Male incontinence
Male incontinence post prostatectomy
Male incontinence post-prostatectomy Perth urologist
Why do prostate cancer treatments sometimes cause incontinence?
Treatments for urinary incontinence after a prostatectomy
- Pelvic floor exercises
- Conservative measures such as incontinence pads/penile clamps
- Male slings
- Artificial urinary sphincter
Artificial urinary sphincter for male incontinence
What is an artificial urinary sphincter (AUS)?
The artificial urinary sphincter (AUS) is the gold standard procedure for male incontinence post radical prostatectomy.
It consists of three parts:
- The cuff – that sits around the urethra (water pipe) causing compression
- The reservoir balloon – that has fluid in it allowing the cuff to fill up at rest
- The pump – that you press to open the cuff so you can void
It is best suited to men who have moderate to severe incontinence or who have had radiotherapy as well as surgery. It is a very successful operation with 80-90% continence rates.
Short term risks include:
- Infection – which may require removal of the device
- Bleeding
- Urethral injury
- Pump positioning issues
- Failure to make you completely dry
- Numbness or discomfort at the operation site
- Difficulty urinating – may require catheter or suprapubic catheter
- Difficulty holding onto urine, urgency and frequency
Long term risks include:
- Urethral atrophy – the waterpipe shrinks and the cuff becomes loose, causing return of leakage
- Mechanical failure
- Erosion of the parts
- Reoperation rates of 20-40% – mechanical failure, erosion, device loosening.
The operation is performed under a general anaesthetic. A small incision is made in the undercarriage below the scrotum and another in the lower abdomen. The cuff is placed around the urethra (waterpipe) and the balloon in the abdomen (tummy). The pump is tunnelled down to the scrotum.
Sling for male incontinence Perth urologist
What is the sling and in what cases is this option chosen over the AUS?
The male sling is preferred for men with mild to moderate incontinence.
It has benefits in that it has fewer mechanical parts and does not require the patient to ‘use’ the device.
Risks include:
- Infection
- Bleeding
- Erosion
- Failure to make you completely dry
- Pain in the groin/upper thigh
- Urethral injury
- Urgency, frequency and difficulty holding on
- Inability to pass urine (uncommon and temporary)
Perth urologist male incontinence
Why Dr Kong for male incontinence post prostatectomy?
Dr Kong understands that after cancer surgery when men have recovered from their initial cancer diagnosis and now are dealing with survivorship they can suffer greatly from the functional effects of treatment.
Many men suffer in silence and it can cause significant reduction in quality of life and affect mental health.
Dr Kong has experience in both cancer surgery and the solution to these uncommon but debilitating side effects of treatment.
She completed a sabbatical in Birmingham specifically in the area of functional urology and is involved in the dedicated reconstructive service for North Metropolitan Health Service.
Dr Kong can see patients urgently if required.
Contact
Kong Urology | Dr Jennifer Kong
Get in touch
Dr Jennifer Kong consults in
West Leederville close to SJOG Subiaco
164 Cambridge Street
WEST LEEDERVILLE WA 6007
Australia