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  • Review Article
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Treatment options for male stress urinary incontinence

Nature Reviews Urology volume 7, pages 222–228 (2010)Cite this article

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Abstract

The diagnosis and management of male stress urinary incontinence (SUI) is complex. Various etiologies exist, with radical prostatectomy being the most common cause in men seeking treatment. SUI in this setting is often temporary and resolves within the first postoperative year. Therefore, it is important to understand the natural history of male SUI before initiating treatment. Generally, the initial management of SUI that persists after 12 months consists of conservative measures, such as pelvic floor muscle exercises. Several treatments are available for men whose continence does not improve after pelvic floor muscle exercises. In order of increasing complexity they are urethral bulking agents, male slings, and the artificial urinary sphincter (AUS). With over 30 years of published data suggesting excellent long-term outcomes, the AUS is considered the gold standard treatment of male SUI. Male slings have recently demonstrated efficacy for selected patients and are likely to be used more often in the future as experience with these devices grows.

Key Points

  • Currently, the most common etiology of male stress urinary incontinence (SUI) is radical prostatectomy (RP)

  • The diagnosis of male SUI can be made with a detailed history, physical examination, and appropriate tests, such as urodynamics and cystoscopy

  • Most patients will recover urinary continence within 1 year of prostatectomy, therefore it is very important to understand the natural history of SUI after RP

  • Pelvic floor muscle exercises can hasten continence immediately after RP and should be attempted in all men presenting for evaluation of SUI after prostatectomy

  • The artificial urinary sphincter and male slings are efficacious in the treatment of male SUI

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Acknowledgements

Désirée Lie, University of California, Orange, CA, is the author of and is solely resonsible for the content of the learning objectives, questions and answers of the MedscapeCME-accredited continuing medical education activity associated with this article.

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  1. Department of Surgery, Urology Service, Memorial Sloan–Kettering Cancer Center, 353 East 68th Street, New York, 10065, NY, USA

    Jaspreet S. Sandhu

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The author declares that he has worked as a Consultant for American Medical Systems.

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Sandhu, J. Treatment options for male stress urinary incontinence. Nat Rev Urol 7, 222–228 (2010). https://doi.org/10.1038/nrurol.2010.26

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