Male urinary incontinence surgery is a necessary option when pharmacological or behavioral treatments fail, aiming to restore urinary control and improve the patient’s quality of life. The choice of surgical procedure depends on the type and severity of incontinence and requires careful evaluation to ensure the best outcome for each case.
What is urinary incontinence in men?
Urinary incontinence in men is an involuntary loss of urine, which is a symptom of a pathological condition that affects the mechanism of bladder control, as its severity varies from simple leakage to a complete loss of urinary control, and the most important types of urinary incontinence in men include:
- Stress Incontinence: Occurs when coughing, sneezing, or lifting something heavy due to weakness of the pelvic floor muscles or the urinary valve, and is often seen after prostate surgery.
- Urge Incontinence: It is characterized by a sudden and strong urge to urinate with an inability to delay, and may be caused by an overactive bladder or neurological disorders.
- Mixed Incontinence: Combines the symptoms of the two previous types of incontinence.
- Overflow Incontinence: Occurs when the bladder is overfilled and does not empty completely, such as in cases of prostate enlargement or weak bladder muscles.
- Functional Incontinence: It is not caused by a direct malfunction of the urinary system but by physical or mental difficulties that prevent the person from getting to the restroom in a timely manner, such as dementia or motor disabilities.
Common causes of urinary incontinence in men
- Prostate surgery (such as radical prostatectomy)
- Aging
- Diabetes
- Injuries or diseases of the nervous system (such as stroke or multiple sclerosis)
- Frequent urinary infections or taking diuretic medications
Common symptoms of urinary incontinence in men
- Involuntary leakage of urine during movement or rest
- Sudden, urgent urge to urinate
- Difficulty starting or weak urination
- Frequent need to use the restroom, especially at night
- Feeling like you’re not completely emptying your bladder
When is male urinary incontinence surgery indicated?
Male urinary incontinence surgery is considered the best option when conservative measures such as pelvic muscle exercises, lifestyle changes, and medications fail to improve symptoms. It is recommended for moderate to severe cases, especially when leakage is persistent and significantly impacts quality of life or daily activities.
Before proceeding, a thorough evaluation is performed, including history, physical examination, and tests like uroflowmetry and bladder dynamics to determine the incontinence type and sphincter function. If persistent sphincter weakness is confirmed and no surgical contraindications exist, procedures such as artificial sphincter implantation or male tape are advised, depending on the severity and type of incontinence.
Surgeries available to treat urinary incontinence in men
When conservative treatment fails to control urinary incontinence, surgical options can be used to treat urinary incontinence, depending on the severity of the condition, the patient’s general health and treatment history, and the most important surgical techniques used to treat urinary incontinence:
Artificial Urinary Sphincter Implant (AUS)
An artificial sphincter is an excellent surgical option for the treatment of severe stress urinary incontinence in men, especially after radical prostatectomy. The device consists of three interconnected pieces: A ring that surrounds and seals the urethra to prevent leakage, a reservoir implanted in the abdomen to store fluid, and a pump implanted in the scrotum that the patient manually activates when the urge to urinate arises.
Process steps
The procedure is performed under general or spinal anesthesia through a small incision in the perineum or lower abdomen, where the urethra is first carefully freed, and then the ring is fitted around it. The reservoir is placed in the retropubic space and the pump is implanted in the scrotum, the components are filled with balanced fluid and connected with fine tubing, the device is left inactive for several weeks until healing is complete and then activated in the clinic.
Success rate
It achieves 85-90% control of urinary leakage, with a notable improvement in the patient’s quality of life.
Possible complications
These include infection, urethral erosion, and possible device failure or the need for revision surgery during the years of use, especially with long-term use or in the presence of chronic co-morbidities such as diabetes.
Male Sling
Used to treat mild to moderate stress urinary incontinence and considered a less invasive option than an artificial sphincter, the urethral belt is based on supporting the urethra to restore the natural balance between intra-abdominal pressure and urethral closure pressure, which reduces leakage without the need for mechanical devices.
