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Lookup NU author(s): Professor Christopher HardingORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2026, Royal College of Surgeons of England. All rights reserved.Introduction Artificial urinary sphincter (AUS) is a guideline-recommended treatment for male stress urinary incontinence. Despite its widespread use, it is thought that there is no standardisation in AUS practice. This study aims to report current AUS insertion practices in the UK and highlight any discrepancies. Methods A REDCap survey was conducted under the British Association of Urological Surgeons (BAUS) Section of Female, Neurological, and Urodynamic Urology, and reported using the CHERRIES checklist. Outcomes were framed using the International Continence Society (ICS) document and recent BAUS consensus document. Results The survey received 34 responses (response rate: 44–94%). Most respondents (80%) used video-urodynamics and patient-reported outcomes in patient workup. Loss of compliance on urodynamics was the most common contraindication, and detrusor overactivity was often treated before AUS surgery. Perioperative preparation and implantation techniques varied significantly from the ICS document, as did complication management. Conclusions The reported variation may result from local or national influences, a lack of high-quality evidence and divergent surgical training. This variability impacts the heterogeneity of outcomes and their reporting. Future efforts should focus on adopting the new national consensus to standardise practice, improving training curricula, researching the effects of variability on surgical outcomes and enhancing the quality of evidence in this field.
Author(s): Bhatt NR, Doherty R, Biers S, Harding C, Thiruchelvam N, Belal M, Sahai A, Hashim H
Publication type: Article
Publication status: Published
Journal: Annals of the Royal College of Surgeons of England
Year: 2026
Volume: 108
Issue: 6
Pages: 457-464
Print publication date: 01/07/2026
Online publication date: 15/12/2025
Acceptance date: 16/10/2025
Date deposited: 20/07/2026
ISSN (print): 0035-8843
ISSN (electronic): 1478-7083
Publisher: Royal College of Surgeons of England
URL: https://doi.org/10.1308/rcsann.2025.0104
DOI: 10.1308/rcsann.2025.0104
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