Male stress urinary incontinence: the place of alternatives to an artificial urinary sphincter

• Published in: Progrès en urologie (Paris) Vol. 19; no. 12; p. 897
• Main Authors: Grise, P, Caremel, R
• Format: Journal Article
• Language: French
• Published: France 01-12-2009
• Subjects: Humans; Male; Urinary Incontinence, Stress - surgery; Urinary Sphincter, Artificial; Urologic Surgical Procedures, Male - methods
• ISSN: 1166-7087
• DOI: 10.1016/j.purol.2009.09.030

Male stress urinary incontinence is most often the consequence of surgery for localised cancer of the prostate. The mechanism is a deficit of the sphincter and a problem of support. Clinical analysis is based on a questionnaire together with mictional results, a standard questionnaire and the pad-test. The value of the pressure of the urethral sphincter and a verification of the absence of urethral stenosis are checked. This allows for the gravity of the incontinence to be evaluated: severe, moderate or minor. First line treatment for severe forms is an artificial sphincter. For more moderate forms or disabling minor forms, mini-invasive surgery can be proposed if physiotherapy does not work. Suburethral tape is inserted via the perineal and transurethral routes, the periurethral balloons are inserted by perineal route and inflated progressively. Total continence is reestablished for half the patients treated with the tape and a third of those with the balloons. There are many complications with the balloons but the long-term effectiveness of both methods needs to be assessed.