Process steps
Performed under general or spinal anesthesia through a small incision in the perineum, the belt, usually made of synthetic mesh material, is placed under the urethra and tightened just enough to provide support without excessive pressure, and no pump or reservoirs are needed. The ends of the belt are attached to the pelvic bones or muscles, depending on the type of technology (e.g., AdVance sling).
Success rate
It ranges from 70% to 90% with varying degrees of improvement depending on the severity of the incontinence. Patients who have not undergone radiation treatments or do not have severe perineal fibrosis are ideal.
Possible complications
These include temporary urinary retention, localized pain, or failure to achieve the desired improvement, but major complications are less frequent compared to AUS surgery.
Injection of bulking agents
This less invasive technique for treating urinary incontinence, usually used in mild cases or for patients not suitable for major surgery, involves injecting synthetic or biological materials around the urethral wall to enhance its ability to close and minimize leakage.
Procedure steps
The injection is done through a urethroscope inserted from the urethra under local or light anesthesia, where materials (such as Durasphere or Macroplastique) are injected at a specific location around the internal urethra, partially narrowing its lumen and improving closure during exertion or coughing.
Success rate
Less than AUS and Sling, an estimated 40-60% of patients see an initial improvement, but many may need repeat injections over 6-18 months to maintain results.
Possible complications
Rarely occur but include localized irritation, inflammation, or failure to improve. They are considered safe but have limited effectiveness in advanced cases.
Post-surgery follow-up and recurrence prevention tips
After completing male urinary incontinence surgery, the follow-up phase begins as an essential step to ensure long-term success and prevent complications or device failure. Regular visits usually start 6–8 weeks post-surgery, when the artificial sphincter is activated, and wound healing and device function are evaluated. Subsequent periodic follow-ups review symptoms, perform clinical or radiological checks if needed, and assess the performance of the implanted device (AUS or Sling) to ensure its continued effectiveness.
After male urinary incontinence surgery, patients receive clear instructions on managing the implanted device—especially AUS users, who learn proper pump operation. They are advised to avoid strenuous activities and heavy lifting in the first weeks, maintain a healthy lifestyle, control chronic diseases such as diabetes, quit smoking, and prevent constipation. Recent studies indicate that pelvic floor muscle rehabilitation after surgery may enhance urinary control, particularly in well-assessed patients. Combined, these measures reduce complication risks and improve long-term outcomes.
Why is Turkey the best choice for the surgical treatment of urinary incontinence in men?
Turkey is one of the most prominent global destinations for the treatment of urinary incontinence in men, thanks to the availability of advanced medical infrastructure and cumulative experience in this type of surgery:
- Competence of surgeons: An elite group of doctors who specialize in surgically treating urinary incontinence using techniques such as artificial sphincter implants or the male urethral girdle.
- Modern technologies: The availability of the latest devices and equipment globally reflects on the accuracy of procedures and improves success rates.
- Affordable cost: Turkey offers male urinary incontinence treatment at much lower costs than European or American countries while maintaining the quality of care.
- Comprehensive patient care: The medical protocol includes careful evaluation before the procedure and regular follow-up afterward to ensure optimal results.
- Easy access to medical centers: Flexible appointments and short waiting periods make for a smoother surgery.
All these advantages make Turkey an ideal choice for those seeking efficient and cost-effective male urinary incontinence surgery without compromising the quality of care.
Male urinary incontinence surgery is an important step toward restoring quality of life, especially in cases where conservative treatments have failed. Thanks to advances in surgical options such as artificial sphincter or urethral girdle implantation, the results have become more accurate and stable in the long term, and with the availability of modern expertise and techniques, especially in advanced centers such as those in Turkey, excellent results can be achieved with minimal complications. Careful follow-up after surgery remains an essential element to ensure the success of the procedure and continued improvement. Deciding on male urinary incontinence surgery should be based on a thorough medical evaluation and discussion with your physician.
Sources:
- Parsons, J. K., & Hu, J. C. (2022). Urinary Incontinence in Men. In StatPearls. StatPearls Publishing.
- MedlinePlus. (2023). Urinary incontinence – male. U.S. National Library of Medicine.
