Treatment for Post-Prostatectomy Urinary Incontinence
Dr. Neil Grafstein, Director of Reconstructive Urology, Female Urology, and Voiding Dysfunction at Mount Sinai, is a renowned expert in the management of post-prostatectomy incontinence problems. Using minimally invasive procedures whenever possible, Dr. Grafstein has been highly successful in helping men regain their pre-treatment continence status.
Treatment for post-prostatectomy incontinence is based primarily on the severity of the problem and its impact on your quality of life. The options are as follows:
Behavioral Techniques (Exercises)
Pelvic floor exercises (Kegel exercises for men) may be helpful in hastening return of urinary control, but it is unlikely to be helpful for incontinence that persists more than one year after prostate surgery.
Medications may be of some benefit for the small percentage of patients who have an overactive bladder. Decongestants and some antidepressants tighten up the muscles of the urethra and are used for stress incontinence. Anticholinergic drugs, which block messages to the bladder nerves and sometimes prevent bladder spasms, are sometimes recommended for urge incontinence.
Urethral bulking agents can be injected into the bladder neck without the need for general anesthesia or skin incisions. Although minimally invasive and well tolerated, this procedure is less effective and less durable than other minimally invasive surgical options.
Male Sling Procedures
A minimally invasive surgical option is the placement of a piece of synthetic material underneath the urethra that compresses it against the pubic bone. The advantage of this procedure, which can be done on an ambulatory or out-patient basis, is that it does not necessitate manipulation of a device by the patient and more closely replicates normal voiding. The sling is most appropriate for mild to moderate incontinence.
Artificial Urinary Sphincter
Generally performed on an outpatient basis, creating an artificial urinary sphincter (AUS) (also called artificial urinary sphincter implantation)is the most traditional treatment for post-prostatectomy incontinence. A hydraulic device is placed in the body, providing simple and discreet control for the patient. Voiding is initiated by simply squeezing a pump hidden in the scrotum
We Can Help
If you are experiencing ongoing incontinence beyond six months following prostate surgery and wish to arrange a consultation with Dr. Grafstein and his team, please call 212-241-4812.
Department of Urology
5 East 98th Street, 6th Floor
New York, New York 10029
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425 West 59th Street
New York, New York 10019