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This 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 and is due to a malfunction of the sphincter mechanism. Usually this leakage is better when lying down, and worse when up and about and active.
This 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. This usually indicates a problem with the bladder.
This is characterised by leaking when the bladder does not empty properly, and the retained urine dribbles out by itself. This can be due to other medical conditions such as a chronically enlarged prostate or a narrowing of the urethra.
In very severe cases of damage to the control muscles, or if there is some abnormality of the openings of the urine tubes, or abnormal connections between the wrong parts of the urinary system, there may be total incontinence, that is no bladder control at all.
Incontinence is not something that you have to put up with and is nothing to be embarrassed about. It is a common problem and one that can be treated by a Urologist such as Dr Love.
Proper treatment can help you return to a more natural lifestyle, regain dignity, resume intimacy and save money on protective garments.
The type of incontinence that you are diagnosed with will determine your treatment options. So, it is very important the correct diagnosis of the type of incontinence is made.
Some treatment options available are:
Dr. Love has extensive experience in all the surgical treatments for male urinary incontinence. Make an appointment now to discuss your symptoms and potential treatment options.
Surgery is a permanent treatment for stress incontinence and incontinence as a result of prostate removal for cancer.
Once an accurate diagnosis of the type of incontinence is made by Dr. Love, it may be determined that the best way to treat your incontinence is to have a surgical procedure such as a Bulbourethral Sling or Artificial Urinary Sphincter.
A bulbourethral sling is a device, generally made of a mesh material, which is implanted underneath the bulbar urethra to elevate and apply a gentle compression to prevent urine leakage. It is a little bit like a hammock under the urethra to support it.
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 sling is the Virtue® Male Sling (Coloplast), a 4-arm mesh sling that both re-positions and elevates the urethra.
A more versatile device is the ATOMS ® adjustable sphincter, combining a sling with an inflatable pad that sits around the urethra, and an injection port for later adjustment of the sling pressure (if required). This can be adjusted in the office as an outpatient. This means that the amount of “dryness” required can be adjusted later, without further surgical procedures. Dr. Love is one of the most experienced surgeons in Australia in implanting the ATOMS device and believes it is the best sling for most men with mild – moderate urinary leakage due to stress incontinence after prostate cancer surgery.
Slings are typically 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, depending on the device used, heavy lifting should be avoided. Dr. Love will provide a detailed individual recovery plan.
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 type of device is also implanted surgically, with a cuff going all the way around the urethra so it applies constant pressure to keep the patient dry. The cuff needs to be opened by pressing on a small pump inside the scrotum when the patient wants to pass urine. The pressure of the cuff closing the urethra is controlled by a pressure regulating balloon positioned in the pelvis.
There are different types of artificial sphincters, allowing for different patient situations, and Dr. Love has extensive experience in advising on, and performing, artificial sphincter procedures. There are newer sphincters that work at two different pressure levels, and these show promise for excellent control of severe urinary incontinence, but with a better long-term risk of eventual damage to the underlying urethra, one of the potential problems of single-pressure artificial urinary sphincters.
Dr Love and his team understand that you may be feeling nervous, anxious or embarrassed about your symptoms or condition. We want you to know that you deserve to get the treatment you need and that you can go on to live a fulfilling and satisfying life. It’s never too late.
You can call our expert team confidentially and ask any questions you may have about your symptoms, condition, treatment options and the best way forward. No obligation.
You can request an appointment with Dr Love by calling 1800 375 683 or or completing the contact form on this page. You do not need a referral from your GP, but this may assist with the cost of the consultation.
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