Selection of patients for implantation of the Brantley Scott artificial urinary sphincter

The Brantley Scott artificial urinary sphincter (AUS) is a safe, effective and relatively trouble-free device for the control of sphincter weakness incontinence. Suitable patients should have no other urodynamic dysfunction or have had such a dysfunction corrected or controlled. Patients with post-prostatectomy incontinence pose no problems in selection, although as a group they are the most prone to develop complications. Pure stress incontinence does not warrant implantation of an AUS except in very rare instances. In neuropathic dysfunction the AUS is one of several treatment options for the correction of incontinence and is most effectively used as such. In all patients, thorough pre-operative videourodynamic evaluation is essential to get the best results and therefore to justify the infective and mechanical risks and the expense of the device.