What are the solutions for male urinary incontinence, Dr. Rodriguez?
For mild or moderate leaks, the solution involves the collation of a "mesh or sling" under the urethra, which returns to place it in its original position. When the leaks are severe, with losses that can reach several hundred milliliters each day, the most effective solution is the placement of a prosthesis, an Artificial Urinary Sphincter, with which very satisfactory results are obtained. After this surgery, the patient only has to "activate" the sphincter every time he wants to urinate.
Tell me a bit about the mesh or sling. What is it and how it works?
When a patient has a prostate removed in a radical way to treat cancer, the position of the bladder and urethra changes, and that's when leaks occur. You have to wait between 6 months and a year after radical prostate surgery to see if, in a natural way, the patient is gradually recovering the continence with pelvic floor physiotherapy.. But if you do not regain control over urine after a year, then we turn to a mesh that replaces that urethra and that neck of the bladder in its original position if it is a mild or moderate loss or an Artificial Sphincter if the loss is important .
In your experience, what do the patients think after the placement of an Artificial Urinary Sphincter or a "mesh"?
In summary, the published data indicate that 92% of men who use an Artificial Sphincter would put it back on and 96% would recommend it to another patient with urinary incontinence. Once the first 30 days have passed after the placement of a sphincter, the activation of the sphincter is carried out, so the patient controls the urine again. In the case of the implant of a "mesh" and if the indication is correct, more than 90% of the patients are satisfied with the surgery.
Are the effects of the treatments lasting?
In principle they are durable long-term solutions, although in the case of the Artificial Urinary Sphincter, being a mechanical device, it may require revisions over time; such as the substitution of a specific component. But this is not a problem, because with a small surgery it is replaced and it works again. The artificial sphincter is the most effective and recommended solution for severe urinary incontinence in men.