982;19(6):602-605. doi:10.1016/0090-4295(82)90008-5
24. Fishman IJ, Shabsigh R, Scott FB. Experience With the Artificial Urinary Sphincter Model AS800 in 148 Patients. The Journal of Urology. 1989;141(2):307-310. doi:10.1016/s0022-5347(17)40748-8
25. Herndon CD, Rink RC, Shaw MB, et al. The Indiana Experience With Artificial Urinary Sphincters in Children and Young Adults. The Journal of Urology. 2003;169(2):650-654. doi:10.1097/00005392-200302000-00056
26. Sacco E, Gandi C, Marino F, et al. Artificial Urinary Sphincter Significantly Better Than Fixed Sling for Moderate Post-Prostatectomy Stress Urinary Incontinence: A Propensity Score-Matched Study. BJU International. 2021;127(2):229-237. doi:10.1111/bju.15197
27. Huang MM, Huffman P, Dani H, et al. Association Between Previous Pelvic Radiation and All-Cause and Cause-Specific Failure of Replacement Artificial Urinary Sphincters. The Journal of Urology. 2022;207(6):1268-1275. doi:10.1097/JU.0000000000002433
28. Srivastava A, Joice GA, Patel HD, et al. Impact of Adjuvant Radiation on Artificial Urinary Sphincter Durability in Postprostatectomy Patients. Urology. 2018;114:212-217. doi:10.1016/j.urology.2017.12.029
29. Brant WO, Erickson BA, Elliott SP, et al. Risk Factors for Erosion of Artificial Urinary Sphincters: A Multicenter Prospective Study. Urology. 2014;84(4):934-938. doi:10.1016/j.urology.2014.05.043
30. Viers BR, Linder BJ, Rivera ME, et al. The Impact of Diabetes Mellitus and Obesity on Artificial Urinary Sphincter Outcomes in Men. Urology. 2016;98:176-182. doi:10.1016/j.urology.2016.06.038
31. Cotte J, Dechartres A, Mozer P, et al. Long-Term Device Survival After a First Implantation of AMS800 for Stress Urinary Incontinence: Comparison Between Men and Women. Neurourology and Urodynamics. 2023;42(1):80-89. doi:10.1002/nau.25047
32. Boston Scientific (American Medical Systems). AMS 800 Urinary Control System for Male Patients: Operating Room Manual. 92116964-01A, English. Device Description; System Operation. Earlier edition than reference 3.
33. Boston Scientific (American Medical Systems). AMS 800 Urinary Control System for Male Patients: Instructions for Use (US). 1004681-A. MRI section (earlier edition).
34. Boston Scientific. AMS 800 Artificial Urinary Sphincter for Male Patients: Directions for Use. 50654580-01A, English section. MRI section.
35. Constable L, Drake MJ, Cooper D, et al. The 24-mo Outcomes from the Noninferiority Randomised Controlled Trial of Surgery for Men with Urodynamic Stress Incontinence After Prostate Surgery (MASTER). Eur Urol Focus. 2026 (online 26 August). doi:10.1016/j.euf.2026.07.012
36. Constable L, Abrams P, Cooper D, et al. Synthetic Sling or Artificial Urinary Sphincter for Men With Urodynamic Stress Incontinence After Prostate Surgery: The MASTER Non-Inferiority RCT. Health Technology Assessment. 2022;26(36):1-152. doi:10.3310/TBFZ0277
37. McKibben MJ, Shakir N, Fuchs JS, Scott JM, Morey AF. Erosion rates of 3.5-cm artificial urinary sphincter cuffs are similar to larger cuffs. BJU Int. 2019;123(2):335-341. doi:10.1111/bju.14483
38. European Association of Urology. EAU Guidelines on Non-neurogenic Female LUTS: Disease Management. 2026, §§4.2.2 and 4.2.4.c.3.c–d. Guideline.
39. Zwaschka TA, Li S, Zhang CA, Sellke N, Scott M, Eisenberg M. "Synchronous versus Staged Implantation of Inflatable Penile Prosthesis and Artificial Urinary Sphincter: A Nationwide Analysis of Infection and Revision Outcomes." Urol Pract. Published online September 11, 2026. doi:10.1097/UPJ.0000000000001089