A solution to male incontinence: Male Sling Procedure

Do you sometimes feel like you leak a little urine when you laugh out loud, cough, lift a heavy object, or exercise? Urinary incontinence is a common problem for many men, especially after radical prostatectomy for prostate cancer. Although it is a somewhat embarrassing topic to talk about in society, it is a treatable condition. The most successful and modern solution for this is the Male Sling surgery. So, let's talk about it clearly today.

Simply put, what is Male Sling surgery?

Male Sling surgery is a minimally invasive surgery that is performed to treat urinary incontinence in men. Imagine that a small support is placed around the urethra, the tube through which urine comes out, to provide support. That's what this does.

In this procedure, your doctor wraps a soft, synthetic mesh-like surgical tape around your urethra, which is a part of your urethra. The urethral bulb is located at the base of your penis. The tape lifts the urethra and bladder neck slightly, providing them with support. This support gives the sphincter muscles that control urination more strength. This helps prevent leakage of urine when you cough or sneeze.

This surgery is also known by brand names such as AdVance® sling or Coloplast Virtue® male sling.

Who is treated with this surgery?

This surgery is often recommended for men who have difficulty controlling their urine after a radical prostatectomy.

What tests are done before surgery?

Before you undergo this surgery, your doctor will order several tests to accurately assess your condition. These tests will help determine whether you are a good candidate for surgery and whether you will have good results after the surgery.

How should I prepare for the surgery?

Preparing for surgery is also very important.

• Tell your doctor about all the medications you take: prescription medications, over-the-counter medications, Ayurvedic medications, vitamins... Inform your doctor about all of these.
• Stop taking blood thinners:You will be asked to stop taking blood thinners (anticoagulants), aspirin, and pain relievers (NSAIDs) one to two weeks before surgery. These can increase the risk of bleeding during surgery. It is okay to take acetaminophen (acetaminophen) for a headache.
• Medications you can continue to take: Unless your doctor advises otherwise, you can continue to take the following medications.
• Antibiotics
• Medicine for high blood pressure
• Hormonal medications
• Medicine for heart disease
• Food and drink: You will be asked to eat only liquid foods (e.g. soup, fruit juice, jelly) from the night before surgery. You will need to stop eating and drinking completely a few hours before surgery. This will help keep your intestines clean during surgery, which will reduce the risk of infection.

What happens during the surgery?

This surgery is performed by a team of specialists, including a bladder and urinary tract surgeon (Urologist), an anesthesiologist, and nurses.

First, you will be completely anesthetized. This means you won't feel anything, you will be completely asleep.

Then the surgeon:

1. A very small incision is made in the area between your scrotum and anus (perineum).

2. The urethra is slowly exposed.

3. Then, the surgical tape (sling) we talked about earlier is very carefully placed around the urethral bulb.

This tape repositions the urethra in a new, more suitable position. This increases pressure in that area and provides good support for the bladder neck. The surgery usually takes about an hour.

What can you expect after surgery?

After the surgery, you will be kept in a recovery room until you regain consciousness and your condition stabilizes.

• Most of the time, this is an outpatient procedure that can be done the same day . However, in some cases, you may need to stay in the hospital overnight.
• After surgery, it may be difficult to urinate at first due to swelling. You may need to have a urinary catheter in place for a few days. Once the swelling goes down, you will be able to urinate normally.
• After recovery, you should be able to urinate normally without any problems.

What are the benefits and success rates of this surgery?

The main advantage of this surgery is that it provides a successful solution to the problem of urinary incontinence. In addition:

• It is a very small incision, so it heals quickly.
• It won't leave any big scars.
• The recovery time is short.
• This sling is completely inside the body, so it is not visible from the outside.

Success and longevity

This surgery is very successful. Recent studies show that nearly 80% of men who have had this surgery have completely eliminated or greatly improved their urinary incontinence. The sling usually lasts for 10 to 15 years.

What are the possible side effects or risks?

As with any surgery, there are some risks, but complications are very rare.

Recovery and resuming daily activities

Recovery time varies from person to person.

• Recovery: Most people start to feel better within a week, but it can take several weeks to fully recover.
• Returning to work: If you have a desk job, you can usually return to work in a few days. However, if you have a job that involves lifting weights or physical exertion, you may need to take a little more time off.
• Having sex: It is important to ask your doctor when it is safe to have sex again after surgery.

When should you see a doctor?

If you experience any of the following symptoms after going home after surgery, call your doctor immediately or go to the nearest hospital's Emergency Department (ETU).

• If you can't urinate at all .
• If you have blood in your urine (hematuria).
• If there are signs of infection (such as fever, chills, swollen testicles).
• If you don't get the results you expected or if the problem of urinary incontinence recurs after a while, talk to your doctor about that as well.