A male sling is a synthetic, mesh-like tape surgically placed to help men regain bladder control. It supports the urethra, the tube that carries urine out of the body, to treat urinary incontinence, particularly involuntary urine leakage during physical activities. This minimally invasive solution aims to restore normal urinary function.
Understanding Male Urinary Incontinence
Urinary incontinence in men is the involuntary leakage of urine, which can significantly impact daily life. Stress urinary incontinence (SUI) is a common type, where urine leaks due to sudden bladder pressure from activities like coughing, sneezing, or exercising. Male SUI often develops when the muscles supporting the urinary tract, including the pelvic floor muscles and the urinary sphincter, become weakened. A frequent cause of SUI in men is prostate surgery, particularly radical prostatectomy for prostate cancer. The prostate gland naturally provides some support for urinary control, and its removal can leave the surrounding muscles less able to control urine flow, leading to leakage.
How a Male Sling Restores Continence
A male sling works by providing support and gentle compression to the urethra and the bladder neck. This supportive mechanism helps to prevent involuntary urine leakage by enhancing the natural closing function of the urethra. The synthetic mesh material acts like a hammock, lifting and repositioning the urethral bulb, which is the part of the urethra located near the sphincter. By exerting pressure on the bulbous urethra, the sling increases resistance in the area and aids in urethral coaptation, effectively aligning the urethral sphincter complex. The device is designed to work continuously without requiring manual activation by the patient.
The Surgical Procedure
The surgical placement of a male sling is typically a minimally invasive procedure, often performed on an outpatient basis or with a short hospital stay. Patients usually receive general anesthesia, ensuring they are asleep and comfortable throughout the operation. In some cases, spinal anesthesia may also be used. The overall surgery typically takes between 45 to 75 minutes.
During the procedure, the surgeon makes a small incision in the perineum, the area between the anus and the scrotum. Through this incision, the urethra is exposed, and the synthetic mesh sling is positioned underneath the urethral bulb. Small additional incisions may be made in the groin area, through which the arms of the sling are passed to secure it in place. The sling is then adjusted to the appropriate tension, and the incisions are closed with dissolvable sutures.
Life After Sling Placement
Following male sling surgery, patients generally experience a relatively brief recovery period. Most individuals begin to feel better within about a week, though full recovery can vary. A temporary urinary catheter may be in place immediately after surgery, which is typically removed within a day or two. It is common to experience some swelling and bruising around the surgical site, which usually resolves within a couple of weeks.
Post-operative instructions include avoiding heavy lifting (over 10 pounds) and strenuous activities for approximately six weeks to allow the sling to properly heal and integrate with the surrounding tissues. Activities that involve wide leg spreading or deep squatting should also be avoided for about six weeks to prevent the sling from loosening. Patients are often advised to take prescribed pain medication, stool softeners, and antibiotics. While some immediate improvement in continence may be noticed, the full benefits can become apparent as swelling subsides and the body adjusts.