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Twenty years later: is the scrotal one-incision AUS of value?

International Journal of Impotence Research volume 34, pages 243–251 (2022)Cite this article

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Abstract

The artificial urinary sphincter, known as AMS 800, has been the gold standard for treating moderate to severe stress urinary incontinence in males for 40 years. Yet, the number of sphincters done globally is quite small and the majority of urologists doing them are infrequent implanters. Estimates for 2019 showed half of implanters did only one implant that year and worldwide only around 13,000 implantations were performed. The traditional two-incision technique of perineal exposure for cuff placement and abdominal incision for pump and pressure regulating balloon persists as the most common technique to surgically place an artificial urinary sphincter. Present estimates are that upwards of 80% are done via the perineal approach and that approach is the highly favored incision of large volume centers. The scrotal one-incision approach was invented by Wilson 20 years ago and was aimed at making the implantation of a sphincter quicker, easier and safer for the occasional implanter. These physicians perform 1–2 devices per year, comprise 60% of implanters who perform the surgery yearly, and implant 22% of all implanted devices. Our article targets these infrequent inserters discussing the history of the two techniques and what the authors have learned about the advantages and hazards of the one scrotal incision procedure over the last two decades.

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Authors and Affiliations

  1. Department of Urology, Institute for Urologic Excellence, La Quinta, CA, USA

    Steven K. Wilson

  2. Department of Urology, University of Texas-M. D. Anderson Cancer Center, Houston, TX, USA

    O. Lenaine Westney

  3. Department of Urology, University of Alabama, Birmingham, AL, USA

    John J. Mulcahy

Authors
  1. Steven K. Wilson
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  2. O. Lenaine Westney
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  3. John J. Mulcahy
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Correspondence to Steven K. Wilson.

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Conflict of interest

SKW: Consultant: AMT, Coloplast, International Medical Devices, Lecturer: Boston Scientific, Stockholder: NeoTract. OLW: Consultant: Boston Scientific. JJM: Consultant: Boston Scientific, Coloplast.

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Wilson, S.K., Westney, O.L. & Mulcahy, J.J. Twenty years later: is the scrotal one-incision AUS of value?. Int J Impot Res 34, 243–251 (2022). https://doi.org/10.1038/s41443-020-0317-6

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