I Have a Penile Implant and an Artificial Urinary Sphincter — Which Pump Is Which?
If you have both an inflatable penile implant and an artificial urinary sphincter (AUS), you may be able to feel two different pumps inside the scrotum.
A common question is: How do I know which pump I am squeezing?
The simplest answer is:
Artificial urinary sphincter pump → helps you pass urine
Penile implant pump → inflates the penile implant for an erection
However, do not assume that one device is always on the left and the other on the right. Pump position depends on your anatomy, previous operations, scarring and how the devices were positioned during surgery.[1-5]
Why are there two pumps?
The implants perform completely different jobs.
An artificial urinary sphincter is used in selected men with stress urinary incontinence. It usually has a cuff around the urethra and a control pump within the scrotum. Operating the pump temporarily reduces pressure around the urethra so urine can pass.[1,3]
A three-piece inflatable penile implant contains cylinders within the penis, a fluid reservoir and a pump in the scrotum. Operating the pump transfers fluid into the cylinders to produce rigidity.[2]
How can I tell the pumps apart?
Learn the position of your own devices
There is no universal left-versus-right rule.
The most reliable approach is for your surgeon or prosthetic urology team to physically show you:
“This is your AUS pump.”
and
“This is your penile implant pump.”
You can then practise locating each one yourself.
Learn the overall shape and feel
Both devices have components that can feel like a small bulb, so identifying a pump by one part alone can be confusing.
Learn the position, overall shape and feel of each of your own pumps. Different implant models have different designs, so a diagram or video online may not exactly match your devices.
Remember the purpose
A simple mental check is:
Need to urinate → AUS
Want an erection → penile implant
Studies of men with both implants have found that appropriately selected and educated patients can generally learn to operate both systems.[4,5]
What if I accidentally squeeze the wrong pump?
A single accidental manipulation does not necessarily mean you have damaged either implant.
If you operate the AUS unintentionally, the urethral cuff may temporarily open and you could notice leakage.
If you begin operating the penile implant instead of the AUS, the penis may start to inflate while the urinary sphincter remains closed.
If you are uncertain, avoid repeatedly experimenting with the pumps. Arrange a review so they can be identified properly.
When should I have the pumps checked?
Seek review if:
you can no longer confidently tell the pumps apart
either pump becomes difficult to reach
a pump appears to have moved significantly
your AUS stops working as expected
your penile implant no longer inflates or deflates normally
you develop increasing pain, swelling, redness or tenderness.
Problems with an existing penile prosthesis can also be assessed through penile implant revision care.
An important warning about urinary catheters
If you have an artificial urinary sphincter, always tell doctors and nurses before a urinary catheter or instrument is passed through your urethra.
The AUS and urethra need to be managed appropriately before instrumentation. Catheterisation while the cuff is not appropriately managed can increase the risk of urethral injury or erosion.[1,3,6]
If you attend an emergency department, clearly tell staff:
“I have an artificial urinary sphincter.”
If you have a full bladder and cannot urinate despite attempting to use your AUS normally, seek prompt medical assessment.
Still unsure which pump is which?
If you cannot confidently identify or operate your implants, a clinical examination can usually clarify their position and function.
Learn more about male urinary incontinence, artificial urinary sphincter surgery or penile implant surgery.
Patients travelling from elsewhere in Australia or overseas can also review the international and interstate patient pathway before travelling to Brisbane.
Medical disclaimer
This information is general educational information only and does not replace individual medical advice. Penile implant and artificial urinary sphincter designs, positioning and operating instructions vary between patients and devices. If you are uncertain how to operate an implanted device, contact your treating urologist or prosthetic surgery team. Seek urgent medical assessment for inability to pass urine, severe pain, increasing swelling, fever or other concerning symptoms.
References
European Association of Urology. EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms. Arnhem: EAU Guidelines Office; 2026.
European Association of Urology. EAU Guidelines on Sexual and Reproductive Health. Arnhem: EAU Guidelines Office; 2026.
Chung E, Liao L, Kim JH, Wang Z, Kitta T, Lin ATL, et al. The Asia-Pacific AMS800 artificial urinary sphincter consensus statement. Int J Urol. 2023;30(2):128-138. doi:10.1111/iju.15083.
Mancini JG, Kizer WS, Jones LA, Mora RV, Morey AF. Patient satisfaction after dual implantation of inflatable penile and artificial urinary sphincter prostheses. Urology. 2008;71(5):893-896. doi:10.1016/j.urology.2007.10.018.
Segal RL, Cabrini MR, Harris ED, Mostwin JL, Bivalacqua TJ, Burnett AL. Combined inflatable penile prosthesis-artificial urinary sphincter implantation: no increased risk of adverse events compared to single or staged device implantation. J Urol. 2013;190(6):2183-2188. doi:10.1016/j.juro.2013.06.084.
Sandhu JS, Breyer B, Comiter C, Eastham JA, Gomez C, Kirages DJ, et al. Incontinence after prostate treatment: AUA/GURS/SUFU guideline amendment 2024. J Urol. 2024.
