Incontinence in Males

Background

Incontinence in men needs to be assessed as it is less common than in women and a potentially serious underlying cause need to be ruled out. Your urologist will work through this with you, and decide a management plan best suited for your condition.

Stress incontinence in males usually arises after treatment for prostate cancer (surgery, radiation or both) but can also be due to disorders of the nervous system, pelvic trauma and other prostate or urinary tract procedures.  Time (usually 1 year or more following prostate surgery) and pelvic exercises are the initial treatments for most cases.  Although several surgical options for this problem have been described, there are currently 2 safe and effective options - the artificial urinary sphincter and the male suburethral sling.  The artificial sphincter is a prosthetic valve that replaces one's natural continence mechanism.  This techonology has been in use for over 30 years and is associated with excellent success rates.  Inherent drawbacks include the chance of mechanical device failure (average 7-8 yrs), need for re-opration, risk of prosthesis infection and risk of erosion into the urethra.  The current male sling (AdVance male sling - American Medical System, Minneapolis, MN, USA) has been used in North America since about 2006.  Dr. Rapoport was involved in one of the largest male sling experiences to date while at Duke University in 2008-2009 where he was involved in over 140 cases.  Currently, the male sling is reserved for those men with intact native control mechanisms as the sling aims to support rather than replace one's own control mechanism.  Cystosocpy is a necessary test to decide whether one is a candidate for a male sling or an artificial sphincter.

 

 

On the Web

General Urology Websites

Canadian Urological Association  Extenstive library of downloadable pamphlets on a wide range of urological conditions

Cleveland Clinic

Mayo Clinic

Medline Plus Produced by the US National Institutes of Health with information on virtually every health topic and extensive list of links

UrologyHealth.org The patient information site of the American Urological Association.