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Advanced Approaches in Managing Incontinence: Can Surgery Help Men?

Surgical treatments can help men with certain types of incontinence, such as incontinence that results from nerve damage due to spinal cord injury or radical prostatectomy, for instance.

One procedure designed for men with minor or moderate incontinence involves surgery to place a supportive sling in the groin area. Synthetic mesh-like surgical tape is used to move the urethra into a new position and is secured with internal stitches that attach the ends of the strip to the pelvic bone. The sling keeps constant pressure on the urethra so that it doesn't open until you consciously want to release urine. For some, the shift in position is enough to remedy the incontinence; for others, it provides noticeable improvement in the condition. Sling surgery often requires just a small incision, a minimal hospital stay (if any) and a relatively short recovery. You might need to use a catheter at first if there is a lot of swelling, and it may take a few weeks before you're completely able to urinate as normally as before.

Another option is implanting an artificial sphincter, a device that keeps the urethra closed until you are ready to urinate. This can help if your incontinence is due to weak sphincter muscles or nerve damage that prevents its normal function. This is a more complex surgery and requires general or spinal anesthesia. The device has three parts—a tight-fitting, liquid-filled cuff that goes around the urethra to prevent leaking, a small balloon reservoir that resides in the abdomen and a pump that's placed in the scrotum. When you need to urinate, you squeeze the pump with your fingers to move the liquid to the balloon reservoir; this deflates the cuff and allows urine to flow through the urethra. When your bladder is empty, the cuff automatically refills to keep the urethra closed.

New advances in incontinence surgery, many involving even more innovative slings or artificial devices, are constantly being developed. Don't assume that nothing can be done to correct or at least alleviate your condition, especially if you're willing to investigate having a surgical procedure. Talk to your urologist or visit the websites of leading medical centers, such as the Mayo Clinic and the Cleveland Clinic to learn about more advances.