Male Sling Procedure in Korea

The Male Sling Procedure is a minimally invasive surgical option to treat male stress urinary incontinence (SUI), particularly after prostate surgery. In Korea, this procedure is a recognized and increasingly utilized treatment, aiming to restore bladder control by supporting the urethra and improving quality of life for men experiencing leakage.

Understanding Male SUI & Indications in Korea

Male SUI is the involuntary leakage of urine with physical exertion.

• Primary Cause: Most commonly occurs after prostatectomy (removal of the prostate for cancer) due to damage or weakening of the urinary sphincter. It can also occur after other prostate surgeries or pelvic trauma.
• Symptoms: Urine leakage when coughing, sneezing, laughing, exercising, or lifting. Severity ranges from mild (occasional drips) to moderate (requiring multiple pads daily).
• Indications for Male Sling: Typically recommended for men with mild to moderate SUI (e.g., using 1-3 pads per day) who have not responded to conservative treatments like pelvic floor muscle exercises.
• Diagnosis: In Korea, diagnosis involves a physical exam, pad test (to quantify leakage), and urodynamic studies to assess bladder and urethral function.

Common Surgical Techniques in Korea

The male sling procedure involves implanting a synthetic mesh to support the urethra.

• Procedure: A small incision is made in the perineum (area between scrotum and anus), and sometimes smaller incisions in the groin. A synthetic mesh sling is placed under the urethra to gently compress and elevate it, providing support to prevent leakage.
• Types of Slings: Various types exist, including non-adjustable slings (e.g., AdVance) and adjustable slings (e.g., ATOMS, Argus), which allow for post-operative tension adjustment.
• Mechanism: The sling repositions the urethra and provides a "hammock-like" support, increasing urethral resistance during abdominal pressure increases.
• Duration: The procedure typically takes less than an hour, often performed under general anesthesia.

Recovery & Outcomes in Korea

Recovery is generally quick, with a focus on restoring continence.

• Hospital Stay: Often an outpatient procedure or a short overnight stay.
• Post-Op: Patients may have a temporary catheter. Mild pain, swelling, and bruising in the perineum/scrotum are common.
• Activity: Light activities within days; strenuous activities and heavy lifting are restricted for several weeks to months to allow proper healing and sling integration.
• Success Rates: Studies show good success rates, with reported improvement or cure (e.g., 0-1 pad per day) in approximately 70-80% of suitable patients. Outcomes can vary based on the degree of incontinence and prior treatments (e.g., radiotherapy may reduce success).
• Complications: Generally low, but can include temporary urinary retention, perineal pain, infection, or rarely, sling erosion.

Korean Guidelines & Practice

Korean urological centers offer advanced care for male SUI.

• Patient Selection: Urologists carefully select patients based on incontinence severity, cause, and overall health to ensure optimal outcomes.
• Minimally Invasive Focus: Favored approach due to reduced patient discomfort and quicker recovery.
• Alternative to AUS: The male sling is a less invasive option compared to the Artificial Urinary Sphincter (AUS), which is generally reserved for more severe incontinence or when slings are not suitable.
• National Health Insurance: The male sling procedure for medically indicated SUI is typically covered by Korea's national health insurance.

Key Takeaways for Male Sling Procedure in Korea

To summarize the essential points about Male Sling Procedure in Korea:

• Treats Male SUI: Effective for mild to moderate incontinence, especially after prostatectomy.
• Minimally Invasive: Involves implanting a synthetic sling to support the urethra.
• Good Outcomes: Aims for significant improvement in bladder control with relatively quick recovery.
• Specialized Care: Offered by expert urologists, with careful patient selection and insurance support.

We hope this guide clarifies the Male Sling Procedure in Korea. Always consult a qualified medical professional for personalized advice, diagnosis, and treatment options for urinary incontinence.