SA first: Landmark op for urinary incontinence in men

PRETORIA – An artificial urinary sphincter has been used for the first time in South Africa. It's used to treat severe urinary incontinence – loss of bladder control – in men.

The minimally invasive surgery involves implanting the device in the groin area, which means it's discreet and there are no external parts. Dr Johan Venter at the Netcare Pretoria East Hospital was the team lead for the surgery and requested the technology for a patient who suffered from stress incontinence problems.

Stress incontinence problems include losing control while coughing, sneezing or performing a simple act like lifting.

Best option yet

In a statement released by the hospital, Dr Venter explained that an artificial urinary sphincter is widely considered the gold standard of treatment for urinary incontinence in men who have suffered irreparable damage to their urinary sphincter.

Dr Venter said, "We were particularly impressed by this new-generation artificial urinary sphincter option, our investigations revealing that it was the best alternative available globally for cases like this.

"Some of the advantages it offers include that it's easy for patients to use and does not require further invasive surgeries, should it require adjustment in future."

Discreet and compact

Dr Venter explained that the device has a pump that the patient needs to apply pressure to when he needs to urinate. It's made of soft silicone, which makes it easy for the patient to operate and serves to deactivate the sphincter cuff for the patient to urinate normally.

"The entire device is implanted and it's compact, limiting the size of the foreign object within the body. These cuffs should be less likely to go on to leak in the longer term, and while we have yet to have the benefit of longer term medical studies, it should offer a more sustainable solution to severe urinary incontinence in men," said Dr Venter.

He added that there are several factors that could potentially cause damage to the urinary sphincter and pelvic floor in men, including ongoing bladder or bowel problems, constipation and heavy lifting. It can also occasionally be a complication of a prostatectomy, which is the surgical removal of the prostate gland to treat cancer.

Dr Erich Bock, director of Netcare's North East Region, said that the new implant is an important development for urinary medicine, enabling improved outcomes for male patients who suffer severe urinary stress incontinence caused by a damaged urinary sphincter.

"This new device was only introduced to the international market late in 2016 and by all indications it will be the most sustainable and practical solution, offering appropriate patients a substantially improved quality of life," said Dr Bock.

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