Treatment Options

There are multiple treatment options and aids available for managing male stress urinary incontinence and urge incontinence. Treatment options and aids range from absorbent pads, which simply absorb leakage of urine, to implantable prostheses, which are designed to provide a permanent, long term solution.

  • Continence Aid: Designed to help manage the symptoms associated with urinary incontinence, but do not treat the cause.
  • Continence Treatment: Designed to treat and alleviate the cause and symptoms associated with urinary incontinence.

When considering the various options available for managing urinary incontinence, the benefits and risks of each option should be considered in consultation with your specialist. These may include:

  • Quality of Life
  • Lifetime cost
  • Surgical invasiveness
  • Suitability dependent on your own medical condition

Permanent implants such as the ATOMS may provide immediate and long-term relief of your symptoms6 and are estimated to have a lower lifetime cost than continence aids such as absorbent pads*. However, this needs to be considered against the medical risks associated with invasive surgery.

The information below is not conclusive, but provides a general overview of the various continence aids and treatments available.

Continence Aids

Please click on the options below to see more information about some of the available continence aids.

Pelvic floor exercises

stress incontinence treatment

Pelvic floor strength and tone is directly related to SUI. To determine whether pelvic floor exercises can help alleviate your symptoms, your doctor will assess your pelvic floor strength.

Like other muscles in your body, your pelvic floor muscles will become stronger with a regular exercise plan. Pelvic floor exercises can be done at a gym or with the assistance of a device.

Pelvic floor exercises may help improve your level of incontinence, but are unlikely to resolve your symptoms definitively.

Advantages

  • Non-surgical, non-medicinal option that may reduce leakage
  • May be performed discretely at the gym or home
  • May increase sexual sensation

Disadvantages

  • Requires commitment
  • May be a long-term effort
  • May be uncomfortable to perform certain exercises with a device
  • May not be able to use a device if a heart condition exist
Incontinence Pads

stress incontinence treatment

Incontinence pads are small pieces of absorbent material, placed into underwear to absorb urine leakage, protect the skin and block odour.

They readily available at most supermarkets and chemists. Continence pads come in different sizes, styles, and absorbency suitable for different volumes of bladder leakage.

Advantages

  • Simple, easy to access
  • Readily available at chemist or supermarket
  • Non-surgical, drug-free option

Disadvantages

  • Uncomfortable, may cause skin irritation and rashes
  • Only contains leakage, doesn’t reduce it
  • Spare pads may need to be carried
  • High long-term cost
  • Create extra waste
Penile Compression Devices

urinary incontinence treatment

A penile clamp is a small reusable device that is designed to compress the urethra in order to prevent leakage. Compression devices are available in different designs including clamps, straps and inflatable cuffs.

Compression devices can be used as an alternative to pads during specific activities where a pad may not be appropriate, for example swimming. Depending on the design, penile compression devices should be released regularly as they may restrict blood flow to the penis and cause irritation.

Advantages

  • Used when pads are not appropriate e.g. swimming
  • Drug-free option
  • Reusable option

Disadvantages

  • Only contains leakage, doesn’t reduce it
  • Unsuitable for use over prolonged periods of time
  • Unsuitable for use during sleep
  • Could be uncomfortable
  • May cause irritation

Continence Treatments

Continence treatments are designed to treat and alleviate the symptoms of urinary incontinence permanently. Restoration of continence with a permanent implant has been shown to greatly improve quality of life 6.

Whilst permanent restoration of continence is appealing from a lifestyle point of view, it is important to note that these treatments may require surgical intervention and the implantation of a prosthetic implant. As such, these treatments carry the medical risks associated with admission to a hospital for a surgical procedure.

It is important that the risks of these procedures are discussed with your specialist, and that your suitability for any of these treatments is considered in conjunction with your individual medical condition.

old man running

Why consider permanent treatments?

The yearly cost of absorbent pads for a male can be estimated to be:

pads cost

Treatment with surgical implants such as ATOMS are covered by most private health insurers. Consultation with a specialist and admission to a private hospital may incur out-of-pocket expenses, but the cost of the implant itself is completely covered by private health insurance.

Bulking Agents - SUI Level Mild

incontinence treatment

Injectable soft-tissue bulking agents are used to treat mild stress urinary incontinence (SUI) caused by intrinsic sphincter deficiency (ISD).

ISD simply refers to the inability to sufficiently close or ‘coapt’ the urinary sphincter in order to prevent urine leakage.

The use of soft tissue bulking agents to ‘bulk’ the urinary sphincter is considered to be a minimally invasive procedure. The bulking agent is injected into the tissue surrounding the urinary sphincter using a specialised instrument called an endoscope. When performed successfully, this procedure restores the normal function of the urinary sphincter.

Patients usually experience a fast recovery and minimal complications.

