What question did this study set out to answer?

To demonstrate the reimplantation of an artificial urinary sphincter while preserving the hydraulic penile prosthesis in a patient with recurrent urinary incontinence.

June 6, 2026

(343) Hydraulic 3-Pieces Penile Prosthesis Sparing Artificial Urinary Sphincter Reimplantation

Puntos clave

To demonstrate the reimplantation of an artificial urinary sphincter while preserving the hydraulic penile prosthesis in a patient with recurrent urinary incontinence.
Presented clinical case of a 64-year-old male with recurrent urinary incontinence after AUS implantation and prior radical prostatectomy.
Performed urodynamic study, diagnosed detrusor overactivity, and managed with antimuscarinic therapy prior to AUS revision.
Surgical reintervention involved components mobilization and careful replacement of the AUS while maintaining the penile prosthesis.
After AUS revision and activation, the patient reported an ICIQ-UI SF score of 0, indicating complete resolution of urinary incontinence.
No complications occurred during or after the surgical revision, ensuring safety for the patient.
Surgery restored the function of the AUS, significantly improving the patient's quality of life.

Resumen

Abstract Introduction Erectile dysfunction after radical prostatectomy is often associated with urinary incontinence. In order to improve the quality of life, a simultaneous or staged penile prosthesis (PP) and artificial urinary sphincter (AUS) implantation can be performed. Long-term AUS use often requires revision due to complications or urinary incontinence recurrence. Considering the close relationship between both implants, revision of one of them carries risks for the other. Objective Hydraulic 3-pieces penile prosthesis sparing artificial urinary sphincter reimplantation clinical case demonstration Methods We present a clinical case of patient with PP and recurrent urinary incontinence after AUS implantation. A 64-year-old male presented with complaints of urinary incontinence. In 2013 he underwent a laparoscopic radical prostatecomy for prostate adenocarcinoma. After the operation, he developed severe stress urinary incontinence and severe erectile dysfunction. In 2014, simultaneous implantation of artificial urinary sphincter AMS 800 (4 cm cuff) and three-piece hydraulic penile prosthesis AMS 700 was performed. After implantation he still used 2 to 3 pads per day. In 2014, a second 4 cm cuff was implanted, with no positive effect. In 2016 urodynamic study was performed, and detrusor overactivity was diagnosed. Antimuscarinic therapy was administrated. Patient used a safety pad, there was a significant improvement in quality of life. In 2025 he noted urinary incontinence recurrence. ICIQ-UI SF score was 21. MRI showed an empty AUS balloon. Urethroscopy confirmed no complete closure of both AUS cuffs. Results After standard antimicrobial prophylaxis, surgical intervention was performed. Mobilisation of connection tubes, reservoir, proximal cuff and pump was performed. No construction defects were detected and no signs of infection were observed. The artificial urinary sphincter was replaced with careful attention to the components of the penile prosthesis. One of the cuffs was leave in place according “drain and retain” conception. There were no complications during the postoperative period. After AUS activation in 6 weeks the patient does not use pads, ICIQ-UI SF score was 0. Conclusions Revision of the artificial urinary sphincter in patients with an implanted hydraulic penile prosthesis is a challenging surgery, which, however, allows restoring the function of the device and improving the patient's quality of life while penile prosthesis sparing Disclosure No

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