Treatment for Urinary Incontinence

[Tiny814]

My husband, age 68, has been incontinent since he had an RRP in 2002. The condition appears to be worsening, and he is ready to consider possible surgical options to correct the problem. He does not relish the idea of an artificial sphincter, but that is the only option his urologist has offered. My husband has, primarily, stress incontinence. He urinates many times a day and usually a couple of times during the night. He seldom--if ever--has the problem of feeling an urgent need to get to the bathroom. His urologist prescribed VESIcare, but it did not seem to help. He is having a great deal of irritation, redness, and sometimes a rash on the scrotum from leakage. He wears Depend/Male Guard pads, and has even tried using washcloths between the pad and his undershorts, but this made the problem worse.

We have heard of InVance and AdVance male slings, but do not know much about them, nor do we know of a urologist in this area that has experience with this. His urologist has only implanted a few of the artificial sphincters.

So, my questions are:

1. What are the pros and cons of the male slings and artificial sphincter?
2. Can you recommend a specialist who has a lot of experience--and success--with these methods in the Dallas/Fort Worth/Tyler/East Texas area?

Thanks!

[Tiny814]

Thank you very much for your response. Travel is an issue (because of severe back problems), but I believe it's best to call UT Southwestern for an appointment for my husband to have a thorough evaluation.

[Dr Smitha Mathews]

Hi,
Patients develop urinary incontinence of varying grades after prostate surgery. This condition is expected to resolve over a course of 5 months to a year.

Doctors usually advice a combination of bladder training, kegel's exercises, medical treatment, and use of pads depending on the intensity of the problem.

For patients with moderate to severe stress incontinence, surgical intervention is warranted.

As you mentioned, slings work with efficacy of about 75-80% in patients with urinary incontinence.

"the AdVance sling, involves passage of a thin strip of mesh between pinpoint incisions on the inner thighs, which is then passed deep beneath the bottom of the urethra to increase support in precisely the area where the tissues are weakened. This additional flow resistance prevents the leakage of urine when abdominal pressure increases. The procedure is best suited for mild to moderate urinary incontinence, usually defined as patients who wear one to four pads per day to absorb any leakage."

"Men interested in the male sling should have a comprehensive evaluation of their incontinence before any recommendations are made regarding treatment. For more information contact the UT Southwestern Department of Urology at 214-648-4765."
www.news-medical.net/?id=29208

Do keep us posted on your doubts and progress.

regards