Male urethral “Mini-Sling” in treating stress urinary incontinence and climacturia after prostate cancer treatment

This study aimed to investigate the use of the 'mini-sling' surgery during placement of penile prosthesis for the treatment of urinary incontinence and climacturia (urine leaking during sexual intercourse) in men with erectile dysfunction after prostate cancer treatment. This study found that this procedure is promising for these patients.

Sling surgery is the most common surgery to treat stress urinary incontinence (SUI). That’s when certain actions such as coughing or lifting put pressure on the bladder and cause urine to leak. This surgery involves a 'sling' being made from mesh. Then they put it under the tube that urine passes through, called the urethra. The sling is like a hammock that lifts and supports the urethra and the neck of the bladder to help prevent leaks. This can be combined with an inflatable penile prosthesis (IPP). This surgery can be used to treat urine leaking at sexual climax (climacturia).

It is unknown if the placement of a mini-sling during IPP placing surgery is safe and effective in treating SUI and climacturia in men who had surgical removal of the prostate.

This study included 36 men with erectile dysfunction and urinary symptoms. All men had prostate surgery previously. 6 men also had radiation treatment to the pelvic area. Average follow-up was 5.9 months after the surgical placement of IPP and mini-sling.

83% of patients had climacturia and 75% had SUI before the surgery. At follow-up, climacturia resolved in 93% of patients. SUI improved in 85% of participants.

There were no complications during surgery. Short-term urinary retention occurred in 2 patients.

This study found that placement of a mini-sling during IPP surgery is promising in men with climacturia and SUI after prostate surgery.

This was a very small study. Further, larger studies are needed for stronger evidence.