Male Urinary Incontinence Treatment in Salt Lake City, UT
Incontinence (involuntary loss of urine) may be a devastating problem, resulting in embarrassment, loss of intimacy, and even social isolation. We describe it to our patients as a “social cancer”.
Incontinence comes in several varieties but the most common are:
Urologist William Brant, MD is a member of the American Urological Association and has extensive experience diagnosing and treating men with urinary incontinence. Dr. Brant performs by far the most urethral prosthetic surgeries for urinary incontinence treatment in the intermountain west. If you’re struggling with urinary incontinence in the Salt Lake City area, contact our office today at (801) 965-2767 to schedule a consultation. Men from all across the intermountain west including Wyoming, Idaho, Colorado, and Utah are willing to travel to Salt Lake City to consult with Dr. Brant given his urologic expertise.
This is defined as leakage associated with activity. This type of incontinence, or involuntary loss of urine, in men usually occurs after prostate surgery for cancer but occasionally may occur after other events such as injury, transurethral resection of the prostate (TURP), etc. Typically there has been injury to the urinary sphincter muscle. Leakage then occurs when the patient uses their abdominal muscles, for example sneezing, coughing, laughing, bending over, athletic activities, etc.
If a man is diagnosed with stress incontinence, various successful treatments are available.
Also known as overactive bladder, this is when the man gets an irrepressible urgency to urinate and cannot get to a bathroom in time. Men can also get urgency without incontinence, which is the feeling of urinary urgency but the man is able to suppress it (sometimes barely!). These are very common problems, with a wide variety of causes. Causes include: infection, medications, prostate growth, overactivity or sensitivity of the bladder muscles, sensitivity to certain foods or substances, neurologic injury or diseases, etc. Occasionally, urgency or urge incontinence can be the sign of a more serious underlying condition such as bladder cancer.
Urgency and urge incontinence are NOT normal and need to be evaluated. Evaluation includes a patient’s history and examination, an analysis of the urine, and often additional testing such as cystoscopy (looking into the bladder with a very small camera, it is not a painful procedure) and/or urodynamics (an outpatient “functional” test of the bladder muscles done in clinic).
Treatment depends on the cause and the individual and may include behavioral therapy, medications, and/or neuromodulation.
This is typically a constant leakage that occurs when a patient is unable to efficiently empty their bladder. Urine builds up and “spills” out, like a reservoir spilling over a dam. This can be due to obstruction (such as prostate or scarring in the urethra) and/or loss of bladder function or sensation. It can be dangerous and requires investigation to make sure no other problems are occurring. Treatments generally include catheters and/or surgery.
Who should perform my incontinence surgery?
As with other specialized surgeries, the patient should be careful about who they choose to perform their incontinence surgery. With artificial sphincters and slings, surgeons often do one or zero per year and may not have specialty training in implant and penile surgery. As with most things, the patient should enquire about the experience of the surgeons performing these cases and only go to someone who is comfortable with all aspects of these cases. For over a decade, we have had the highest volume by far in the intermountain west for prosthetic surgery (both penile implants and urinary incontinence implants). Of course, high volume only matters in the context of the desire for clinical excellence and improvement and we are constantly making improvements to make the procedures safer and more satisfying for the patient.
It is obvious to most people that you want a surgeon (or a contractor, or a car mechanic, etc) who has a lot of experience. It is only with experience that someone can not only know all the nuances but also can deal with any unusual situations or complications that might arise. In surgery, often things are not as straightforward as they seem and a surgeon needs a deep and detailed knowledge of normal and abnormal anatomy, and how do deal with things that are not the norm.
When you are meeting your surgeon, it is important to ask how many of that case they have done and either try to verify that or at least feel you are getting an honest answer. Surgeons should know their own numbers and not just quote from the general medical literature.
Be very suspect of any surgeon who says they are “the best”. Any surgeon who says they are the best is likely not. You don’t want a big ego getting in the way of your operation. Rather, you want someone who is never quite satisfied, who always wants things to be better, and who takes 100% responsibility for your outcome. And as always, the most important thing is that you, as a patient, are comfortable with your physician and surgeon and comfortable with their levels of experience and skills.
In Dr. Brant’s practice, Dr. Brant performs approximately 70 sphincter procedures and 20 sling procedures per year and has been doing so for well over a decade.
Additionally, it is important to know who is doing your surgery. You should clarify whether your surgery is being done by a trainee (student, resident, fellow) or by the surgeon you have chosen. In our practice, we do not have trainees, and you can rest assured that your surgery will be performed exclusively by Dr. Brant.
For more information on why it’s important to know who’s performing your surgery, check out this article in Medpage Today.