New type of male sling procedure to improve the urinary control

Aug 29 2007

Michael Yarborough, a 58-year-old business owner from Waxahachie, Texas, was fortunate. A routine check-up three years ago revealed prostate cancer, but a side effect of his successful surgery was "driving him nuts."

"After surgery to remove the cancer, I started experiencing incontinence," said Mr. Yarborough, who operates a landscaping company. "Although my case was far better than most, the condition, simply put, drove me nuts."

Losing urine control because of coughing, laughing, sneezing, or lifting is both frustrating and debilitating for the more than 2 million men worldwide afflicted with the condition. Many of these men are prostate-cancer survivors, having undergone surgery for the treatment of their cancer with the often unavoidable outcome of a damaged urinary sphincter.

Mr. Yarborough was referred to Dr. Allen Morey, professor of urology at UT Southwestern Medical Center who joined the faculty in June as a subspecialist in reconstructive urology. He suggested a new type of male sling procedure to improve the urinary control.

Although slings have been used widely for years in women to improve urinary control, they are a relatively new treatment for men. Prior slings were anchored to the pelvis with small bone screws to secure fixation, but that was painful for many patients.

The new type of device Mr. Yarborough received, called the AdVance sling, involves passage of a thin strip of mesh between pinpoint incisions on the inner thighs, which is then passed deep beneath the bottom of the urethra to increase support in precisely the area where the tissues are weakened. This additional flow resistance prevents the leakage of urine when abdominal pressure increases. The procedure is best suited for mild to moderate urinary incontinence, usually defined as patients who wear one to four pads per day to absorb any leakage.

"I believe there are many men who have a ‘nuisance' level of urinary incontinence after prostate cancer treatment which is bothersome during strenuous activities," Dr. Morey said. "To cope, these men often restrict their activities or limit their fluid intake. We can now offer these men a chance to return to their daily activities with minimal or no pain. They are the ones who would benefit from this low-risk procedure."

Mr. Yarborough is the first patient at UT Southwestern to be treated with the AdVance sling, manufactured by American Medical Sytems, Inc., of Minnetonka, Minn. Since surgery, he said his situation has improved dramatically. While he admits things are not exactly as they were before prostate cancer, he said he believes the procedure has been tremendously helpful.

"It's made a difference in my life, and I would recommend it to anyone suffering something similar," Mr. Yarborough said.

Men interested in the male sling should have a comprehensive evaluation of their incontinence before any recommendations are made regarding treatment. For more information contact the UT Southwestern Department of Urology at 214-648-4765.

http://www.utsouthwestern.edu