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 within the scrotum.
A very reasonable question is:
How do I know which pump I’m squeezing?
The short answer
Artificial urinary sphincter pump → allows you to urinate
Penile implant pump → inflates the penile implant to create an erection
Importantly, there is no universal rule that the AUS is always on one side and the penile implant on the other.
The position depends on your anatomy, previous surgery, scarring, surgical technique and how your individual devices were positioned.[1-4]
The safest approach is to learn the position and feel of your own two pumps with your surgeon.
Learn more about Artificial Urinary Sphincter surgery and Penile Implant Surgery.
Why are there two pumps?
The two devices perform completely different functions.
Artificial urinary sphincter
An artificial urinary sphincter is used to treat significant male stress urinary incontinence.
The system typically includes a cuff around the urethra and a control pump positioned within the scrotum.[1,2]
Operating the pump temporarily reduces pressure around the urethra, allowing urine to pass. The cuff then gradually repressurises to restore continence.
Being able to locate and operate the pump is therefore an important part of successful AUS use.[1,2]
You can read more about male urinary incontinence here.
Penile implant
A three-piece inflatable penile implant generally contains cylinders within the penis, a fluid reservoir and a pump in the scrotum.[3]
Repeatedly compressing the inflation bulb transfers fluid into the cylinders, producing penile rigidity.
A separate control mechanism allows the implant to deflate again.[3]
How can I tell the pumps apart?
1. Learn where each pump was placed
Surgeons generally try to position both pumps so that they remain accessible and distinguishable.
They may be positioned on opposite sides of the scrotum, but do not assume left or right identifies a particular device.[2,4]
At your postoperative review, ask your surgeon to physically identify:
“This is my AUS pump.”
and
“This is my penile implant pump.”
Then practise locating each one yourself.
2. Feel the whole pump
Both devices contain compressible components, so simply finding something that feels like a bulb may not be enough.
Instead, learn the overall shape, location and control mechanism of each device.
Penile implant pump designs vary, as do AUS control pumps, which is why generic diagrams found online may not perfectly match your implants.[2,3]
3. Remember what each pump does
A useful mental check is:
Need to urinate? → AUS
Want to inflate the penile implant? → penile implant pump
Published studies involving men with both an AUS and penile prosthesis suggest that most appropriately selected and educated patients can learn to operate both devices successfully.[4,5]
What happens if I squeeze the wrong pump?
Accidentally manipulating the wrong pump does not automatically mean that you have damaged the device.
If you accidentally operate the AUS, the cuff may temporarily open and you may notice some urinary leakage.
If you accidentally begin pumping the penile implant while trying to urinate, the penis may start to inflate — but importantly, the AUS may still be closed.
If you are uncertain which device you are operating, avoid repeatedly experimenting with the pumps.
What if I cannot find my AUS pump?
The position of a scrotal pump can sometimes feel different as postoperative swelling settles or because the pump sits within mobile scrotal tissues.[2]
Arrange review if:
you cannot confidently distinguish the pumps;
a pump has become difficult to reach;
its position has changed substantially;
the AUS no longer seems to operate normally;
the penile implant no longer inflates or deflates normally; or
you develop new pain, redness, swelling or tenderness.
An important warning about urinary catheters
If you have an artificial urinary sphincter, tell any doctor or nurse before they attempt to insert a urinary catheter or instrument through the urethra.
Urethral instrumentation while an AUS cuff remains activated may injure the urethra and potentially contribute to cuff erosion.[2]
If you attend an emergency department, say clearly:
“I have an artificial urinary sphincter.”
What if I have completely forgotten which pump is which?
Don't guess repeatedly.
Having two hydraulic devices within the same area can understandably be confusing.
A brief examination can usually identify both pumps, after which your surgeon can show you how to locate each one yourself.
The simplest way to remember their functions is:
AUS = urination
Penile implant = erection
But learn the position and feel of your own devices, rather than relying on left versus right.
Still unsure which pump is which?
If you have both an AUS and penile implant and cannot confidently identify or operate the devices, a specialist review can clarify their position and function.
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Frequently Asked Questions
Is the AUS pump always on the right?
No. There is no universal left-or-right convention. Your surgeon should show you the position of your individual devices.
Which pump do I squeeze to urinate?
The artificial urinary sphincter pump.
Which pump inflates my penile implant?
The penile implant pump.
What if I can't tell the pumps apart?
Arrange an examination rather than repeatedly trying each device. Your surgeon can identify both pumps and teach you how to distinguish them by position and feel.
What if I cannot urinate?
If you have a strong urge or full bladder and remain unable to pass urine despite attempting to operate your AUS, seek prompt medical assessment.
Tell the treating team that you have an artificial urinary sphincter before urinary catheterisation is attempted.[2]
Medical disclaimer: This information is general in nature and does not replace individual medical advice. Device type, position and operation vary between patients. If you are unsure how to use your implant, have it reviewed by your treating urologist.
References
European Association of Urology. EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms: Male Urinary Incontinence. 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.
European Association of Urology. EAU Guidelines on Sexual and Reproductive Health: Management of Erectile Dysfunction. Arnhem: EAU Guidelines Office; 2026.
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 with single or staged device implantation. J Urol. 2013;190(6):2183-2188. doi:10.1016/j.juro.2013.06.084.
