Surgery For Incontinence

Any disease or injury that damages the nerves can lead to a lack of bladder control that requires surgery for incontinence.

Incontinence is often seen in men who have prostate problems. Encircling the urethra just below the bladder, the main function of this gland is to produce the liquid part of the semen.

As a man grows older, it can become enlarged causing pressure on the urethra and affecting the control of urination. This enlargement can sometimes be caused by cancer which, in some cases, can involve quite radical surgery. Control of the bladder can be impaired following the operation, requiring the use of incontinence pads but, for most men, this will improve within a few months.

However, for some, the lack of bladder control can be so severe that just standing up can cause a large flood of urine to be expelled. This type of incontinence is beyond the capabilities of the various pads, clamps and other commercially-available aids, so a more effective treatment for incontinence needs to be found.

The next stage is to test the bladder and the sphincter to see how much urine can be retained.

If, during a gravity test, the sphincter has insufficient strength to withhold the urine, then further surgery for incontinence may be required.

There are three surgical treatments for incontinence - a sling, a urinary diversion, or an artificial urinary sphincter.

The sling method wraps a strip of material around the urethra and attaches the ends to the pelvic bones creating a support. By keeping constant pressure on the urethra, it is unable to open unless the patient consciously releases the urine.

A urinary diversion is utilised if all bladder function has been lost due to nerve damage or if the bladder itself needs to be removed. The surgeon creates a reservoir from a piece of the small intestine and directs the ureters towards it. He then makes an outlet (or stoma) in the abdomen to allow a catheter to drain the urine into an external bag.

The artificial urinary sphincter consists of a cuff, which is fitted around the urethra and when this is in place, it inflates to squeeze the urethra closed.

Connected to the cuff is a balloon which is inserted into the abdomen underneath the rectus muscle. It is all controlled using a push-button pump, which is pushed into the scrotum. Once all the tubes are connected together and everything is tucked in, the patient is now able to turn his water on and off with the flick of a switch.


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For more information on prostate incontinence and the artficial urinary sphincter
To find out more about kegel and pelvic floor exercises to promote good prostate and urinary sphincter health