Alex J. Vanni, MD | Lahey Hospital and Medical Center, Burlington, MA (781) 744-8762

Male stress urinary incontinence (SUI) is the involuntary leakage of urine that occurs with physical activity such as coughing, standing, lifting, or exercise. It most commonly develops after prostate surgery, including radical prostatectomy or procedures for benign prostatic enlargement, and can significantly affect quality of life.

Dr. Alex J. Vanni is a nationally recognized reconstructive urologist with extensive experience in the surgical management of male stress incontinence, including both artificial urinary sphincter (AUS) implantation and AdVance™ male sling surgery. Patients are referred nationally for his expertise in selecting and performing the most appropriate procedure to achieve durable continence.

Male Stress Incontinence Educational Video

What Is Male Stress Urinary Incontinence?

Stress urinary incontinence occurs when the urinary sphincter mechanism is weakened or damaged, most often as a result of prostate surgery. When pressure increases in the abdomen, the sphincter is unable to maintain closure, resulting in leakage.

Male SUI is commonly associated with:

Severity can range from mild leakage with exertion to complete dependence on pads.

How Is Male Stress Incontinence Evaluated?

A careful and structured evaluation is essential to determine the most effective surgical treatment. This typically includes:

Accurate diagnosis ensures appropriate selection between male sling and artificial urinary sphincter.

What Are the Surgical Treatment Options for Male Incontinence?

AdVance™ Male Sling

The AdVance™ male sling is designed for select men with mild to moderate stress urinary incontinence and preserved sphincter function.

Key Features:

  • Provides urethral support and repositioning
  • Does not require patient activation
  • Typically recommended for men without prior radiation and with lower pad usage

Ideal Candidates:

  • Mild to moderate incontinence
  • Good urethral and sphincter function
  • No history of pelvic radiation
  • Stable urethral anatomy

Careful patient selection is critical to achieving durable success with sling surgery.

Artificial Urinary Sphincter (AUS)

The artificial urinary sphincter is considered the gold-standard treatment for moderate to severe male stress urinary incontinence.

Key Features:

  • Mechanical device that restores continence by compressing the urethra
  • Patient-controlled pump allows voiding when desired
  • Highly effective for a wide range of incontinence severity

Commonly Recommended For:

  • Moderate to severe incontinence
  • Prior pelvic radiation
  • Failed sling surgery
  • Complex anatomy or prior urethral reconstruction

Dr. Vanni has extensive experience with both primary AUS placement and revision surgery, including management after prior reconstructive procedures.

Choosing Between Sling and AUS

The decision between male sling and AUS depends on multiple factors, including:

  • Severity of incontinence
  • Prior radiation or surgery
  • Urethral and bladder neck anatomy
  • Patient expectations and lifestyle

Selecting the correct procedure is as important as the surgery itself. High-volume reconstructive expertise ensures that patients receive the most appropriate operation for long-term success, not simply the least invasive option.

Why Experience Matters in Male Incontinence Surgery

Outcomes after male incontinence surgery depend heavily on:

  • Accurate diagnosis
  • Proper procedure selection
  • Technical expertise during implantation
  • Long-term follow-up and management

This is especially important in patients with prior prostate cancer treatment, radiation, or reconstructive surgery.

Dr. Vanni's outcomes reflect a commitment to technical excellence, patient safety, and durable continence, with thoughtful planning for long-term urinary function.

National Referral Center for Male Stress Incontinence

Men with persistent urinary leakage after prostate surgery—particularly those with prior failed procedures or complex anatomy—are referred nationally to Dr. Vanni for expert evaluation and surgical management. He works closely with referring physicians to ensure coordinated care and clear communication.

Dr. Vanni's surgical approach is informed by peer-reviewed evidence and current guidelines from the American Urological Association (AUA) for the treatment of male stress incontinence.

Treatment Outcomes at a Glance

Success Rate

94% success rate with artificial urinary sphincter (AUS); 85% with male slings

Surgery Duration

About 1 hour, performed as an outpatient procedure

Recovery

Return to normal activities in 4–8 weeks

20+ Years Experience in Reconstructive Urology Certified by the American Board of Urology American Urological Association Member Society of Genitourinary Reconstructive Surgeons Fellow of the American College of Surgeons

Schedule a Consultation

If urinary leakage is affecting your daily activities or quality of life, expert evaluation can help determine the most effective and durable surgical solution.

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