Concierge urology · London
Male urinary sling - AdVance XP or Virtue, for mild-to-moderate leaks after prostatectomy.
A synthetic sling repositions the bulbar urethra to correct stress incontinence after radical prostatectomy. Right for men leaking 1–3 pads a day after six to twelve months of pelvic floor work - and honestly not right for severe leaks, where a sphincter is better.
Why patients choose us
- 01
A consultant urologist who fits slings weekly
Not a general urologist dabbling. A named surgeon who implants AdVance XP and Virtue slings often enough to be honest about who they suit.
- 02
Sling or sphincter - the honest conversation
A sling suits mild-to-moderate leaks; an artificial urinary sphincter suits severe ones. We say which one before you commit.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private male sling costs in London.
Indicative ranges across our partner clinics. Male slings are NHS-funded when clinically indicated - the private figures below are what you would pay to bypass the waitlist.
In short
An AdVance XP sling in our network: £8,000–£12,000, home the same day or after one night.
| Procedure | Indicative range | Typical duration | Stay / turnaround |
|---|---|---|---|
| AdVance XP transobturator sling (private) | £8,000–£12,000 | 60–90 min | Same day / overnight |
| Virtue quadratic sling (private) | £9,000–£14,000 | 75–100 min | Same day / overnight |
| Urodynamics (pre-op) | £500–£900 | 45 min | Report in 1 wk |
| Flexible cystoscopy (pre-op) | £450–£800 | 15 min LA | Same visit |
| Consultation with urologist | £250–£450 | 30–45 min | Same visit |
| NHS-funded pathway (via GP referral) | No charge | As above | Waitlist varies |
Prices vary by clinic, by surgeon, by device chosen (AdVance XP vs Virtue) and by whether you need urodynamics and cystoscopy first. We come back with a firm quote within one working day.
The problem
The right device, for the right leak.
Male incontinence surgery is quietly one of the most poorly counselled areas of private urology - slings offered when a sphincter is needed, sphincters offered when a sling would do. We fix that before you commit.
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Not sure it is needed?
Another supervised pelvic floor course sometimes finishes the job. We say so before booking theatre.
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Sling or sphincter?
Mild-to-moderate leaks: sling. Severe leaks or previous radiotherapy: sphincter. Neither surgeon should push one on you.
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Want it done properly?
A named consultant urologist with a male-incontinence subspecialty interest, proper urodynamics, and both devices available.
The journey
From enquiry to recovery - what happens, in order.
One clinician from first message to three-month review - including the recovery window.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us how bad the leak is
A short, confidential form. Pads per day, when the leak happens, how long since your prostate surgery, what you have already tried.
- 02
Before
We come back with a recommendation
Within one working day: sling, sphincter, or another round of pelvic floor rehab first. If a sling is not the right step, we say so.
- 03
Before
Assessment: urodynamics and cystoscopy
Bladder pressure studies and a look inside the urethra. The two tests that tell the surgeon whether a sling will actually hold.
- 04
On the day
Arrival at the hospital
Admission, consent and a chat with the urologist and anaesthetist. Usually a spinal or general anaesthetic - you choose with the team.
- 05
On the day
The procedure itself
60 to 90 minutes in a proper theatre. A polypropylene sling is passed through the obturator foramina and repositions the bulbar urethra.
- 06
On the day
Home the same day or overnight
Most men go home the same day with a catheter overnight. A short recovery, written aftercare, and a follow-up plan.
- 07
After
Recovery and review
Office work in one to two weeks; no gym, cycling or heavy lifting for four to six weeks. A pad-test review at three months.
Typical end-to-end: 3–4 weeks from enquiry to procedure. Full result: 3 months.
When it helps
When a male sling is the right step.
The situations that make a sling a good idea, plus the one red flag that means an artificial urinary sphincter instead.
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Mild-to-moderate post-prostatectomy SUI
Stress leaks after radical prostatectomy - a squirt when you cough, laugh, lift or stand up. Usually 1–3 pads a day.
