The major complications, which lead to subsequent short term revisions or explants after an Artificial Urinary Sphincter (AUS) surgeries are infection, or unadverted injuries during implantation. Medial or long term AUS complications (as urethral atrophy or erosion) are linked to high occlusion pressure (1,2).  VICTO is a single unit pre-connected adjustable device with an occluding cuff (OC), which includes a filling procedure that is performed before the implant, and unlike other artificial sphincters an intra-abdominal prosthetic implant, which determined a perineal and a intraperitoneal surgical access at the same time.
The AIM of this video demonstration is to provide an educational video in a reproducible surgical technique, friendly to use, that in our understanding we can reduced the rate of complications in the use of AUS VICTO.

We perform an educational video, with the information collected of the authors with great experience in the implantation of this new AUS, highlighting the intra-surgical technical details that they we have collected for the reduction of complications to contribute to the urological society. The video sequence obtained, was then discuss by the panel of authors and, reconstructed to deliver an educational surgical technique video demonstration.

Our results, which are detailed in the educational video, clearly contribute to transforming concomitant perineal and intraperitoneal access into a simple, reproducible access without risk to both the patient and the safety and indemnity of the product, which could suffer injuries during implantation. We detail the most appropriate way to achieve the measurement of the AUS caliber to be used with simple and accessible surgical maneuvers. In this way, this educational video achieves the expected result in a reproducible and accessible technique for the intra-surgical management of a new product for male urinary incontinence.

In conclusion this technical surgical procedure show in this educational video of the new AUS VICTO, we have no revisions due to urethral injury, abdominal complications, infections, and reducing the times of surgery and AUS air exposure up to 30%, achieving a continence rate almost of 60%. The complete absence of erosions or abdominal complications proves that this surgical technique described in this educational video of the AUS VICTO implant to be particularly safe. These results are promising and challenge prior AUS series, to confirm our surgical technique.

Long-term Outcomes Following Artificial Urinary Sphincter Placement: An Analysis of 1082 Cases at Mayo Clinic.  Linder BJ, Rivera ME, Ziegelmann MJ, Elliott DS.Urology. 2015
The artificial urinary sphincter after a quarter of a century: a critical systematic review of its use in male non-neurogenic incontinence.  Van der Aa F1, Drake MJ, Kasyan GR, Petrolekas A, Cornu JN; Young Academic Urologists Functional Urology Group.Eur Urol. 2013

Continence 7S1 (2023) 100793
DOI: 10.1016/j.cont.2023.100793