Stress incontinence is the loss of urine when laughing, coughing, sneezing, or doing activities. It is usually caused by a weak or damaged sphincter muscle. In men, it is a condition often seen after prostate surgery.
The AdVanceTM Male Sling System is intended for the placement of a suburethral sling for the treatment of male stress urinary incontinence (SUI).
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, Cheshire. 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.
Installation of an artificial sphincter or sling may be done for:
- Urinary incontinence caused by the removal of the prostate.
- Severe continual leakage of urine from the urethra.
- Severe urinary incontinence for which other methods of treatment have failed.
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). This innovative, and effective treatment solution is designated for men suffering from mild to moderate stress urinary incontinence. AdVance is ideal for men with some sphincter function who seek a minimally invasive surgical procedure or who are not candidates for an artificial urinary sphincter.
We understand that having any medical procedure, even one as relatively straightforward as this, can cause anxiety. Our experienced and dedicated medical staff will be there to reassure you throughout.
AdVance™ male sling
The AdVance Male Sling System is a mesh “sling” that is implanted completely in your body that repositions and supports the urethra to restore normal bladder control. The AdVance sling requires no patient interaction to urinate normally and is completely undetectable to others.
- Three small incisions
- Often rapid recovery
- No device activation required
- Immediate improvement
- Restored dignity and quality of life
Artificial urinary sphincter
The artificial urinary sphincter is still considered the “gold standard” for the correction of all types of male stress urinary incontinence. At this time it has the best long term success rate, especially for more severe incontinence. It is a slightly more complicated procedure and because the device is mechanical there is a 15% chance of malfunction at 7 years. This may require another operation. Also it requires some manual dexterity to operate the pump, which is located in the scrotum. The AdVance™ sling has no working parts making it an attractive option for mild to moderate incontinence.
Both procedures are done under a general anaesthetic.
AdVance male Sling
Your consultant may insert a catheter through your urethra to drain your bladder immediately after the surgery. This catheter is usually removed the same day or shortly after. Patients who have a sling are discharged the following morning following removal of the catheter.
The AdVance procedure is a fast, minimally invasive surgery that can restore bladder control the day it is performed. Your consultant may prescribe oral antibiotics for a period of time following the procedure. We recommend that normal activities be resumed after a few days, although patients should avoid physical strain and lifting for 2 to 3 months. Your consultant will provide you with personal instructions following surgery.
Artificial Urinary Sphincter
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.
Artificial sphincter placement is a successful treatment for up to 90 out of 100 men who have incontinence after prostate removal. And most men are happy with the artificial sphincter. *1
Complications with this type of surgery include:
- An infection in the artificial sphincter.
- Wearing away (erosion) of the skin of the urethra.
- Failure of the artificial sphincter to work.
Men with these problems usually need to have another surgery (revision). This happens in about 23 out of 100 men who have the surgery.*1
Because complications may occur, this is a treatment method that generally is reserved for people for whom all other treatment options have failed.
But everybody is different. If you have any questions or concerns, we're here to help.
*1. Wessells H, Peterson AC (2012). Surgical treatment of male sphincteric urinary incontinence: The male perineal sling and artificial urinary sphincter. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2290-2305. Philadelphia: Saunders.
- Provide an indication if the reader will need to stay overnight or if the treatment is done as a day case.