The gold-standard solution for male stress incontinence
The Artificial Urinary Sphincter (AUS) is the most effective long-term treatment for men with stress urinary incontinence — especially after prostate cancer surgery. A patient-controlled, fully implanted device that restores confidence and continence. Performed at Prestige Medical Group by Dr. Hari Sawkar, MD — a board-certified urologic surgeon.
What is the Artificial Urinary Sphincter?
The Artificial Urinary Sphincter (AUS) is a small, three-piece implanted device that acts as a replacement urinary sphincter — restoring continence for men whose natural sphincter has been damaged, typically as a result of prostate cancer surgery (radical prostatectomy) or radiation therapy.
It works by gently squeezing the urethra closed until the patient is ready to urinate. When the patient wants to void, they simply squeeze a small, discreet pump inside the scrotum that momentarily releases the pressure — allowing urination — before automatically re-closing the urethra shortly afterward. The entire device is fully implanted and invisible from the outside.
The AUS is widely considered the gold-standard treatment for moderate-to-severe male stress incontinence — with decades of published clinical data and consistently high patient satisfaction rates. At Prestige Medical Group, this surgery is performed exclusively by Dr. Hari Sawkar, MD — a board-certified urologic surgeon with subspecialty training in prosthetic urologic surgery.
Dr. Hari Sawkar, MD
Dr. Sawkar’s expertise in prosthetic urologic surgery — combined with his broader background in urologic oncology and post-prostate cancer care — makes him well-suited to guide patients through the treatment options for post-surgical incontinence, from conservative approaches to the AUS implant.
Who is a candidate for the AUS?
The AUS is typically considered for men with moderate-to-severe stress urinary incontinence that hasn’t responded to conservative treatments or minimally invasive procedures.
Post-prostatectomy incontinence
The most common indication — men with persistent leakage after radical prostatectomy for prostate cancer, especially where pelvic floor therapy alone hasn’t restored continence.
Post-radiation incontinence
Men who developed stress incontinence following radiation therapy for prostate cancer. AUS is particularly valuable here since other options may work less well after radiation.
Moderate-to-severe leakage
Patients using multiple pads per day or dealing with substantial leakage that affects daily life, work, or intimacy — where meaningful, reliable improvement is the goal.
Failed prior treatment
Pelvic floor therapy, medication trials, and male sling procedures haven’t produced adequate results — the AUS is designed for exactly this level of incontinence.
The male incontinence treatment ladder
Treatment for male stress incontinence typically starts conservative and escalates as needed. The AUS sits at the top of the ladder — reserved for cases where meaningful, reliable improvement is essential.
Pelvic floor therapy & lifestyle
Kegel exercises, biofeedback, and pelvic floor physical therapy — the first-line approach, often combined with fluid management strategies.
Medications & adjuncts
In some cases medications, urethral bulking agents, or absorbent products may be tried while assessing whether more definitive treatment is needed.
Male sling procedure
For mild-to-moderate stress incontinence, a male sling can provide meaningful improvement with a less complex device than the AUS.
Artificial Urinary Sphincter (AUS)
The definitive solution for moderate-to-severe stress incontinence — providing reliable, patient-controlled continence when other approaches haven’t been enough.
The three-piece AUS device
The AUS is a fully implanted hydraulic system — no external parts. All three components work together to mimic the function of a natural urinary sphincter.
Urethral cuff
A soft, inflatable silicone cuff is placed around the urethra. When inflated with fluid, it gently closes the urethra to prevent leakage. When deflated, urination can occur.
Discreet control pump
A small pump is placed in the scrotum where it can be easily accessed. Squeezing the pump temporarily deflates the cuff so the patient can urinate, then it re-inflates automatically.
Pressure-regulating balloon
A small balloon in the lower abdomen holds the fluid and maintains the correct pressure — ensuring the cuff closes with just the right amount of force to prevent leakage.
What to expect on surgery day
AUS placement is typically performed under general anesthesia and takes about 1-2 hours. Most patients go home the same day or after a short overnight stay.
Consultation & workup
Dr. Sawkar reviews your history, evaluates your continence status, may perform urodynamic testing, and confirms candidacy before scheduling surgery.
Surgery day
Under general anesthesia, Dr. Sawkar places all three components through small, discreet incisions. Total surgery time is typically 1-2 hours.
Initial healing
The device is intentionally kept deactivated for 4-6 weeks while tissues heal — so incontinence continues temporarily during this period.
Device activation
At the 4-6 week follow-up, Dr. Sawkar activates the device and teaches you how to use the pump — you’ll leave that visit continent for the first time.
What recovery looks like
Recovery involves a period of temporary continued incontinence while healing takes place — followed by dramatic improvement once the device is activated.
AUS questions answered
Have a question not answered here? Call (949) 825-7650 to speak with our team.
Will the device be visible?
Why is the device kept off for 4-6 weeks after surgery?
How long does the AUS device last?
How is this different from a male sling?
Who performs AUS surgery at Prestige Medical Group?
Is this covered by insurance?
What are the risks?
Ready to explore your options?
Living with incontinence after prostate surgery isn’t something you have to accept as permanent. Dr. Sawkar can help you understand your treatment options — from conservative approaches to the AUS — and choose what’s right for you. Schedule a private consultation today.