Male Urinary Incontinence

It is estimated the in Australia nearly 1 million men suffer with incontinence. It is a serious problem that men are reluctant to discuss with others.

When the muscle (sphincter) that holds the bladder outlet closed is not strong enough to retain urine in the bladder, or if there are abnormalities of bladder function, the result is urinary incontinence.

Incontinence may occur when:

  • The sphincter is too weak
  • The bladder muscles contract too strongly
  • The bladder is not emptied completely

In men, urinary incontinence is often related to a medical problem or a surgical treatment involving:

  • The prostate gland
  • Enlargement (benign prostatic hyperplasia, BPH)
  • Prostate removal due to cancer

WHAT ARE THE TYPES OF INCONTINENCE

Stress Incontinence: Is the accidental release of urine when pressure is applied to the bladder, such as when you cough, sneeze, laugh or lift something heavy. This is the most common type of incontinence after prostate cancer surgery.

Urge Incontinence: Is when the bladder contracts at the wrong time giving you the feeling that you have to urinate immediately, even if you may have just emptied your bladder, and you may not get to the toilet in time.

Overflow Incontinence: Is characterised by leaking when the bladder does not empty properly. This can be due to other medical conditions such as an enlarged prostate or a narrowing of the urethra.

Total Incontinence: Is continual leakage of urine due to complete sphincter deficiency.

HOW IS INCONTINENCE TREATED?

Proper treatment can help you return to a more natural lifestyle.

  • Regain dignity
  • Resume intimacy
  • Save money on protective garments

The type of incontinence that you are diagnosed with will determine your treatment options. Some options available are:

  • Behavioural modification – weight loss, cease smoking etc
  • Medication
  • Surgery

We will focus on the permanent surgical treatment available for stress incontinence and incontinence as a result of prostate removal for cancer.

SURGICAL TREATMENT

Once an accurate diagnosis is made by Dr. Love, it may be determined that the best way to treat your incontinence is to have a bulbourethral sling implanted, this device being surgically placed under the urethra (water-tube) to elongate and support it.

The sling is made of a polypropylene mesh material, which is implanted underneath the bulbous urethra to elevate and apply a gentle compression to prevent urine leakage.

There are a variety of slings available, and all are similar but also have differences in the way they work, making some more suitable than others in different men.

One such sling is the Virtue® Male Sling (Coloplast )

Typically, Virtue® is inserted during a small operative procedure involving one night in hospital. Individual recovery time may vary, but the average time is 4-6 weeks. During this time, heavy lifting should be avoided. Dr. Love will discuss your recovery plan in greater detail.

Another useful sling is the ATOMS ® adjustable sphincter, combining a sling and an injection port for further adjustment of the sling (if required) in the office as an outpatient.

Virtue® and other slings, like ATOMS ®, should offer a permanent solution. Once the sling is in place, you can enjoy the active lifestyle you had before, playing sports, exercising, dancing and just carrying in the groceries without fear of leaking.

For men with more significant incontinence, or who have complex bladder reconstruction surgery, an artificial urinary sphincter may be required.

This device is also implanted surgically around the urethra, but applies constant pressure and needs to be opened by a scrotal pump when a patient wants to pass urine.