Editing Functional: Surgery for Male SUI (section)

=== History and Physical Exam ===

* '''<span style="color:#ff0000">History</span>'''
**'''<span style="color:#ff0000">Characterize incontinence</span>'''
***'''<span style="color:#ff0000">Type of incontinence</span>'''
****Treatment for SUI (caused by sphincteric insufficiency) vs. urgency incontinence (caused by bladder dysfunction) are different.
*****'''In cases of mixed incontinence, determine which component is more prevalent and bothersome''' (stress or activity related versus urgency related)
****** Increases in abdominal pressure such as that caused by straining, walking, cough, and exercise are suggestive of SUI
******The sudden compelling desire to void that is difficult to defer and results in leakage indicates urgency incontinence.
******Presence of incontinence while asleep as well as nocturia are also important to note, because this may indicate urgency urinary incontinence or severe SUI.
****'''Differentiation between stress and urge UI can be aided by the voiding diary and pad test'''
***'''Progression or resolution of incontinence over time, exacerbating factors'''
*** '''<span style="color:#ff0000">Severity of incontinence</span>''' (i.e. volume lost over time)
****'''Can be determined by history, or more objectively, by pad testing'''
**** In the case of sphincteric insufficiency, some treatments (e.g., male slings), clearly have inferior results in severe incontinence.
***'''<span style="color:#ff0000">Degree of bother</span>'''
** Previous surgical procedures
** Symptoms of neurologic disease
* '''Physical exam'''
** '''Abdomen, back, genitalia, perineum, rectum, and neurologic system'''
** '''Scrotal exam''' 
***May detect pathologic processes that can influence pump placement such as hydrocele, hernias, and scrotal masses.
****If inguinal hernia identified and contralateral pressure-regulating balloon (PRB) placement is not possible, concomitant hernia repair is advisable.
** '''Previous surgical incisions should be noted when planning AUS pressure-reservoir balloon placement'''