Male Sling
For Urinary Incontinence
Some degree of urinary incontinence is a virtual guarantee after invasive prostate cancer treatment, including radical prostatectomy and even radiation therapy. Fortunately, most prostate cancer patients have their continence restored within a year after surgery. After this point, however, if symptoms persist, it’s unlikely that complete continence will return, so patients may need assistance in urinating more predictably to avoid pads and briefs. In addition to prostate cancer, incontinence can result from bladder conditions caused by overactive bladder.
The Male Sling
The male sling is a simple, highly effective treatment option for mild to moderate urinary incontinence that can get a man down to a zero to 1 pad almost immediately after surgery. During the procedure, which is performed under general anesthesia in an ambulatory surgery center or hospital setting, the urologic surgeon implants a bio-compatible, plastic mesh hammock under the urethra to lift and support it, thus helping prevent incontinence.
The Ideal Candidate for a Male Sling
Candidates for a male sling should have mild to moderate urinary incontinence and complete sensation of their bladder’s fullness. The patient must be able to urinate somewhat more frequently before the bladder fills up too much and overwhelms the sling.
For patients with severe stress urinary incontinence, an artificial urinary sphincter may be a better option, as the patient has direct external control over urination.
A Note on Mesh
Over the past decades, we have heard much about pelvic mesh and the safety concerns surrounding certain brands, especially counterfeit meshes. The mesh used for the male sling is not the same as the female pelvic mesh, but even so, improvements in mesh technology and customization available to virtually any anatomy make its use an excellent and long-lasting option.
Possible Risks and Considerations of the Male Sling
As mentioned above, the male sling is best for men with mild to moderate urinary incontinence. This typically means 4 pads or less per day. Patients with more severe incontinence may not benefit from it. Even if patients have a sling, an AUS can still be performed with a sling in place.
The sling is implanted surgically; thus, the risk of any surgical procedure is also relevant. Most patients experience some discomfort and minor pain a few days after implantation. There can be some swelling and redness at the incision site and mild pain in the scrotum, which should improve each day after surgery. Most patients are pain-free just a few days after surgery. From a mesh standpoint, there are a few complications. Though extremely rare, migration or erosion of the mesh is possible and requires a follow-up surgical procedure.
Fortunately, the male sling has excellent results in the appropriately selected individual, and most men experience relief from their symptoms and the elimination of the worry associated with unpredictable urination. However, it is crucial to speak to a urologist experienced in both male slings and artificial urinary sphincters to ensure that you receive the best treatment recommendation for long-term relief.
The most critical next step is to speak to your trusted urologist at Georgia Urology to learn more about incontinence treatment options and schedule a consultation for evaluation for a male sling.