BACKGROUND: Urinary incontinence is defined as the loss of urine control and it can be a temporary or permanent problem. Some estimate that about five million men in the United States are affected by the condition. Incontinence can be due to a number of reasons. In males, it is often arises from prostate cancer surgery, the most common cancer in males in the United States. "While the advantage of prostate cancer surgery is that it will most likely cure the cancer, it may also carry the side effect of weakening some of the support structures around the urethra," Allen Morey, M.D., a professor in the department of urology at the University of Texas Southwestern Medical Center in Dallas, told Ivanhoe. "As a man with an active lifestyle exerts himself, the pressure becomes too great for that delicate area and troublesome urinary leakage may develop," he explained.

According to Dr. Morey, there are two types of incontinence: stress and urge. Men can also experience both types, called mixed incontinence. Stress incontinence typically occurs during activities that require exertion, like golfing, sneezing, walking and exercising. "Those types of activities may produce extra pressure on the urinary control mechanism and override it, causing leakage," Dr. Morey said. Urge incontinence involves a sudden need to urinate. Leakage occurs when the bladder muscles contract incorrectly.

TREATMENTS: According to Dr. Morey, the AdVance Male Sling is a simple, safe method of treating male incontinence in those with a moderate version of the condition, where it is "bothersome but not severe." The sling works by providing extra support to the urethra, stabilizing it during periods of exertion. As pressure is placed on the urethra, the sling helps keep the urethra closed, but does not hinder urination when necessary. Only two tiny incisions on either side of the pelvis are required to place the sling in a patient, making it a very minimally invasive procedure.

The procedure requires only one night in the hospital and no catheter. Doctors recommend patients stick to only light activity for about four weeks afterwards. Results can be experienced almost immediately. Since the device was developed only two years ago, long-term results are not clear, but Dr. Morey says he is optimistic. "We know from similar procedures in women that long-term results with the same material used in the sling tend to be very favorable."

Other incontinence therapies include injection treatment, where collagen or other special compounds are injected into the muscle surrounding the urethra. This method is typically reserved for the most minimal incontinence cases. For the most severe cases, an artificial sphincter operation may work best.

FOR MORE INFORMATION, PLEASE CONTACT:

UT Southwestern
Department of Urology Patient Office
(214) 645-8765
http://www.utsouthwestern.org