ABSTRACT
The artificial urinary sphincter (AUS) remains an alternative to slings or periurethral injection therapy in the management of urinary incontinence, especially when the aforementioned interventions have failed. The AUS has been most often used for the treatment of incontinence due to primary urethral sphincter deficiency. The pubovaginal sling is considered the gold standard for the treatment of ISD, yet some patients will have less than adequate results despite several attempts. Previous pelvic radiation is considered an absolute contraindication to female AUS placement; however, studies have reported use in select cases of pelvic radiation with understanding on risks including urethral atrophy, erosion, and increased need for revision surgery. The cuff measuring tape is passed around the bladder neck and the circumferential dimension of the bladder neck is assessed. The anterior rectus sheath is then incised vertically and the retropubic space is developed adjacent to the bladder.
