Several reports showed the efficacy of tandem cuff placement.14, 16 and 24 Among tandem cuff placements, 56% of patients used 1 pad or less daily. These studies did not compare the outcomes of tandem cuff placement to other revision techniques, however. A study from 2008 with a smaller cohort but longer follow-up comparing 25 men who GSK1210151A underwent initial single cuff placement (74 months follow-up) to 22 who underwent initial tandem cuff placement (58 months follow-up) found no difference in continence between the 2 groups, but a higher rate of complications requiring reoperation in the tandem cuff group (7 vs 12).25 It is possible that with a longer follow-up in our study, we would find a higher rate of complications; however, our study looked at AUS revisions and not initial placements as theirs did. In our study, we found that tandem cuffs were superior to all other revision techniques with regard to recurrent SUI. We, therefore, recommend climax community as the technique of choice for patients with recurrent or persistent SUI in whom the urethra visibly coapts during cystoscopy.