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Frequently asked questions about bladder leakage in men

About male incontinence

Urinary incontinence — also known as loss of bladder control— is when you accidentally leak urine. There are four main types:

  • Stress urinary incontinence (SUI) happens when you leak during activities such as sneezing, coughing, laughing, and lifting. 
  • Urge incontinence, also known as overactive bladder (OAB), is when you feel a sudden need to urinate. The urgency may prevent you from reaching the toilet in time. 
  • Mixed incontinence includes symptoms of both SUI and OAB.
  • Overflow incontinence occurs when the bladder can't empty completely, causing frequent dribbling of urine.

Watch on YouTube: DRY FAQ: What are the different types of incontinence?

Leakage can happen for many reasons. Some of the more common urine leakage causes include prostate surgery, pelvic injuries, or nerve problems. It’s important to talk with a specialist to determine the cause.

Watch on YouTube: DRY FAQ: What was it like living with incontinence?

Both men and women can experience incontinence, such as SUI, even though it is more common in women. About 1 out of every 10 men experience urinary leakage at some time in their lives.1 

Watch on YouTube: DRY FAQ: Does incontinence impact men and women? In the same ways?

If you leak urine when you move or do activities, you may have SUI. You might leak when you play sports, exercise, sneeze, laugh, cough, or lift something heavy — or even with simple movements like standing up, walking, or bending over. If these symptoms are bothering you and interrupting your life, an incontinence specialist may be able to help. Connecting with a specialist can help you to understand severity of symptoms and discuss potential treatment options.

Watch on YouTube: DRY FAQ: How is Stress Urinary Incontinence diagnosed?

People manage urinary incontinence with adult incontinence products such as adult diapers/absorbent products, pelvic floor exercises, medicine, and surgical intervention. Lifestyle changes like reducing caffeine and alcohol may also help. But every man is different. Talk with a specialist to find available treatment options.

Watch on YouTube: DRY FAQ: What resources were helpful while you were selecting treatment?

Kegel exercises may strengthen the muscles that control urination. They may be able to help some men and women. Examples of Kegel exercises include repeatedly contracting and relaxing the pelvic floor muscles, which can be done by imagining you are stopping the flow of urine. These exercises do not require a prescription. Connect with an incontinence specialist to learn more and talk about treatment options.

Seeing an incontinence specialist is important because they specialize in urinary issues and can offer treatment options. They can make a plan to help treat your condition. Find a urologist in your area.

Watch on YouTube: DRY FAQ: What made you feel comfortable & confident with your physician?

Prostate health and stress urinary incontinence (SUI)

Yes, bladder leakage is one of the two most common side effects of a prostatectomy, with the other being erectile dysfunction (ED). If these side effects persist, there are treatment options available. To learn more, explore male SUI treatment options. For more information on ED after prostatectomy, visit EDCure.com.

Watch on YouTube: DRY FAQ: How did cancer impact your incontinence journey?

SUI may be resolved within the year following prostatectomy, but in some cases, SUI can persist past a year without improvement. Approximately 9–16% of men have persistent post-prostatectomy leakage 1 year after treatment.2

Many men start managing their bladder leakage with products they can buy at pharmacies or grocery stores, such as pads and diapers. Other treatment options can come from your doctor, such as disposable condom catheters, penile clamps, or implantable treatment options such as the AdVance™ XP Male Sling System and the AMS 800™ Artificial Urinary Sphincter (AUS).

If bladder control is still an issue 6 months post-prostatectomy, consider making an appointment with a urologist specializing in the treatment of male stress urinary incontinence.2-3

If bladder control is an issue 6 months after a prostatectomy and is not improving, you could consider seeing a specialist. You could have persistent SUI. An incontinence specialist can provide advice and discuss your treatment options.3 Find an incontinence specialist in your area.

Watch on YouTube: DRY FAQ: Is there a spectrum of severity for incontinence?

Treatment options for male stress urinary incontinence (SUI)

You might consider surgery if behavioral or other treatments aren’t working. A urologist who specializes in incontinence can help you decide if surgery is right for you. Find an incontinence specialist in your area.

Watch on YouTube: DRY FAQ: Did the concept of surgery for incontinence scare you?

The male sling is designed to support the urethra like a hammock to help control bladder leakage. It’s completely concealed inside the body and works without being manually operated. 88.1% of patients surveyed would recommend the AdVance XP Male Sling procedure to a friend.4 Potential risks you should discuss with your doctor may include inability to urinate (urinary retention), return to incontinence, infection, wearing away (erosion), device migration, pelvic organ disfunction, bleeding, and pain. 

