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Sling after Prostate Surgery for Urinary Incontinence

New Procedure Helps Prostate Cancer Patients Maintain Bladder Control following Surgery

More than 200,000 new cases of prostate cancer are identified each year in the U.S., according to the Prostate Cancer Research Institute. Many of the men who elect to have their prostate gland removed will experience some degree of urine control loss, or incontinence, after surgery. "The prostate gland normally provides passive resistance for the urethra," says Dr. Ali Sarram, a urologist at Sky Ridge Medical Center. “So once the prostate is removed, approximately 10–15% of these men may end up having long-term, minimal [one to three pads per day] incontinence when they’re active. It’s an anatomical problem, so this condition doesn’t respond to medical therapy.”

"If these men knew about this procedure, they would come in, get it done and it would change their lives. For the men we’ve performed it on, they’re really happy with it." –Dr. Ali Sarram

Sling Procedures Replaces the Need for an Artificial Urinary Sphincter

Until recently, the only procedure available to treat male incontinence was the artificial urinary sphincter. "It’s a good procedure for significant incontinence, but it’s major surgery to implant the device and may not be necessary in men with minimal incontinence. The majority of men who develop long-term incontinence after prostatectomies have minimal incontinence, and therefore may not be good candidates for an artificial sphincter," says Dr. Sarram. “Instead, we can perform what’s called the male sling procedure and have most of these men back to their normal activities in a matter of weeks."

The Male Sling Procedure: A Minimally Invasive Treatment that Improves Quality of Life for Men

To improve urinary control, slings have been used for years in women, but they’re a relatively new treatment for men. The earlier slings were anchored to the pelvis with small bone screws, but the newer slings are much improved. For men, a small incision is made between the scrotum and anus, and a thin strip of mesh is inserted under the urethra to provide support and prevent the leakage of urine when abdominal pressure increases or the man is relatively active.

"Today the procedure doesn’t require any screws," says Dr. Sarram, “and the mesh sling adheres to the tissue after a short time. The pain and risk of bleeding or other problems is minimal. And it’s permanent.” According to Dr. Sarram, it’s a simple procedure that takes about 30–45 minutes and is typically performed on an outpatient basis. Once the sling takes hold in the tissue after four to six weeks, men can go back to their normal activities, like golfing, skiing and running.

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