The commonest cause of male urinary incontinence is radical prostatectomy for the treatment of prostate cancer. In the vast majority of cases, the involuntary leakage is temporary and minor. However, some men will continue to have significant leakage of urine in the longer term, impacting on their quality of life. Fortunately, there are highly effective treatment options which include insertion of an artificial urinary sphincter, or a synthetic male sling.
The most important component of the urinary continence mechanism is the body’s own urethral sphincter, which is a muscle that surrounds the urethra just below the prostate. Although utmost care is taken to prevent injury to this structure during radical prostatectomy, weakening of the sphincter does occur in a proportion of patients, leading to ongoing incontinence.
The artificial urinary sphincter (AUS) is the gold standard of treatment for male urinary incontinence. It has withstood the test of time, being unsurpassed by any other device for decades, and AUA Urologists have been responsible for publishing the largest Australian experience with this device1. The AUS is particularly effective for the more severe type of male urinary incontinence, where circumferential compression of the urethra is required. The AUS can be inserted via one or two small incisions and typically involves an overnight stay in hospital.
The device has 3 main components attached to each other: the cuff (surrounding the urethra), the pump (placed in the scrotum next to one of the testes) and the reservoir (placed in the pelvis). In the normal resting mode, the cuff is full of water, compressing the urethra. When the patient feels his bladder is full, he goes to the toilet and squeezes the pump, which opens the cuff, allowing urine to drain out. Over the next 2-3 minutes the cuff automatically re-fills, closing the urethra again.
To discuss male incontinence and its treatment please call AUA on 03 8506 3600 to make an appointment with one of our urologists.
1. Sathianathen N, McGuigan S, and Moon D. Outcomes of Artificial Urinary Sphincter Implantation in the Irradiated Patient. BJU Int Apr 2014; 113(4): 636-641