Male Sling for Urinary Incontinence

What is the male sling?

The male sling is a surgical treatment for men who have problems with bladder control after prostate surgery. The medical term for problems with bladder control is urinary incontinence. This procedure is most effective for men who have mild to moderate urinary incontinence.

Why is this done?

The male sling procedure is done to help men have better control of urination after prostate surgery. It may be done after surgery for:

• an enlarged prostate
• prostate cancer.

How do I prepare for the procedure?

Plan for your care and recovery after the operation. Find someone to give you a ride home from the hospital.

Allow for time to rest. Try to find people to help you with your day-to-day duties for the first couple of days after surgery.

Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.

If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your surgery. You may need to stop some other medicines before surgery.

Your provider will give you instructions on how to prepare for the surgery. You may be told not to eat anything the night before the procedure, and to drink only clear liquids. After midnight and the morning before the procedure, do not eat or drink anything. Do not even drink coffee, tea, or water.

You may be given antibiotics to prevent infection.

What happens during the procedure?

You will be given a regional or general anesthetic to keep you from feeling pain during the operation. A regional anesthetic numbs part of your body while you remain awake. General anesthesia relaxes your muscles, puts you to sleep, and prevents you from feeling pain.

Your surgeon will make a small cut (incision) in the area between your anus and scrotum. Meshlike surgical tape or another material will be placed against the urethra like a hammock. The urethra is the tube that drains urine from the bladder. This sling of tape will raise the urethra. The support and new position of the urethra can help improve bladder control.

What happens after the procedure?

This procedure can be done as an outpatient but sometimes you may stay overnight at the hospital. A urinary catheter may be left in your bladder overnight or for a few days. A catheter is a tube inserted into the penis and the urethra and then into the bladder. The catheter helps the bladder drain urine as you recover from the surgery.

You may need pain medicine for a few days after the procedure.

What are the benefits of this procedure?

For most men the male sling procedure greatly improves or completely cures their incontinence.

What are the risks of this procedure?

• You may have infection from the surgery.
• The mesh may cause a loss of tissue around it (a problem called erosion).
• The sling may be too tight and make it hard for you to urinate.
• You may have leakage of urine again.

When should I call my healthcare provider?

Call your provider right away if:

• You develop a fever over 100°F (37.8°C).
• You have any change or worsening of pain or symptoms.
• You have unusual drainage from the surgery area (including bloody drainage).
• You cannot urinate.

Call during office hours if:

• You have questions about the procedure or its results.
• You want to make another appointment.