Many men who experience moderate to severe urinary incontinence following prostate cancer surgery can find relief with a male “sling.” During the InVance procedure, a sling made of synthetic mesh is attached to each side of the pubic arch with three bone anchors to allow pressure to be placed directly on the urethra. The minimally invasive outpatient surgery can be performed in 45 to 60 minutes, said Dr. Rodney L. Dennis of Urology Centers of Alabama. “Not everybody will have 100 percent dryness with this device, but the vast majority describe 90 to 95 percent improvement, and all seem to be very happy with the degree of dryness,” Dennis said. The sling offers an alternative to the artificial urinary sphincter, he said. “That (sphincter) device has been around since about 1972 and really hasn’t changed a whole lot. It’s still a good way to treat severe leakers, usually after radical prostatectomies. The great advantage to this (sling) is that there are no working parts that the patient has to manipulate in order to urinate.” A catheter is left in place after surgery. Approximately 24 hours later, the patient takes the catheter out at home. “The vast majority of those patients notice a definite improvement in their incontinence right at that point, and the vast majority will also be able to continue to urinate without retention,” Dennis said. To determine if a patient is a good candidate for the sling, Dennis performs an examination with a cystoscope to rule out the presence of scar tissue at the bladder neck. He also conducts a urodynamics study to ensure there is no primary bladder problem. He stressed that he always reiterates to patients, no matter what type of procedure is considered, he cannot give them 100 percent assurance they will be completely dry. September 2007