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Failed pelvic floor rehab
Six to twelve months of supervised pelvic floor work has not fixed it - the standard threshold before surgery is offered.
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Pad test confirms the severity
A 24-hour pad test quantifies the leak. Small-to-moderate volumes point toward a sling; heavy volumes point toward a sphincter.
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Good residual sphincter function
Cystoscopy shows the sphincter still moves. A sling repositions the urethra - it does not replace what is not there.
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No previous pelvic radiotherapy
Radiotherapy scars the tissues and lowers sling success rates. Not an absolute bar, but a real caution - an AUS may be safer.
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Wants to avoid a mechanical device
A sling has no pump or moving parts. For men who dislike the idea of an AUS, that is a genuine reason to consider a sling first.
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Cognitively able to manage a catheter
You will have a catheter for a day or two after. If self-care is difficult, the team plans support before you go home.
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Red flag: severe leak or radiotherapy
More than 3–4 pads a day, or previous radiotherapy - the honest answer is usually an artificial urinary sphincter, not a sling.
Device options
A sling is not the only device.
What each option on the table actually involves - and which fits which leak.
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AdVance XP (transobturator)
A polypropylene tape passed through the obturator foramina that lifts and repositions the bulbar urethra proximally. The most-used sling in UK practice.
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Virtue quadratic sling
A four-arm sling - two transobturator, two prepubic - providing both repositioning and compression. Chosen for slightly heavier leaks.
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Retrourethral compressive sling
A compressive rather than repositioning design. Less commonly used in the UK today, but still an option in selected cases.
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ATOMS adjustable system
A compressive cushion with a titanium port that can be topped up in clinic. A middle ground between sling and full AUS for some men.
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Artificial urinary sphincter (AUS)
The gold standard for severe leaks - 85–90% dry rates. A pump-and-cuff device controlled by the patient. See our AUS page for detail.
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Repeat pelvic floor rehab
For borderline leaks, a further supervised course with a specialist physiotherapist is sometimes the right next step before surgery.
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Bulking agent injection
A submucosal injection to plump the urethra. Short-lived and rarely curative in men - occasionally useful as a bridge.
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Consultation only
An honest discussion of which device fits your leak, your anatomy and your preferences - no obligation.
Our vetted London network
A small panel of male-incontinence urologists, we picked them.
Consultant urologists across central, north, west and south London - all with a subspecialty interest in male incontinence and both devices available. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every urologist in our network.
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Consultant urologists with subspecialty interest in male incontinence
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Urodynamics and cystoscopy on-site so pre-op work is not fragmented
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Both slings and artificial urinary sphincters offered - no single-device bias
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Honest counselling when a sling is not the right answer
Safety and recovery
What to expect afterwards - honestly.
A male sling is a well-established procedure with a known risk profile. The things worth planning are your anaesthetic, the catheter window, and knowing what is normal after.
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Spinal or general anaesthetic
Either works. A spinal keeps you awake with the lower half numb; a GA puts you to sleep. The anaesthetist walks you through which suits you.
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Catheter for a day or two
A urethral catheter stays in overnight or a little longer. It is removed on the ward or in clinic before you go home fully.
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Urinary retention in 5–10%
A minority of men cannot pass urine after the sling - usually resolves with a short period of catheterisation, occasionally needing the sling to be loosened.
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Persistent leaks are possible
Around 60–80% of men are pad-free at 12 months in mild-to-moderate SUI. The rest are improved but not dry, or need a further step - usually an AUS.
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Perineal pain is common early on
Bruising and pain in the perineum for two to four weeks is normal. Simple painkillers manage it; it should settle steadily, not worsen.
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Mesh infection or erosion is rare
Modern male slings have a low infection and erosion rate, but it is not zero - fevers, worsening pain or fresh bleeding need same-day review.
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No cycling or gym for 4–6 weeks
Walking is fine from day one. Cycling, running, heavy lifting and the gym wait a full month to protect the sling as it beds in.
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Sex when comfortable, usually 4–6 wk
Sling surgery does not cause erectile dysfunction directly, though prostatectomy already may have. Resume when comfortable.
