The AUS "gold standard" is not for very active people who do certain activities. From my extensive research, my understanding is that it is invasive and not reversable. For example, cycling, horseback riding, martial arts, skiing or trail running (where you might fall), or any exercise that may cause you to hit the button can cause problems. However, those who are active doing activities such as golf, swimming, or walking should see an improved quality of life. And, for those who are not physically active, who enjoy reading, watching TV, sightseeing, cruises, etc., they should also have an improved quality of life. My husband decided that he would rather try ProAct, even if it only improves his incontinence by 50%, than have the AUS improve the incontinence 95%, but he cannot do the activities that bring him joy in life. In other words, the AUS would not improve his quality of life by 95%. If you can, I suggest you look at premiere clinics outside of your area, if you are not finding someone who will do the procedure in your area, other than your doctor whom you are not confident in. It may take many phone calls and Google searches, but it may well be worth it to speak to someone who does the procedure and who you can trust.