105HO - Regaining Control: A Practical Guide on Treating Stress Urinary Incontinence in Men

Stress urinary incontinence in men is a debilitating condition and often follow prostate surgery, especially a radical prostatectomy (whether open, laparoscopic or robotically assisted). Studies show 6-8% of all patients experience stress incontinence after prostatectomy.

As the incidence of prostate cancer increases worldwide, SUI is now a significantly worsening issue facing urologists, nurses and advanced care practitioners.

Current surgical management options are urethral bulking agents, fixed and adjustable trans-obturator slings and the artificial urinary sphincter.

This course is aimed at all urologists/residents/care practitioners with an interest in male incontinence surgery and will provide a practical hands-on teaching experience for participants in the field of incontinence surgery in men.

This course will aim to teach participants the latest knowledge on urethral bulking agents, fixed and adjustable trans-obturator slings and the artificial urinary sphincter, how to perform patient selection for each technique, common and uncommon issues during follow up, as well as tips and tricks in how to perfect each surgical technique to achieve the best outcomes for our patients.

This will be achieved through a mix of lecture based teaching, “ask the experts” question and answer session and most importantly, small group hands-on practice with each device to familiarize participants in their use.

SCIENTIFIC PROGRAM

2:00 – 2:05 p.m. Welcome & Introduction
Bob Yang, FRCS (Urol) & Susan MacDonald, MD

2:05 – 2:20 p.m. Urethral Bulking Agents
Bob Yang, FRCS (Urol)

2:20 – 2:35 p.m. Trans-obturator Slings
Steve Foley, FRCS

2:35 – 2:50 p.m. Artificial Urinary Sphincter
Susan MacDonald, MD

2:50–5:00 p.m. Wrap up and Hands-on Orientation
Bob Yang, FRCS (Urol) & Susan MacDonald, MD

Surgical Skills Stations: 3 rotations of 40 minutes each (120 minutes), 3 Topics, 6 Stations
1) Urethral Bulking Agents (Lab stations 1 and 2 combined for US; 3 and 4 for Global)

Skills Trained - Global
• Set up Deflux syringe, needle and prime Deflux system
• Set up cystoscope, fluid and stack
• Access bladder neck cystoscopically
• Create adequate bulking mounds

Skills Trained – US
• Set up Bulkamid syringe, needle and prime Bulkamid system
• Set up cystoscope, bulkamid sheath, fluid and stack
• Access bladder neck cystoscopically
• Create adequate bulking mounds
 
2) Sub-urethral Sling (Lab stations 5 and 6 combined for US; 7 and 8 for Global)

Skills Trained - US
• Identify components of AdVance
• Identify key anatomical landmarks in the pelvis model
• Use an obturator tunneler to insert the arms of AdVance
• Demonstrate proper placement and tensioning of the Advance in relation to the perineal body

Skills Trained – Global
• Identify components of ATOMS
• Identify key anatomical landmarks in the pelvis model
• Use an obturator tunneler to insert the arms of ATOMS and tie them to ATOMS
• Fill the balloon using the scrotal port

3) Artificial Urinary Sphincter (Lab stations 9-10 combined for US; 11-12 for Global)

Skills Trained - US
• Identify components of AMS 800
• Identify key anatomical landmarks in the pelvis model
• Prepare and connect the cuff, pump and reservoir of AMS 800 avoiding air bubbles in the system
• Activate and deactivate the AMS 800

Skills Trained – Global
• Identify components of ZSI 375
• Identify key anatomical landmarks in the pelvis model
• Activate and deactivate the ZSI 375

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Accreditation: The American Urological Association (AUA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation: The American Urological Association designates this live activity for a maximum of 3.0 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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