Male incontinence

Male incontinence post prostatectomy

On this page, Dr Kong explains the options for men who have incontinence following surgery for prostate cancer.

Male incontinence post-prostatectomy Perth urologist

Why do prostate cancer treatments sometimes cause incontinence?

Prostate cancer surgery requires the removal of the prostate and seminal vesicles. The prostate sits right next to the muscles and nerves that help with continence. In surgery, these muscles can be damaged with cutting, heat and pressure.

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:

  1. The cuff – that sits around the urethra (water pipe) causing compression
  2. The reservoir balloon – that has fluid in it allowing the cuff to fill up at rest
  3. 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.
It is an extremely effective operation for many men who suffer in silence with incontinence. It has been used extensively for over 30yrs and there is significant data to support its use. Over the years the technology has improved and device failure, erosion and risks of infection have been reduced.

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.

male incontinence

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)
The sling is placed through a small incision made in the undercarriage below the scrotum. The sling is attached to the waterpipe and tunnelled through the front of the pelvis to the upper thigh / groin.

Perth urologist male incontinence

Why Dr Kong for male incontinence post prostatectomy?

Dr Jennifer Kong | Perth urologist

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.

Kong Urology | Dr Jennifer Kong

Get in touch


Dr Jennifer Kong consults in
West Leederville close to SJOG Subiaco

164 Cambridge Street