Procedures for men suffering with stress incontinence available

Procedures for men suffering with stress incontinence available
Tuesday 20 March 2018

Miss Charlotte Foley, Consultant Urological Surgeon, at Pinehill Hospital has just started male sling & artificial urinary sphincter procedures for men suffering with stress incontinence.

Male stress incontinence is rare, and almost exclusively seen in men after prostate cancer treatment and less so after a TURP. Many patients accept incontinence as the price paid for cancer cure but in fact they do not have to. Despite pelvic floor exercises, 5% of men will still have significant incontinence a year after their radical prostatectomy which impacts on their quality of life.

However, there are two devices which offer good success rates for curing incontinence - the insertion of a male sling or an artificial urinary sphincter. Some men will feel that they have been through enough, and will have adjusted to their new 'normal', but others are very ready to consider these operations.

Both devices are implanted via a perineal route and patients are discharged catheter free the following day. Miss Foley started this service at the Lister in 2016, and has just implanted a male sling at Pinehill Hospital for the first time in January 2018. This turned out to be a first for any Ramsay Hospital.

The male sling is similar to the transobturator tape used for female stress incontinence. However it is pulled tight, to reposition and support the urethra, and does not seem to be beset by the erosion concerns we see in female slings. Cure rates are around 70% with about 20% noticing no improvement. The Artificial Urinary Sphincter is a saline filled cuff fitted around the urethra which is mechanically emptied using a pump positioned in the scrotum when the patient wants to pass urine. Cure rates are better at 90% but the patient must embrace the added complexity of using the pump and the risk of device malfunction. It is also perfectly possible to insert a sphincter into a man whose sling was not successful.

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