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.
“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
Back to Publications
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