Update in management of male urinary incontinence

Abstract

The surgical armamentarium for stress urinary incontinence in men ranges from minimally invasive endoscopic procedures to artificial urinary sphincter implantation. In this rapidly moving field, respective indications of surgical options are also evolving, as evidence for the use of innovative devices is growing. This review is focused on recent data about injectables, stem cells and periurethral balloons implantation. Periurethral injections are probably the most minimally invasive options, but are considered of low efficacy, with a high recurrence rate in the short term. Reinjections are often needed. However, the market share of periurethral bulking is decreasing relatively slowly. Innovative, so-called regenerative therapies, including injection of biological material, stem cells, myoblasts and muscle strings implantation have shown promising results but did not yet reach maturity for daily use in the clinic. Periurethral balloons implantation shows an acceptable success rate at mid-term follow-up, but are associated with a high rate of complications and reoperations. Indications of periurethral bulking are decreasing. Regenerative therapies are still under investigation in men, and long-term studies are still required. Comparative studies against male slings and other compression devices are still awaited to accurately determine the role of periurethral balloons implantation.