Treatment of Stress Urinary Incontinence (men)

About the disease

Stress urinary incontinence, also known as SUI, is the unintentional release of the urine, caused by inability of the bladder to hold urine for continuous period of time. Weakening of the bladder muscles most often happens because of the physical stress. Most often urinary incontinence develops in men who underwent prostate surgery during which the tumorous or enlarged prostate was removed. This condition also occurs in males, whose urinary sphincter was severely damaged and bladder muscles are not supported anymore. In some cases stress urinary incontinence develops as a result of nerve damaged, when bladder muscles lose control because of weak interconnection of the nerve endings. Men with diabetes are more likely to develop stress urinary incontinence in future.

Symptoms

• Urination urgency, when a person can not hold urine for more than 15 minutes, after the bladder was filled
• Urine leakage during the day and night
• Sudden urge to urinate in the most random periods of time
• Bladder can not be emptied completely
• Frequent urination (8 - 10 times a day)

Most often problems with urination are linked to the prostate that is why if you notice symptoms of urinary incontinence, do not hesitate to check your prostate for the signs of inflammation. 80% of stress urinary incontinence is attributed to prostate problems.

Diagnosis

• Urine test is important to conduct to see if there is inflammation, droplets of blood or other abnormalities.
• Ultrasound of prostate is needed to check the prostate and determine its size
• Physical examination of the genitals is needed to see if there are painful areas and if testicles function properly.
• You may need to keep a voiding diary for several days or a week to determine the number of times you use bathroom during the day and how many times you were not able to hold urine for more than 10-15 minutes. 

Treatment

• Setting the remeex sling system is a procedure, during which a surgeon makes an incision on the perineal tissue and creates sling support or suspension around the urethral bulb. This helps the bladder muscles hold the urine for a needed period of time. 
• Implantation in retro urinal advance ® sling also uses the implantation of sling to help the bladder hold urine. This is a more modern technique of stress urinary incontinence treatment.
• Implantation of an artificial urinary sphincter is used if incontinence was caused by damaged urinary sphincter. During this procedure the urinary sphincter is removed and the new one is implanted. 

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko