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Just for Men: Regaining Control after Prostate Cancer



From the time we are toddlers, we are taught to “hold it” until we can get to the bathroom. But for many adults, it’s not that easy.

Millions of healthy Americans suffer from Stress Urinary Incontinence (SUI) – loss of urine when pressure (stress) is exerted on the bladder during physical activities such as exercising or lifting heavy objects. Among the causes in men, SUI can be a side effect of prostate surgery.

“In some patients, incontinence is a result of surgery to treat the prostate cancer,” said Winthrop urologist Robert A. Edelman, MD, FACS. “At Winthrop- University Hospital, we are able to offer patients a full complement of services to successfully treat prostate cancer and its secondary effects.”

In 2004, Vincent Burger of Floral Park was diagnosed with prostate cancer. Following treatment, including a radical prostatectomy and a subsequent procedure to remove excess scar tissue, he began to struggle with bladder control.

“It was a continual problem that infringed on my ability to do some of the things that I enjoy – like exercising,” said Mr. Burger, an otherwise healthy 65-year-old man. Once an avid runner, Mr. Burger found that he could no longer follow his normal routine of running three to four times a week for 45 minutes.

Though it’s a condition that affects millions, the treatment options for male SUI have been limited over the years. To help men cope, they may be prescribed medication, limit fluid intake, or wear protective pads. Yet Mr. Burger hoped for a lasting solution and continued to discuss all of the options with his long-time urologist Dr. Edelman.

During a routine examination in November, Mr. Burger learned about a minimally invasive surgical procedure involving the transobturator male sling which would soon be added to the armamentarium of treatment options at Winthrop for patients with moderate SUI.

The procedure involves passing a thin strip of mesh through small incisions on the outside of the body, which is then passed beneath the bottom of the urethra, increasing support to the pelvic organs where the tissue is weakened. The sling grows with the tissue to increase muscle strength and improve bladder control.

“Compared to other surgical therapies such as the artificial sphincter, the transobturator male sling is less invasive and has excellent patient outcomes,” said Dr. Edelman. “What’s more, the procedure can be performed in less than 30 minutes on an outpatient basis under general or spinal anesthesia.” In December, Dr. Edelman and his colleague, Winthrop urologist Barry R. Shepard, MD, FACS, traveled to France to undergo hands-on training in this advanced device under the instruction of Dr. Bertin Njinou-Ngninkeu, a worldrenowned expert who has performed male sling procedures for more than a decade at Clinique Des Ormeaux in Le Havre, France.

“There is nothing that can take the place of hands-on training. The experience that Dr. Shepard and I gained by learning under Dr. Njinou-Ngninkeu was priceless,” said Dr. Edelman.

The male sling has been providing relief to patients in Europe for many years and was approved by the FDA for use in the United States in 2006. However, recent improvements to the device have taken the technology to a new level.

5 “The new polypropylene mesh sling that Dr. Shepard and I received training on is far better than other male sling devices that we’ve used in the past. The material is more flexible and friendlier to the natural tissue, and the equipment is more advanced,” said Dr. Edelman. “These innovations will serve Winthrop patients well as we now offer them another cuttingedge option for treatment,” he added.

Upon Dr. Edelman’s return from France, he once again met with Mr. Burger, who was eager to learn more about the success of this minimally invasive procedure.

“Statistics show the procedure to be successful in 75 to 80 percent of patients with moderate stress urinary incontinence. Mr. Burger was in overall good health, which made him an ideal candidate,” said Dr. Edelman.

On May 11, Mr. Burger was the first patient of Dr. Edelman’s to undergo the procedure at Winthrop using the improved transobturator male sling. After a brief recovery period at home, Mr. Burger was back to work within one week and experiencing marked improvement from the SUI.

Today, though his continence is not 100 percent, “it’s even better than the average success rates have shown,” said Mr. Burger. And, he is hopeful that one day he will regain total continence.

“I’m looking forward to my complete recovery. With some diligence on my part practicing bladder control measures, I think it’s quite possible to achieve,” said Mr. Burger.

The Division of Urology in Winthrop’s Institute for Family Care is committed to ensuring the best treatment and outcomes for all patients. For more information about the services that are available, call 1-866-WINTHROP.
Vol. 19, No. 2
Summer 2009

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