Spire Regency Hospital now have urologists who can treat men with severe incontinence. The AdVance sling offers a minimally invasive procedure. The Artificial Urinary Sphincter is used for men with severe urinary incontinence and for those men who, after examination, are not suitable for an AdVance Male Sling.
Consultant Urologist, Mr. Andrew Sinclair, performs both the Artificial Urinary Sphincter and the AdVance Male Sling at the Spire Regency Hospital in Macclesfield. Mr. Sinclair is currently the only urologist in the North West to place the Advance Sling.
Until recently men experiencing stress urinary incontinence had only 2 extreme options. The first would be to wear pads and the second would be to have an artificial urinary sphincter. However, over the last few years male slings have been devised (very similar to the female tapes for incontinence) which provide an alternative option and bridges the gap between the 2 extremes.
For patients with severe incontinence, the Artificial Urinary Sphincter is still the preferred treatment. It has been used for over 26 years and has excellent long term results. However, for patients with mild to moderate urinary incontinence, they often do not feel their symptoms, which include complex invasive surgery and the need to activate and deactivate a cuff in order to urinate, warrant the risks associated with the sphincter. As a result, they often remain incontinent and continue to use pads. The AdVance sling offers a minimally invasive procedure without the need for activation and deactivation. A recent publication showed that if offered either a sphincter or a sling, 92% of patients would prefer a sling (Kumar A et al. J Urol. Jan 2009; 181: 1231-1235).
From an operative point of view there is good evidence that both the sling and sphincter are safe procedures. After a sphincter, the catheter is removed the following morning but the patient remains in hospital for 72 hours to receive intravenous antibiotics. When discharged the sphincter remains deactivated for 6 weeks to allow healing. At 6 weeks the patient will be seen in the clinic to active the device and demonstrate how to use it.
Patients who have a sling are discharged the following morning following removal of the catheter. The device does not require activation. The device aims to reposition the membranous urethra rather than compress the urethra leading to minimal risk of urinary retention and erosion. The other benefit to this procedure is that if it does fail to cure the incontinence then you can proceed (at a subsequent time) to placing an Artificial Urinary Sphincter without difficulty as the sling is placed proximally.