Bladder sling after prostate surgery

Solve prostate cancer recovery leaking

If you have had surgery to remove prostate cancer, you may have a difficult time peeing as part of the recovery process. The innovative bladder sling for urinary incontinence helps solve issues with leaking or dribbling. Our team of exceptional urologists at Sky Ridge Medical Center treat patients with the modern, minimally invasive procedure.

"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

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.”

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.

Incontinence after prostate surgery often misunderstood

Interestingly, many men facing prostate surgery don’t even know how good their options are for treating potential long-term incontinence. "Unfortunately, there’s a lot of misinformation out there, and many men think that if they have prostate surgery, they’re most certainly going to develop incontinence, just as their fathers did with their surgeries," says Dr. Sarram. "We need to let men know about these advancements." Dr. Sarram notes three important factors surrounding incontinence following prostate surgery:

  1. The chances of incontinence over the long term (at least 9–12 months) are small.
  2. If there’s incontinence in the long run, most of the time it’s very minimal.
  3. If the minimal incontinence is bothersome to men, there’s a fix available—the male sling procedure.

Dr. Jonathan Seidlin, who has developed a successful program identifying and treating men who suffer from urinary incontinence,leads the male incontinence program at Advanced Urology. Though performed at Sky Ridge by Dr. Sarram and his partner, Dr. Seidlin, the male sling isn’t widely used at this point. But with the frequency of prostate surgery, this highly successful procedure for combating male incontinence is encouraging and fortunately available. "It’s amazing," says Dr. Sarram. "Prostate surgery is very common, so if you assume that 10-15% of these men have long-term incontinence, there are a lot of men walking around who have some incontinence, who are socially embarrassed by it, and who limit their activities and lifestyle. 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."

Sling patient discusses his experience

That’s certainly the case for Don Hicks, a 58-year-old facilities administrator and Sky Ridge’s first patient to receive the male sling. After surgery in 2002 for prostate cancer, Don had moderate incontinence that was “embarrassing and very inconvenient,” he says. "There were occasions in my job, like heavy lifting, that would cause incontinence. Plus, I’m a pretty active individual. We like to ski, hunt, fish and hike, and I love to work in my yard. After several years, it started to really wear on me. I decided that I was too young and too active to be bothered with this kind of problem."

"It’s not embarrassing or inconvenient for me anymore, and psychologically that’s huge. I was able to get back to my old self."
Don Hicks

Don first consulted a urologist who told him about the artificial urinary sphincter, which didn’t strike Don as a good choice for several reasons, particularly how invasive the procedure was. That’s when Don turned to Dr. Sarram. Already aware of the male sling procedure, Dr. Sarram decided to forge ahead and bring it to Sky Ridge. In May 2007, Dr. Sarram performed his first male sling procedure on Don, a self-described "happy guinea pig." "I was willing to try anything," says Don.

Following the normal recovery period of four to six weeks, and after doing the muscle-strengthening exercises recommended by Dr. Sarram, Don was able to return to his normal activities without worry. Well, almost. "At first, I was extremely nervous about not using the pads," says Don. "I even tested out the sling, drinking a lot of water. But it held up very, very well. It’s not embarrassing or inconvenient for me anymore, and psychologically that’s huge. I was able to get back to my old self."

Don says Dr. Sarram was instrumental in getting his life back to normal. "To his credit, Dr. Sarram is a concerned doctor who is always looking for new procedures that will enhance a person’s life after the kind of traumatic surgery I had. So hat’s off to Dr. Sarram that he did what was necessary to help me."

Health & Wellness

This article appears in Health & Wellness Magazine by Solve Publications.