Frederic E.B. Foley: Beyond the catheter

A historical perspective and evolution of the treatment of male urinary incontinence

AIMS

To describe the historical changes from antiquity until present in the presentation and treatment of male urinary incontinence.

METHODS

A literature review of PubMed articles in English pertaining to male incontinence was performed.

RESULTS

Male urinary incontinence was first mentioned in Egyptian manuscripts in 1500 B.C. In 1564, Ambroise Pare designed portable urinals for incontinent males. Wilhem Hildanus created the first condom catheter with pig bladder in the 1600s and was also credited with fashioning the first penile clamp. Lorenz Heister introduced a perineal bulbar urethral compression belt in 1747 which would provide the blueprint for air-inflated bulbar urethral compression devices such as the one designed by S.A. Vincent in 1960. Robert Gersuny performed the first periurethral paraffin injection bulking therapy in the late 19th century. In 1929, Frederic Foley introduced the modern catheter, and also credited with conception of the first artificial sphincter. From 1970 to 1973, Joseph Kaufman surgically created bulbar compression for post-prostatectomy incontinence, but not before designing the first male sling with John Berry in 1958. In 1973, F. Brantley Scott introduced the first multi-component artificial inflatable sphincter. Improvements upon periurethral bulking therapy occurred rapidly in the late 20th century with Teflon, collagen, autologous adipose, tissue and cross-linked silicone gels. Since 2007, stem cell injection therapy has emerged as a new therapeutic option for incontinence; however, results are mixed and remains experimental.

CONCLUSION

Treatment for male urinary incontinence has evolved from noninvasive devices to various surgical procedures. Artificial sphincters remain the gold-standard therapy for male urinary incontinence.