Timing and Cost Consideration in Surgery for Male Stress Urinary Incontinence For Current Urology Reports

Surgery remains the standard of definitive care in male stress urinary incontinence (SUI). This narrative review provides a critical discussion of pertinent aspects of male continence surgery, including cost-benefit analysis and whether continence surgery should be offered earlier.

Controversies exist regarding the timing of surgery and whether the male sling (MS) is superior to the artificial urinary sphincter (AUS). Presently, significant gaps exist in the cost analysis and modelling for the most effective treatment in male SUI. Each continence device has its own merit and drawbacks, and patients should be counselled on the procedure, mechanics, expectations and surgical complications, with emphasis on shared decision-making and personalised care. More high-quality studies of surgical interventions, including direct comparison against non-surgical methods, coupled with in-depth evaluation on why patients choose a particular treatment over another, will be useful in preoperative counselling and streamlining decision-making in male SUI.