Urinary slings and sphincters at Spire Edinburgh Hospitals Murrayfield and Shawfair Park

Until recently men experiencing stress urinary incontinence had only two extreme options. The first would be to wear pads and the second would be to have an artificial urinary sphincter. However, over the last few years male slings have been devised (very similar to the female tapes for incontinence) which provide an alternative option and bridges the gap between the two extremes.

Installation of an artificial sphincter or sling may be done for:

• Urinary incontinence caused by the removal of the prostate
• Severe continual leakage of urine from the urethra
• Severe urinary incontinence for which other methods of treatment have failed

For patients with severe incontinence, the Artificial Urinary Sphincter is still the preferred treatment. It has been used for over 26 years and has excellent long term results. However, for patients with mild to moderate urinary incontinence, they often do not feel their symptoms, which include complex invasive surgery and the need to activate and deactivate a cuff in order to urinate, warrant the risks associated with the sphincter. As a result, they often remain incontinent and continue to use pads.

The AdVance^™ sling offers a minimally invasive procedure without the need for activation and deactivation. AdVance^™ is ideal for men with some sphincter function who seek a minimally invasive surgical procedure or who are not candidates for an artificial urinary sphincter.

If you decide to have any of these procedures with us, you’ll be cared for by an expert consultant and a team of experienced and dedicated professionals who understand what you’re feeling and are committed to getting the best results for you. Your treatment will be tailored around you, with your choice of consultant, location and timing.

Our patients are at the heart of what we do and we want you to be in control of your care. To us, that means you can choose the consultant you want to see, and when you want. They'll be with you every step of the way.

All of our consultants are of the highest calibre and benefit from working in our modern, well-equipped hospitals.

Our consultants have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. Many of our consultants have international reputations for their research in their specialised field.

You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.

We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.

We've tried to make your experience with us as easy and relaxed as possible.

For more information on visiting hours, our food, what to pack if you're staying with us, parking and all those other important practicalities, please visit our patient information pages.

Our dedicated team will also give you tailored advice to follow in the run up to your visit.

We understand that having any medical procedure, even one as relatively straightforward as this, can cause anxiety. Our experienced and dedicated medical staff will be there to reassure you throughout.

AdVance^™ male sling

The AdVance^™ Male Sling System is a mesh “sling” that is implanted completely in your body that repositions and supports the urethra to restore normal bladder control. The AdVance^™ sling requires no patient interaction to urinate normally and is completely undetectable to others.

Benefits

• Three small incisions
• Often rapid recovery
• No device activation required
• Immediate improvement
• Restored dignity and quality of life

Artificial urinary sphincter

The artificial urinary sphincter is still considered the “gold standard” for the correction of all types of male stress urinary incontinence. At this time it has the best long term success rate, especially for more severe incontinence. It is a slightly more complicated procedure and because the device is mechanical there is a 15% chance of malfunction at seven years. This may require another operation. Also it requires some manual dexterity to operate the pump, which is located in the scrotum. The AdVance™ sling has no working parts making it an attractive option for mild to moderate incontinence.

Both procedures are done under a general anaesthetic.

AdVance^™ male sling

Your consultant may insert a catheter through your urethra to drain your bladder immediately after the surgery. This catheter is usually removed the same day or shortly after. Patients who have a sling are discharged the following morning following removal of the catheter. 

The AdVance^™ procedure is a fast, minimally invasive surgery that can restore bladder control the day it is performed. Your consultant may prescribe oral antibiotics for a period of time following the procedure. We recommend that normal activities be resumed after a few days, although patients should avoid physical strain and lifting for 2 to 3 months. Your consultant will provide you with personal instructions following surgery.

Artificial urinary sphincter

After a sphincter, the catheter is removed the following morning but the patient remains in hospital for 72 hours to receive intravenous antibiotics. When discharged the sphincter remains deactivated for 6 weeks to allow healing. At 6 weeks the patient will be seen in the clinic to active the device and demonstrate how to use it.

Artificial sphincter placement is a successful treatment for up to 90 out of 100 men who have incontinence after prostate removal. And most men are happy with the artificial sphincter.

Complications with this type of surgery include:

• An infection in the artificial sphincter.
• Wearing away (erosion) of the skin of the urethra.
• Failure of the artificial sphincter to work.

Men with these problems usually need to have another surgery (revision). This happens in about 23 out of 100 men who have the surgery.

Because complications may occur, this is a treatment method that generally is reserved for people for whom all other treatment options have failed. 

If you have any questions or concerns, we're here to help.

We are committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results. For us it's more than just treating patients, it's about looking after people.

Important to note

The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.