The male sling for stress incontinence

The male sling is a relatively new and very promising treatment for male stress incontinence, offering a less invasive option than the artificial urinary sphincter.

For many years, the only established treatment for severe male stress incontinence was the Artificial Urinary Sphincter (AUS).

Very recently, a new treatment called the male sling has become available, based on the same technology and principles as the TVT or transvaginal tape used to treat female incontinence. The male sling is a less invasive treatment than AUS and early results show the male sling is very effective for patients with mild to moderate incontinence. Harley Street Urology is leading the world’s first comparative study of male incontinence treatments.

Is this the right treatment for me?

The male sling is a treatment for mild to moderate stress incontinence. In these conditions, the sphincter control mechanism around the urethra is insufficient to hold back the urine even with minimal activity, such as changing from a sitting to a standing position. In some cases the leakage is so severe that patients are constantly wet at rest and in bed.

The most common causes of this degree of leakage are radical prostatectomy or radiotherapy for prostate cancer, and a TURP procedure for an enlarged prostate. For a small number of patients, the spinchter mechanism is damaged during surgery. People who have had congenital abnormalities, spinal cord injury or urethral reconstruction following pelvic fractures may also have intrinsic dysfunction of the sphincter, resulting in severe stress incontinence.

If you have significant incontinence six months to one year after prostatectomy, an artificial urinary sphincter or a male sling may be considered. The choice of device depends on the degree of incontinence. Male slings are useful for mild to moderate degrees of incontinence, whilst the AUS is very effective for severe incontinence. Your specialist will organise urodynamic investigation and will be able to advise you based on the results of these tests.

What is the male sling made of?

The male sling is made from polypropylene mesh similar to that used in Tension-free Vaginal Tape (TVT).

How is the male sling fitted?

The male sling is implanted during an operation, which takes place under general anaesthetic. The device is passed underneath the urethra through a single, small incision in the perineal.

How does the male sling work?

The male sling repositions the curved (bulbar) part of the male urethra, to give more urethral resistance and prevent urinary leakage during times of higher abdominal pressure eg when coughing or exercising. The sling has no moving parts and is active once fitted.

Male sling patient Paul Deacon

“My advice to anyone else out there suffering with incontinence would be to recommend the male sling. It is a procedure which simply does the job it is designed for.”

Paul Deacon, male sling patient
Read Paul's account of his male sling treatment for stress incontinence

How effective is the male sling?

Male slings are a new treatment. Early data has been reported for 6 and 12 months in small numbers of patients. For patients with mild to modest leakage, the slings seem to allow significant or complete improvements in two thirds of patients.

Are there any complications and problems with the male sling?

The placement of a male sling does not prevent future placement of an AUS. For those in whom a male sling is insufficient, an AUS can still be considered. Male slings also risk infection and erosion. The long term risk of this has yet to be documented.

Related links

▸ Read more about Harley Street Urology's step-by-step incontinence treatment approach.
▸ Find out more about the Artificial Urinary Sphincter (AUS)
▸ Read a patient's account of the male sling treatment for stress incontinence
▸ Please contact us if you would like to find out more about having a male sling fitted as a treatment for male stress incontinence.