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Red flags
Fever, spreading redness, inability to pass urine, or fresh heavy bleeding after surgery are not normal - call the clinic or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever sling was used, the note the urologist sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and device chosen
Why the sling was done - mild-to-moderate SUI after radical prostatectomy - and which device (AdVance XP, Virtue) was implanted.
- 02 Technique
Anaesthetic and surgical technique
Whether it was done under spinal or GA, the route (transobturator, quadratic), tension set, and any incidental findings at cystoscopy.
- 03 Findings
Sphincter, urethra and pad-test result
Notes on residual sphincter function, urethral integrity, the pre-op pad-test volume, and any perineal or scrotal findings.
- 04 Impression
Recovery, catheter plan, review timing
Read this first: catheter removal plan, when it is safe to return to work and exercise, and when to come back for a pad-test review.
Recognised by major UK insurers
Most major UK insurers cover a male sling when there is documented post-prostatectomy incontinence and failed conservative treatment. We confirm cover with your insurer before booking.
Frequently asked
Everything we get asked about the male sling.
Quick answers on device choice, success rates, cost, recovery, and the honest sling-vs-sphincter question.
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What is a male urinary sling and who is it for?
A male sling is a strip of polypropylene mesh implanted under the urethra to correct mild-to-moderate stress urinary incontinence after radical prostatectomy. It is for men who leak with coughing, lifting or standing up - usually 1–3 pads a day - after six to twelve months of pelvic floor rehab.
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AdVance XP or Virtue - which sling is better?
AdVance XP is the most-used sling in UK practice and works by repositioning the bulbar urethra. Virtue is a four-arm sling that adds a compressive element and is chosen for slightly heavier leaks. Neither is universally better - the surgeon chooses based on your pad-test volume and anatomy.
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Sling or artificial urinary sphincter - which do I need?
Slings suit mild-to-moderate leaks (up to 2–3 pads a day) with good residual sphincter function. Artificial urinary sphincters (AUS) suit severe leaks or previous pelvic radiotherapy and are 85–90% effective. A sling has no moving parts; an AUS does. Honest counselling before you commit matters more than the device.
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How successful is a male sling?
Roughly 60–80% of men are pad-free at 12 months when patient selection is right - mild-to-moderate SUI, no radiotherapy, good sphincter function. That is inferior to an AUS (85–90%) for severe leaks, which is why device choice matters.
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How much does a male sling cost privately in the UK?
AdVance XP is typically £8,000–£12,000 and Virtue £9,000–£14,000, including surgeon, anaesthetist, hospital and the device itself. Urodynamics and cystoscopy are extra. Male slings are NHS-funded when clinically indicated - a GP referral is the alternative route.
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Does insurance cover a male sling?
Most major UK insurers cover male slings when there is documented post-prostatectomy incontinence and failed conservative treatment. Cover for the device varies - we confirm with your insurer before booking.
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How long is the recovery?
Home the same day or after one night, catheter out within 24–48 hours, office work in one to two weeks. No gym, cycling or heavy lifting for four to six weeks. Full sling incorporation and final result assessed at three months.
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What are the main risks?
Persistent incontinence, urinary retention in 5–10% (occasionally needing the sling to be incised or loosened), perineal pain for a few weeks, sling infection or erosion (rare with modern mesh), and the possibility of needing a subsequent AUS if the sling fails.
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Can I have a sling if I had radiotherapy?
It is not an absolute bar, but radiotherapy scars the tissues, reduces success rates and raises the risk of urethral erosion. Most surgeons will recommend an artificial urinary sphincter instead in this situation.
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What if the sling does not work?
The usual next step is an artificial urinary sphincter, which is 85–90% effective and can be implanted after a failed sling. Revision surgery is discussed honestly at your three-month review, not left as a surprise.
Related treatments
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Artificial urinary sphincter
The gold-standard device for severe post-prostatectomy leaks.
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Radical prostatectomy
The surgery that often precedes stress incontinence in men.
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