Monthly Archives: December 2015

Surgical Treatment for Urinary Incontinence

Urinary incontinence, or involuntary urination, is any involuntary leakage of urine. Treatable medical or surgical conditions almost always are the cause for urinary incontinence. It is under-reported to medical practitioners because many view it as part of getting older or a minor annoyance. But in reality urinary incontinence should be addressed to rule out more serious health problems.

Causes of Urinary Incontinence

Typically men experience incontinence less often than women and urinary incontinence it affects older men but the onset of urinary incontinence can happen at any age. Some of the causes for urinary incontinence include drugs, radiation, or surgery used to treat prostate cancer. Additionally, an enlarged prostate is the most common cause of incontinence in men after the age of 40. Prostate cancer may also be associated with urinary incontinence and is common with all forms of prostate cancer treatments.

 Treatment

Urinary incontinence is treatable and often curable at all ages.  Treatments include urological procedures and surgical procedures that include slings and artificial sphincters.

Surgical Treatment

Incontinence problems caused by an enlarged prostate (also known as benign prostatic hyperplasia or BPH) or removal of the prostate gland may also be treated with surgery if the incontinence isn’t cured within a reasonable time as recommended by your doctor. Urinary incontinence surgery is an option for men experiencing chronic incontinence, have urinary tract infections that keep coming back or have moderate to severe blood in the urine that keeps coming back.

Surgery for severe stress incontinence that does not improve with behavioral methods includes:

  • Artificial sphincter: A silicone rubber device is fitted around the urethra (the tube that carries urine away your bladder) that can be inflated or deflated to control urination.
  • Urethral bulking: Material is injected around the urethra to control urination by closing a hole in the urethra or building up the thickness of the wall of the urethra.
  • Bulbourethral sling: A sling is placed beneath the urethra and attached to either muscle tissue or the pubic bone. This raises the urethra and gives it greater resistance to pressure from the belly.
  • Sacral nerve stimulation (SNS): The electrical stimulator under your skin sends pulses to the sacral nerve in your lower back that plays a role in bladder functions.

Is  Surgical Treatment Right For You?

Urinary incontinence surgery works for most people but it is most successful when the diagnosis is right, the cause of your symptoms can be resolved by surgery and of course, if your surgeon is experienced and skilled in urinary incontinence surgical treatment.

Patients need to have realistic expectations as urinary incontinence surgery treatment won’t always cure the symptoms, but it will usually reduce them. Some factors that may affect the success of surgery include weight problems, long-term cough, radiation therapy, inadequate nutrition, age and heavy physical activity.

Making the decision to undergo  Surgical Treatment is an important decision that needs a medical consultation. Contact us today at 212-541-6239 to schedule an appointment to discuss your options with the best Urinary Incontinence surgical doctor in NYC.

Post Prostatectomy Incontinence: Symptoms and Solutions

Post Prostatectomy Incontinence

A high percentage of men, about 75%, experience a short period of mild Prostatectomy incontinence after surgery to remove the prostate gland (radical prostatectomy). This typically occurs after removal of the catheter that was placed in the bladder during surgery. For most men this is a temporary situation and most regain urinary control without any treatment.

Post prostatectomy incontinence can include stress incontinence or urge incontinence. Stress incontinence is the involuntary loss of urine that can occur during physical activity. Lifting a heavy item or laughing or sneezing, puts an increased “stress” or pressure on the bladder. Stress incontinence accounts for the majority of incontinence problems in patients who had radical prostatectomy. Urge incontinence is the sudden need to urinate due to contractions or bladder spasms.

Significant improvement from incontinence issues can be seen in the first three months after surgery and can consistently improve during the first year after surgery. The majority of men will no longer have incontinence issues within six months of their surgery. For the small percentage of men who continue to have moderate urinary leakage, improvement may be seen even a year after prostate surgery. Patients who continue to have problems after the first year should seek medical attention for treatment options available for post prostatectomy incontinence.

Solutions for Post Prostatectomy Incontinence

Doctors generally do not recommend aggressive treatment for incontinence until one year after prostate surgery. But there are patients who continue to have severe incontinence six months after prostate surgery. For these men, surgical treatment may be considered sooner than one year after surgery. Patients receive thorough evaluation, including detailed medical history so the appropriate surgical treatment can be recommended and performed.

Surgical treatments available include, urethral bulking, artificial sphincter and sacral nerve stimulation (SNS) for moderate leakage. The bulbourethral sling is an option for severe urinary incontinence following prostate surgery. Getting information about each procedure can help patients decide which option they prefer:

Urethral bulking material is injected around the urethra by either closing a hole in the urethra or increasing the thickness of the wall of the urethra. This surgery helps the bladder control urination.

Artificial sphincter. This procedure involves fitting a silicone rubber device around the urethra. The uretha is the tube that carries urine from your bladder to the outside of your body. It can be inflated or deflated to control urination and stop leakage.

Sacral nerve stimulation (SNS) An electrical stimulator under your skin sends pulses to the sacral nerve in your lower back. This nerve plays an important role in bladder control.

Bulbourethral sling

The sling is placed under the urethra and is attached to either muscle tissue or the pubic bone. The sling compresses and raises the urethra. This allows the urethra to have greater resistance to pressure from the belly.

Post prostatectomy incontinence symptoms that do not go away on their own usually require medical intervention. If you have questions about post prostatectomy incontinence, contact us at 212-541-6239 to schedule an appointment with the best Penile Implant Surgery doctor in NYC.