Do you sometimes accidentally leak urine when you laugh out loud, cough, sneeze, or lift a small weight? This is a very embarrassing and embarrassing situation in society. Especially for men who have undergone surgery on the prostate gland, this condition, that is, urinary incontinence, can occur. But there is no need to be afraid or ashamed of this. Because there are successful medical solutions for this. We are talking about one such solution today. That is the 'Male Sling' surgery.
Simply put, what is Male Sling surgery?
This is not as big or complicated as you might think. It is a minimally invasive surgery. Your doctor will take a soft, synthetic mesh-like surgical tape that is designed to fit the human body and carefully place it around your urethra.
Think of it like putting a little ' spot ' underneath something that's sagging and weak. This band lifts your urethra and bladder neck (the lower part of the bladder that connects to the urethra) a little, giving them better support. This allows the sphincter muscles that control urination to do their job properly.
This band is placed around the urethral bulb, a bulb-like part of the penis that surrounds the urethra. This part is especially helpful for urinary control during times like when we exercise.
Who is this surgery recommended for?
Male Sling surgery is often recommended for urinary incontinence following radical prostatectomy, a surgical procedure to remove the entire prostate gland due to prostate cancer.
Most importantly, this surgery is usually recommended for people with mild to moderate incontinence. Simply put, it works best for people who use one, two, or at most three pads a day to absorb urine.
What tests are done before surgery?
Before deciding to perform this surgery, your doctor will perform several tests to make sure everything is correct. These will help you determine exactly how suitable this surgery is for your condition.
| Test | Simply put, what happens? |
|---|---|
| Urodynamic tests | They measure things like how your bladder and the muscles and nerves around it are working, the pressure inside your bladder, and the speed at which you urinate. |
| 24-hour pad test | They measure exactly how many pads you need and how much urine you leak in 24 hours. |
| Cystoscopy | A thin tube (endoscope) with a camera attached is passed down the urethra to examine the inside of the urethra and bladder. |
| ECG test (Electrocardiogram) | This is done to make sure your heart is healthy enough to withstand the surgery. |
| Blood tests | We check for conditions such as blood clotting problems (e.g. hemophilia), as these can increase the risk of bleeding during surgery. |
| Urinalysis | We check for other conditions that could affect the surgery, such as urinary tract infections (UTIs), diabetes, or kidney disease. |
How should I prepare for the surgery?
Your doctor will give you clear instructions on this, but in general, you should be careful about these things.
- Tell your doctor about all the medications you take: Tell your doctor about all the medications, vitamins, and herbal supplements you take. You may be asked to stop taking blood thinners (anticoagulants), aspirin, and some pain relievers (NSAIDs) about two weeks before your surgery.
- Dietary advice: You may be asked to eat only liquids (e.g. soup, fruit juice, jelly) from the night before surgery. You will need to stop eating completely a few hours before surgery.
- If you are taking medication: If you need to take any essential medication the morning of your surgery, you can take it with just a sip of water. However, consult your doctor first.
Let's learn about how the surgery is performed.
This surgery is performed by a team of specialists, including a urologist, an anesthesiologist, and nursing staff.
First, you will be completely anesthetized, so you will not feel any pain, and you will be completely asleep. Then, the surgeon will make a very small incision in the area between your scrotum and anus (the perineum). Through this, the urethra will be gently exposed, and the mesh-like sling will be placed around the urethra, exactly where it needs to be, and secured. The incision will then be stitched closed. The entire surgery may take an hour or a little longer.
What happens after the surgery?
After surgery, you will feel a little sluggish when you wake up from the anesthesia. You will be taken to a recovery room, where you will be closely monitored. You will be given medication to control the pain.
Most of the time, this is an outpatient procedure. This means you can go home the same day. However, in some cases, depending on the doctor's decision, you may need to stay in the hospital overnight.
Initially, you may have difficulty urinating due to the swelling. You may need to have a urinary catheter inserted for a few days. Once the swelling goes down, you will be able to urinate normally.
What are the benefits and success rates of this surgery?
The main advantage of this surgery is that it provides a successful solution to urinary incontinence. In addition,
- Only a very small incision is made on the body.
- Therefore, scarring is minimal.
- The recovery time is short.
- This sling strap is completely inside the body, so it is not visible from the outside.
Studies have shown that nearly 80% of people who undergo this surgery have completely eliminated or greatly reduced urinary incontinence. The sling typically works well for 10-15 years.
Are there any side effects or complications?
As with any surgery, there are risks involved. However, serious complications from Male Sling surgery are rare. Some of the possible complications include:
- Urinary retention: This is the most common temporary problem. This may require the use of a catheter for a few more weeks.
- Bleeding or infection.
- Rarely, the sling may slip into the urethra.
- Recurrence of urinary incontinence.
- Urinary tract infection (UTI).
- New or worsening symptoms of overactive bladder, such as urinary frequency or urinary urgency.
When should you see a doctor?
When you go home after surgery, if you have any of these symptoms, you should call your doctor immediately .
- If you can't urinate at all.
- If you have blood in your urine (hematuria).
- If you are showing signs of infection, such as fever, chills, and swollen testicles .
Also, if you don't get the results you expected over time or if the problem with urination recurs, talk to your doctor about that as well.
Take-Home Message
- Male Sling surgery is a very safe and effective treatment for mild to moderate urinary incontinence, especially after prostate surgery.
- This is a minimally invasive surgery with a quick recovery.
- Before surgery, talk openly with your doctor about all the medications you take and any problems you may have.
- For best results, follow your doctor's instructions exactly after surgery.
- If you experience any unusual symptoms after surgery, notify your doctor immediately. Don't be embarrassed or afraid.
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