Here are some tips if you have an ever growing wsuscontent directory and you are running out of space:
1. Decline superseded update
You can delete superseded updates IF you have approved the superseding updates. If you decline the superseded updates the “Server Cleanup Wizard” will delete them and you will get more free disk space.
2. WsusDebugTool.exe
WsusDebugTool.exe /Tool:PurgeUnneededFiles
Deletes files no longer needed.
3. WSUS Cleanup Script
http://www.codeplex.com/WSUS/Release/ProjectReleases.aspx?ReleaseId=17612