Male Sling Post-Op Recovery Instructions

About Male Sling Recovery

The male transobturator sling (most commonly the AdVance sling) is the preferred surgical option for men with mild to moderate stress urinary incontinence after prostate surgery. Unlike the artificial urinary sphincter, the sling is a permanent passive implant — there is no device to activate, no pump to operate, and no parts that can mechanically fail. The sling repositions and supports the bulbar urethra to restore continence.

What sets male sling recovery apart:

• No device to operate. Recovery is simpler than for AUS because there is no activation visit, no pump cycling, and no learned technique. Continence is restored passively, and most patients notice the improvement immediately after the catheter is removed.
• Avoid perineal pressure for 6 weeks. Sitting directly on the perineum (bicycle saddles, motorcycle seats, hard chairs) can shift the sling before tissue ingrowth fixes it in place. Sit on your buttocks with an air-filled donut cushion if needed.
• Temporary retention or slow stream is common in the first 1-2 weeks. The sling is intentionally placed with just enough tension to restore continence, and post-operative swelling can briefly narrow the urethra. This typically resolves on its own; rarely a short-term catheter is needed.
• Urethral catheterization remains safe with a sling in place — unlike the AUS, the sling does not have to be deactivated for catheter procedures. Still notify any treating physician that you have a sling.

Advance Male Sling Post-Operative Instructions

What you can expect

• Bruising and some mild bleeding from incision site(s).
• Scrotal swelling
• Possible pain and/or burning with urination.
• Mild pain at operative site.
• Mild discomfort in the groin region
• Mild discomfort moving your legs inward
• Slower urinary stream

Activity

• No heavy lifting (more than 20 lbs) for 4 weeks.
• No driving the day of surgery
• No long trips for 3 weeks.
• No vigorous activity for 4 weeks (shoveling snow, mowing the lawn, raking leaves etc).
• No sexual activity for 4 weeks.
• If you experience discomfort, reduce activity, and more gradually resume activities.
• Regular light activity is encouraged several times daily. We encourage walking. Do not be a couch potato.
• Care of your perineal incision:(between the scrotum and anus), you should sit with your weight shifted onto you buttocks for 6 months. You may use an air-filled donut or soft cushion for 4 weeks.
• No activity that involves straddling for 6 months (riding a bike, motorcycle, ATV, horseback riding etc).

Diet

• Drink plenty of fluids (6-8 glasses of water daily).
• Resume regular diet at home.
• If you have a special diet due to diabetes, kidney disease, liver disease etc, you may resume eating when tolerated.

Medications

• You will not require narcotic medication.
• Pain control with 600 mg ibuprofen and 500 mg Tylenol every 6 hours unless your doctor states otherwise. These medications can be staggered so that you can take something every 3 hours.
• Resume all medications you normally took before surgery, unless instructed otherwise.
• Resume Aspirin and blood thinners as directed by your physician.
• If you have any questions regarding your medications please call our office at 781-744-8420 or call the Lahey Clinic Urologist on-call.

Bowel habits

• Avoid constipation to prevent straining (do not strain when having a bowel movement).
• Increase fiber in your diet
  • Fruits, vegetables, salads
  • Metamucil
• Drink plenty of fluids (8 glasses of water a day)
  • Can add prune or apple juice
• Stool softeners
  • Colace
• Laxatives

  Bathing

• Shower daily beginning 48 hours after surgery.
• Gently wash the incision with soap and water, rinse, and pat dry.
• No baths, hot tubs, or swimming for 6 weeks

Reasons to call your doctor

• Bladder feels full
• Incision becomes red, swollen, opens, or has pus-like drainage.
• Skin around your incision becomes warmer than elsewhere.
• Chills or fever greater than 101 degrees F.
• Nausea and vomiting or inability to keep down fluids.
• Severe pain not controlled by pain medication.

Additional instructions

• Given on a case by case basis. Ask your surgeon if any other instructions are necessary.

For emergent situations call 911 or go to the Emergency Room.

Please feel free to contact us with any other questions or concerns at 781-744-8420.

Sling-Specific Warning Signs

In addition to the general warning signs above, these symptoms warrant prompt contact with Dr. Vanni's office:

• Inability to urinate after the catheter has been removed, or a sense of incomplete emptying with a weak stream that does not improve over a few days — can indicate post-sling retention.
• Increasing perineal pain beyond the first 2-3 weeks rather than steady improvement.
• Worsening incontinence after a period of improvement — can indicate sling displacement or tissue stretching.
• Painful urination or new urinary tract infections — most slings remain free of urinary tract complications, but symptoms warrant evaluation.
• Recurrent groin or scrotal swelling at the small skin incisions in the groin where the sling arms exit.
• Any skin breakdown over the perineal or groin incisions.

Follow-Up Schedule & Continence Assessment

• Week 2-3 (catheter removal): Most patients can self-remove the catheter at home; some will have catheter removal in the office with a voiding trial. Most patients notice substantial continence improvement immediately at this point.
• 6 weeks: First post-op visit. Continence is confirmed and activity restrictions lifted if recovery is on track.
• 3 months: Follow-up to objectively document the continence result.
• 6 months: Final routine continence check.
• Annually: Symptom-based follow-up. Slings are durable; most do not need revision, but any worsening incontinence over time should be evaluated.