Treatment of Stress Urinary Incontinence

Products that absorb urine

These include diapers and pads. Although they are very helpful, many men are dissatisfied with the smell and inconvenience.

Medications

Currently there are no approved medications for male SUI

Behavioral changes

Many men discover that there are strategies they come up with on their own to minimize leakage. These include purposeful dehydration, keeping the bladder relatively empty by urinating frequently, and avoiding foods and other products that cause bladder stimulation. A short and incomplete list of these include:

• Tobacco
• Alcohol
• Caffeine (coffee, tea, soda pop, chocolate)
• Spicy foods (jalapeno and other peppers)
• Citric acid foods (grapefruit, etc)
• Tomato-based foods (pasta sauce, etc)

External devices

These include clamps that “squeeze” the penis and avoid leakage and condom catheters. In the latter, the patient uses a device similar to a condom that goes over the penis and the patient urinates into it, then it drains to a bag. Although these devices are fairly easy to use and may be satisfying for some men, they have certain risks and most men find them very awkward to use.

Internal catheters

These are catheters that go inside the bladder. They work very well but have a very high rate of infection and many men find them uncomfortable.

Bulking products

These are various materials (collagen, carbon beads, coaptite) that are injected into the urethra to push the tissue together and so cause some “obstruction” that may help the incontinence. Although they are generally safe, they rarely cure the problem and usually have to be repeated periodically to maintain continence.

Surgery

Surgery for SUI mainly falls into two categories: slings and sphincter

Slings

Slings are appropriate for men with mild-moderate incontinence (less than 3 pads per day).

Slings “boost” up the urethra, restoring support to the urethra that may be lost after prostatectomy. It is performed with an incision in the perineum (the area between the scrotum and anus) and two tiny incisions in the groin

Benefits: no moving parts, continence is restored immediately

Risks/downsides: temporary urinary retention (requiring use of a catheter) is common, not as reliable as artificial urinary sphincter (AUS; see below) for more severe incontinence, does not work as well in certain situations (after radiation, immobile urethra)

William O. Brant, M.D.

Locations

Redstone Health Center	(801) 213-2700
University Hospital	(801) 213-2704

Specialties: Erectile Dysfunction, General Urology, Male Incontinence, Men's Health, Trauma and Reconstructive Urology, Urology, Vasectomy

Colleen A. Lowe, ANP

Locations

University Hospital

(801) 581-7674

Specialties: Erectile Dysfunction, Men's Health, Nurse Practitioner, Trauma and Reconstructive Urology, Urology

Jeremy B. Myers, M.D.

Locations

University Hospital

(801) 213-2702

Specialties: General Urology, Neurogenic Bladder, Trauma and Reconstructive Urology, Urinary Diversion, Urinary Strictures and Fistula, Urology, Vasectomy

Kathryn M. Trueheart, PA-C, MPAS

Specialties: Erectile Dysfunction, Men's Health, Physician Assistant, Trauma and Reconstructive Urology, Urology

Clinical Trials

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