Genitourinary Reconstruction

Solutions for Male Urinary Incontinence

Urinary leakage (stress urinary incontinence) often happens when the valve mechanism (sphincter) that holds urine in the bladder becomes weakened or injured, frequently after prostate surgery or radiation. When pelvic floor exercises or lifestyle changes aren’t enough, surgical options offer long-lasting relief.

Artificial Urinary Sphincter (AUS)

The Artificial Urinary Sphincter is considered the gold standard treatment for moderate-to-severe urinary leakage. It is a completely hidden, fluid-filled device that mimics the natural action of a healthy urinary valve.

• How it works: A small, soft cuff is placed around your urethra (the tube that carries urine from the bladder) to keep it closed and prevent leaks. A small control pump is placed discreetly inside the scrotum. When you need to urinate, you simply squeeze the pump. This squeezes fluid out of the cuff, opening the urethra so you can empty your bladder normally. The cuff automatically refills and closes itself a few minutes later.
• Who it helps: Men with significant urinary leakage, especially those who have had prior prostate surgery, pelvic radiation, or previous incontinence treatments that didn’t provide enough control.

Male Slings

A male sling is a minimally invasive treatment designed for mild-to-moderate urinary leakage.

• How it works: A small strip of supportive synthetic mesh is placed under the urethra through a small incision. The sling gently lifts and supports the urethra, restoring it to a more natural position and providing the support needed to prevent leaks during coughing, sneezing, lifting, or exercising.
• Who it helps: Men with lighter leakage (typically using 1 to 3 pads per day) who have a functioning natural sphincter and have not had radiation therapy to the pelvis.

Treatments for Urethral Strictures

A urethral stricture occurs when scar tissue forms inside the urethra, narrowing the passage and blocking the normal flow of urine. Common symptoms include a weak urine stream, straining to urinate, frequent urinary tract infections (UTIs), or feeling like your bladder never fully empties.

Optilume® Drug-Coated Balloon Dilation

Optilume® is an advanced, minimally invasive technology designed to open urethral strictures and prevent scar tissue from returning.

• How it works: A specialized balloon catheter is inserted into the narrowed area of the urethra and inflated to gently stretch the scar tissue. As the balloon expands, it delivers a localized medication (paclitaxel) directly into the tissue wall. This medication prevents new scar tissue from forming as the area heals.
• Who it helps: Patients with short strictures in the anterior urethra who want a quick, minimally invasive procedure with significantly better long-term success rates than standard stretching or endoscopic cutting alone.

Urethroplasty

Urethroplasty is a definitive surgical repair used to permanently fix complex, severe, or recurring urethral strictures.

• How it works: Depending on the location and length of the scar tissue, the surgeon either removes the narrow segment and reconnects the healthy ends of the urethra (anastomotic repair) or uses a small piece of healthy tissue—most commonly a tiny tissue graft taken from the inside of the cheek—to widen and reconstruct the urethral channel (substitution repair).
• Who it helps: Patients with long strictures, complex scarring, or those whose strictures have returned after prior endoscopic procedures or balloon dilations. Urethroplasty offers the highest long-term success rates of any stricture treatment.