CLINICAL SUBSPECIALTY FOCUS · RECONSTRUCTIVE UROLOGY
Evaluation and treatment for leakage after prostate surgery, stress incontinence, and other bladder control problems in men.
EXERTIONAL / STRESS LEAKAGE
Leakage with Physical Movement
Leakage triggered by coughing, sneezing, laughing, standing up, bending over, or exercising. No bladder pain or sudden spasms.
AdVance™ XP male sling (mild to moderate leakage) or AMS 800™ artificial urinary sphincter (moderate to severe leakage).
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POST-PROSTATECTOMY INCONTINENCE
Leakage Following Prostate Cancer Surgery
Persistent leakage requiring pads months or years after radical prostatectomy (open, laparoscopic, or robotic).
Testing in the office, followed by an artificial urinary sphincter (AUS) when appropriate, the most established option for moderate to severe leakage. Some men still leak with a working sphincter because of an overactive bladder, which is treated separately.
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URGENCY / SPASMS (OAB)
Sudden, Uncontrollable Urges
Sudden urgent need to urinate, unable to hold it until reaching the bathroom, frequent urination (>8 times/day), and waking up multiple times at night.
Stepwise medical management, beta-3 agonists, anticholinergic therapy, pelvic floor therapy, or sacral neuromodulation.
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Should I wait after prostate surgery before getting help?
Leakage often improves over the first year, and pelvic floor therapy helps. If it's still bothering you at 6 to 12 months, or it's severe, it's worth an evaluation.
Sling or artificial sphincter: which is right for me?
A male sling usually suits mild to moderate leakage. The artificial urinary sphincter is the usual choice for moderate to severe leakage, or after radiation. Testing in the office helps decide.
Can anyone see the device?
No. Both are entirely inside the body. The sphincter's pump sits in the scrotum, where you can feel it but no one else will notice it.
Will I be completely dry?
Most men improve a great deal. Some still use a single light pad for security. Leakage from sudden urges is a separate problem with its own treatment.
Is this covered by insurance?
These procedures are usually covered when they're medically necessary. The office can check your plan before surgery.
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