Surgery
If your symptoms haven’t improved after six months of pelvic floor exercises and incontinence bothers you, your doctor might recommend surgery. Even if you’re not bothered by incontinence, surgery might be worth pursuing if you’ve had this issue for a year. There are several types of surgical options available — your doctor will help choose which one is best for you based on your previous treatments and incontinence level.
Male Urethral Sling
The male sling is a treatment for mild to moderate incontinence. During the procedure, the surgeon places a sling made from polypropylene mesh underneath the urethra, says Gomez. The mesh acts like a hammock, lifting and supporting the urethra to keep the sphincter muscle closed and prevent leaks, he says.
Artificial Urinary Sphincter (AUS)
An artificial urinary sphincter (AUS) is a treatment for mild to severe urinary incontinence. It’s an implanted silicone device that acts like your natural sphincter, says Gomez. A cuff wraps around your urethra and squeezes it to hold in urine. You control the AUS from a small pump in your scrotum.
“When you go to the bathroom, you give a small squeeze to the pump, which opens up the cuff and allows you to urinate normally,” Gomez says.
There’s a minimal risk of infection with both the sling and AUS procedures. And because the AUS is a mechanical device, it can break down over time. If that happens, you’ll need another procedure to replace it.
Balloon Devices
Another surgical treatment is to implant a balloon at the base of the bladder.
It’s an option for people with mild to moderate stress urinary incontinence who have not had radiation therapy. The balloon inflates and presses the bottom of the bladder closed to stop urine leakage.
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