Macroplastique is an injectable bulking agent that has been used safely and effectively in over 70,000 patients for more than 15 years8. Many clinical studies have reported Macroplastique to be clinically effective in 80% of patients up to 5 years after the procedure, with a low rate of side-effects5.

Advantages

  • Non-invasive procedure
  • May be performed as day procedure
  • Covered by private health insurance
  • May be combined with other surgical options where symptoms of SUI are still being experienced

Disadvantages

  • Suitable for patients that suffer from mild incontinence and ISD only
  • Further surgical treatment may be required

Learn About Macroplastique

Slings - SUI Level Moderate to Severe

urinary incontinence

Slings are a strap of tissue or synthetic material, such as polypropylene mesh, that create a pelvic hammock under the urethra to keep it closed during normal activities.

This is also considered to be a minimally invasive procedure and is recommended for men with mild to moderate incontinence.

Slings are generally non-adjustable after the surgery. If you would like to learn more about an adjustable option, read more about the ATOMS.

Learn About ATOMS

Advantages

  • Minimally invasive procedure
  • Does not require manual activation
  • Suitable for patients with dexterity problems

Disadvantages

  • Cannot be adjusted post-operatively, leaving a risk of leakage post-operatively
  • Less effective in patients with moderate urinary incontinence
  • Risk of urinary retention (not being able to urinate) requiring surgical reintervention
  • Not suitable for patients that suffer from severe incontinence or have no urinary sphincter function
Hydraulically Adjustable Substitute Sphincter - SUI Level Mild to Severe

adjustable transobturator

Adjustable implants have the benefit of being able to be adjusted post-operatively without requiring any further surgical intervention. This means that after surgery:

  • If a patient still leaks, the implant can be adjusted to increase the level of continence
  • If a patient is in urinary retention (not being able to urinate), the implant can be adjusted to reduce the level of continence
  • If access to the urinary tract is required to treat or investigate other conditions (cystoscopy, urethral stenosis), the implant can be adjusted simply. This removes any risk of interference with surgical instruments which can occur with non-adjustable slings.

The ATOMS is the only long-term adjustable sling-type implant for the treatment of mild to severe SUI in males. The ATOMS can be adjusted without further surgery and does not require manual operation of mechanical parts to relieve urine, which is the case with an artificial urinary sphincter.

The ATOMS device has the longest-term clinical data showing efficacy, durability, and high patient satisfaction in treating SUI when compared to other sling-type male incontinence devices6.

Advantages

  • 7 year follow up data demonstrating high patient satisfaction6
  • Can be adjusted via hydraulic port
  • Minimally invasive procedure
  • Does not require manual activation
  • Can be used on patients who are still experiencing leakage after treatment with other sling-type implants6

Disadvantages

  • Not suitable for patients that have no urinary sphincter function

Learn About ATOMS

Artificial Urinary Sphincters - SUI Level Severe

turp surgery

An artificial urinary sphincter (AUS) is a device implanted to treat severe male SUI. It is placed completely within the body providing simple and discreet control.

The AUS is designed to treat severe male urinary incontinence, where circumferential compression of the urethra is required. The AUS can be inserted via one or two small incisions and typically involves an overnight stay in hospital.

The device has 3 main components attached to each other: The cuff surrounding the urethra, the pump placed in the scrotum next to one of the testicles, and the reservoir placed in the pelvis. In the normal resting mode, the cuff is full of water, compressing the urethra. When you feel your bladder is full, squeeze the pump, which forces the water out of the cuff and into the reservoir, so that the urethra is opened and urine is free to drain out. Over the next 2-3 minutes the water passively returns to the cuff, closing the urethra again.

Advantages

  • Last line of defence to combat incontinence
  • Minimally invasive procedure
  • Gold standard for treating male SUI

Disadvantages

  • Requires manual activation
  • Has several working parts which may fail
  • Can’t be adjusted without further surgery
  • Long term, may cause urethral tissue atrophy requiring revisionary surgery
  • Requires hospital admission and overnight stay
Percutaneous Tibial Nerve Stimulation (PTNS) - Specific to OAB

oab treatment

Bladder function is regulated by a group of nerves at the base of the spine called the sacral nerve plexus. By stimulating these nerves through gentle electrical impulses (neuromodulation), OAB symptoms can be treated. Sacral nerve neuromodulation can be administered via PTNS.

The Urgent PC Neuromodulation System is a PTNS device designed to treat OAB. Urgent PC is an effective office-based method, which means there is no need for hospital submission. Clinical evidence shows that 80% of patients respond to treatment with Urgent PC.4

Advantages

  • Performed in out-patient clinics

Disadvantages

  • Must complete 12 sessions to determine success

Learn About Urgent PC

Did you know ?
Studies show that 80% of ATOMS devices are still functioning 6 years after the surgery. Patient satisfaction is high and quality of life significantly improved6.