Improved Method Treats Stress Urinary Incontinence

A new male sling procedure has been developed for the management of stress urinary incontinence (SUI) occurring after prostate surgery.

Researchers from the University Hospital Center (CHU) Sahloul (Sousse, Tunisia) examined 16 patients who underwent an innovative male sling procedure for treatment of urinary stress incontinence following prostate surgery between January 2005 and December 2006. The procedure was performed with the patient in the lithotomy position using a perineal approach, and without the use of a bone anchoring system. Operative time was 30 to 80 minutes (mean 50); the catheter was removed after 1 to 3 days, and no intraoperative complications were recorded.

Results showed that after a median follow up of six months, 11 patients were dry, four patients had significant improvement and only one patient, who had suffered previously from severe incontinence showed no improvement. All patients who were dry or who showed improvement were satisfied and presented no obstructive or irritative urinary disorders. No cases of pubic pain, osteitis, or urethral erosion were reported. The study was presented at the 29th Congress of the Societe International d'Urologie, held in Paris (France) during September 2007.

"Our modification of the male sling procedure has satisfactory results like the original technique. This new procedure appears to be safe, efficacious, and low cost,” concluded lead author Dr. A. Hidoussi.

Male stress urinary incontinence is the result of sphincter insufficiency and is a potential complication of prostate surgery. It is particularly common after radical prostatectomy, but can also occur after surgical adenomectomy or endoscopic resection of the prostate. Sling procedures treat SUI by producing enough obstruction in the bulbous urethra to lessen incontinence, while still permitting voiding.