Male urinary leakage is usually the consequence of prostate cancer and prostate removal.
Post-prostate surgery urine leakage typically occurs during physical activity or straining. This type of urine leakage is called “stress” incontinence. It is caused by a faulty urinary valve – also known as a “sphincter”. If the sphincter (valve) has been injured during prostate surgery and does not close properly, a person can leak urine.
Valve function typically comes back with time and by doing regular isometric exercises of the pelvic floor muscles. These muscle exercises are called “Kegels”. Six months after prostate surgery, the majority of valve function typically has returned. Patients who are still leaking 6 months after prostate surgery can consider a surgical repair.
What types of surgeries can cure male stress incontinence?
Patients who are leaking less than 250 ml of urine a day - which usually works out to 4 or fewer pads a day – are best served by a sling procedure. Sling surgery is performed through an incision in the area between the scrotum and the anus. This surgery takes about an hour and is out-patient (go home after the surgery). In the properly selected patient, success rates (marked improvement to near dry) approach 80%. The most popular slings on the market today are the Advance sling by Boston Scientific and the Virtue sling by Coloplast.
Artificial Urinary Sphincter (AUS):
Patients who have very poor urine control - needing more than 4 pads a day or pullups – usually require an artificial urinary sphincter (AUS) device.
An AUS is a mechanical device that is surgically implanted, which can open and close the urethra. It is totally concealed underneath the skin. The sphincter is the gold standard of devices to control post-prostate surgery urine leakage. It has been in existence for over 30 years and has a greater than 90% satisfaction rating. As a mechanical device, it has a life span of 7 to 10 years and will need to be replaced periodically.