The AUS works like a healthy urinary sphincter, closing off the urethra to prevent leakage. When it is time to urinate, you simply squeeze a small pump in your scrotum. This opens up the cuff and allows urine to flow naturally. The entire system is completely concealed within your body. It’s not detectable from the outside. 

Potential risks to discuss with your doctor include device malfunction or failure, which may require additional surgery, wearing away/loss of tissue (device/tissue erosion), being unable to urinate (urinary retention), infection, and pain or soreness.

Procedures for the male sling and AUS are usually straightforward but need a urologist who specializes in incontinence. Recovery and care after surgery vary, so follow your doctor’s advice. 

A male sling procedure is usually done on an outpatient basis and is performed under anesthesia. Small openings are made to access the urethra and the urinary sphincter. The sling is placed under the urethra and tensioned to reposition the urethra and optimize the sphincter’s function.  

Most patients can resume normal, non-strenuous activities within a few days. No activation is required. 

As with any medical procedure, complications may occur. Some risks include, but are not limited to, device failure, urinary retention, post-operative pain, irritation at the wound site and foreign body response.

The AUS procedure can be performed on an outpatient basis or may require a short hospital stay. Small openings are made near the scrotum and below the abdomen to insert an inflatable cuff, a pump and a small balloon (pressure regulating balloon). The surgery is performed under anesthesia.  

Your specialist will manage your care right after the procedure and over the next several weeks. Four to six weeks after surgery, you will return to the urologist’s office to have the AUS activated and learn how to use it. As with any medical procedure, complications can occur. Requires manual dexterity; some risks include, but are not limited to, device malfunction or failure which may require revision surgery, wearing away/loss of tissue (device/tissue erosion), inability to urinate (urinary retention), infection and postoperative pain.

Watch on YouTube: DRY FAQ: How is a surgical option selected for a patient?

AdVance XP Male Sling System is a market leading male sling in the U.S.. 88.1% of patients surveyed would recommend the AdVance XP Male Sling procedure to a friend.4

The AUS implant has been available to patients for more than 50 years and it’s considered a gold standard treatment for SUI. In a study of 105 patients implanted with an AMS 800 AUS, 93% of patients were satisfied with the overall surgical outcome.5

Erectile dysfunction (ED) after prostate cancer

With nerve-sparing procedures, some men may regain their previous level of erectile function, although it may take up to a year.6 Prostate cancer treatments can affect a man’s ability to achieve an erection on a temporary or permanent basis. Should ED persist, there are treatment options.

You can learn more about erectile dysfunction (ED) after prostate cancer treatment at EDCure.com.

Your doctor will discuss when you will be able to use your device. Doctors recommend that you wait four to six weeks before having intercourse. This time allows your incision site to heal and help your body adapt to your implant. You will probably have an appointment with your doctor during the recovery period to be sure you are healing. At your doctor’s discretion, you may have additional visits or follow-ups from this procedure. After your doctor says you can begin using the device, follow the operating instructions.

You can learn more about these treatment options at EDCure.com.

References:

  1. Markland AD, Goode PS, Redden DT, et al. Prevalence of urinary incontinence in men: results from the national health and nutrition examination survey. J Urol. 2010 Sep;184(3):1022–7.
  2. Ficarra V, Novara G, Rosen RC, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol. 2012 Sep;62(3):405–17. 
  3. Biardeau X, Aharony S; AUS Consensus Group, et al. Artificial urinary sphincter: executive summary of the 2015 Consensus Conference. Neurourol Urodyn. 2016 Apr;35 Suppl 2:S5–7. 
  4. Hüsch T, Kretschmer A, Thomsen F, et al. The AdVance and AdVance XP male sling in urinary incontinence: is there a difference? World J Urol. 2018 Oct;36(10):1657–1662. (ERA EL 9)
  5. Sayedahmed K. Olianas R, Kaftan B, et al. Impact of previous urethroplasty on the outcome after artificial urinary sphincter implantation: a prospective evaluation. World J Urol. 2020 Jan;38(1):183-91.
  6. Linder BJ, Rivera ME, Ziegelmann MJ, et al. Long-term outcomes following artificial urinary sphincter placement: an analysis of 1082 cases at Mayo Clinic. Urology. 2015 Sep;86(3):602–7.

Caution: U.S. Federal law restricts this device to sale by or on the order of a physician.

There are risks associated with all medical procedures. Please talk with your doctor about the risks and benefits associated with the Advance XP Male Sling and/or AMS 800 Artificial Urinary Sphincter.