What are the solutions for male urinary incontinence, Dr. Rodriguez?
For mild to moderate leaks, the solution is to place a “sling” under the urethra to return the urethra to its original position. When the leaks are severe, with losses that can reach several hundred milliliters per day, the most effective solution is the placement of a prosthesis, an Artificial Urinary Sphincter, with which very satisfactory results are obtained. After this surgery, the patient only has to “activate” the sphincter every time he/she wants to urinate.
Tell me a little about the sling, what is it and how does it work?
When a patient’s prostate is radically removed to treat cancer, the position of the bladder and urethra changes, and this is when leakage occurs. It is necessary to wait between 6 months and a year after radical prostate surgery to see if, in a natural way, the patient gradually recovers continence with pelvic floor physiotherapy. But if he does not regain control over urine after a year, we then resort to a mesh that repositions the urethra and the bladder neck in its original position if it is a slight or moderate loss, or to an Artificial Sphincter if the loss is significant.
In your experience, what do patients think after the placement of an Artificial Urinary Sphincter or a “mesh”?
In summary, published data indicate that 92% of men who use an Artificial Sphincter would wear it again and 96% would recommend it to another patient with urinary incontinence. Once the first 30 days have elapsed after the placement of a sphincter, the sphincter is activated and the patient regains control of urine. In the case of a “mesh” implant and if the indication is correct, more than 90% of patients are satisfied with the surgery.
Are the effects of the treatments long lasting?
In principle, they are long lasting solutions, although in the case of the Artificial Urinary Sphincter, being a mechanical device, it may require revisions over time, such as the replacement of a specific component. But this is not a problem, because with a small surgery it is replaced and it works again. The artificial sphincter is the most effective and recommended solution for severe urinary incontinence in the male.