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Surgery

Surgery may be an option for men who:

  • Have ongoing (chronic) incontinence.
  • Have severe symptoms and total incontinence.
  • Are extremely bothered by their symptoms.
  • Have problems with urinary retention.
  • Have moderate to severe blood in the urine (hematuria) that keeps coming back.
  • Have urinary tract infections that keep coming back.
  • Have a medical problem that can only be treated with surgery. One example is a bladder outlet blockage that is affecting kidney function.

Surgery choices

Overflow incontinence caused by an enlarged prostate (benign prostatic hyperplasia, or BPH) is the form of incontinence most often treated with surgery. For more information about surgery options and treatment for BPH, see the topic Benign Prostatic Hyperplasia (BPH).

Stress incontinence caused by removal of the prostate gland may also be treated with surgery if the incontinence isn't cured after a period of watchful waiting.

Surgery for severe stress incontinence that does not improve with behavioral methods includes:

  • Artificial sphincter. A silicone rubber device is fitted around the urethra (the tube that carries urine from your bladder to the outside of your body). It can be inflated or deflated to control urination.
  • Urethral bulking. Material is injected around the urethra. This serves to control urination by either closing a hole in the urethra or building up the thickness of the wall of the urethra.
  • Bulbourethral sling. A sling is placed beneath the urethra. It is attached to either muscle tissue or the pubic bone. The sling compresses and raises the urethra. This gives the urethra greater resistance to pressure from the belly. Sling surgery may be considered as a treatment for severe urinary incontinence from prostate surgery.
  • Sacral nerve stimulation (SNS). An electrical stimulator under your skin sends pulses to the sacral nerve in your lower back. This nerve plays a role in bladder storage and emptying.

What to think about

Surgery works for some people and not others. It is most likely to improve incontinence when:

  • The diagnosis is right.
  • The cause of your symptoms is something that can be fixed by surgery.
  • Your surgeon is very experienced and skilled with the surgery you're having.

Things that can lead to disappointing results include:

  • Unrealistic expectations. Surgery won't always cure the symptoms, but it will usually improve them.
  • Physical factors such as obesity, long-term cough, radiation therapy, poor nutrition, age, and heavy physical activity.

WebMD Medical Reference from Healthwise

Last Updated: May 06, 2013
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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