Urinary Incontinence FAQs

No, not for the first 8 weeks. It is vital that ample time is given for the sling to integrate into position.

Men are admitted to hospital overnight with a small catheter in place. This is removed in the morning and men typically discharged by lunchtime as long as they pee and empty their bladder well. Most men have very little pain following the treatment. It is crucial to avoid overactivity for the first 8 weeks as this can cause the sling to “slip” resulting in a return of incontinence.

This is usually a straight forward procedure which takes around 30-45 minutes to perform.

This procedure is performed under a general anaesthetic. A small incision is placed in the perineum. A sling is then placed under the urethra and this is elevated so that the urethra is less mobile. This in effect provides a “backboard” to support the urethra.

The first issue here is to quantify the amount of leakage a man is experiencing. This can be done by counting the number of pads used in a day, or more accurately weighing the pads to assess the volume of urine leaked in a 24 hr period. As a crude rule of thumb an artificial urinary sphincter is used for larger leakages whilst a sling can be used for smaller volumes.

As urge incontinence is related to obstruction in most men treatment of the obstruction will usually improve things. If the urgency is unrelated to obstruction matters can be improved by using certain bladder medications such as Vesicare.

There are two types of incontinence: urge and stress. Urge incontinence usually arises in the context of having bladder outlet obstruction. In men who have a large obstructing prostate the bladder wall can become very thick and stiff which results in high bladder pressures and loss of elasticity which in itself can cause a strong desire to pee that can lead to urinary leakage. The other type of incontinence is stress leakage. This is usually related to prior surgery such as a TURP or radical prostatectomy. Men with stress leakage tend to leak urine when they cough, strain, lift something heavy or are generally exerting themselves more.

In the majority of men, as they get older this is associated with prostatic growth. As the prostate grows it gradually and progressively obstructs the outlet of the bladder. In turn, the bladder has to “work harder” to empty and through this process becomes thicker and stiffer. All of these changes result in a slower stream, more frequency in the day and night and in certain circumstances more urgency and potentially urge incontinence.