September is National Prostate Health month. In honor of raising awareness about some of the serious conditions that can afflict this important glad, we look at one of the side effect of having prostate surgery, and provide tips on how to manage the little-talked-about issue of urinary incontinence.
One of the most stress-producing side effects that a man may experience after a radical prostatectomy is the loss of urinary control. What once was a normal bodily function that occurred many times throughout the day all of a sudden becomes a hassle, and an issue one is not eager to share with others.
Urinary incontinence, or the loss of the ability to control urination, is considered common after the removal of the prostate. The possibility of urinary incontinence should be thoroughly discussed with any man who will be undergoing surgery for the removal of the prostate gland.
Generally incontinence after prostate surgery should be short-lived, but it can certainly complicate a man’s life for however long it sticks around. This temporary incontinence is the result of disruption or distress to the sphincter muscles that control the release of urine. This type of incontinence is similar to stress incontinence (losing urine due to movements such as sneezing, running or lifting a heavy object) that women sometimes experience after delivering a baby.
The majority of men with urinary incontinence after prostate surgery will primarily experience it as a slight dribble or leak. Rarely does it result in a complete emptying of the bladder. When and if a man experiences urinary incontinence after surgery, it usually happens during strenuous activity or possibly after he sneezes, coughs, or laughs.
Why does prostate surgery cause urinary incontinence?
To understand why some men face the issue of urinary incontinence after prostate surgery, it helps to have an understanding of the bladder and the job the bladder performs. The function of this hollow, muscular, balloon-shaped organ is to hold urine, which is produced by the kidneys after filtering waste material from the blood. Urine will travel down the tubes connecting the kidneys to the bladder, called the ureters. When the bladder becomes filled, a person feels the urge to eliminate the urine, passing it through the urethra. The prostate gland usually surrounds the urethra, but once the prostate is removed through surgery, the way the bladder holds urine is disrupted and urine leakage can result.
How long does urinary incontinence usually last?
Recovery from incontinence after prostate surgery is different for every man, but generally you’ll regain normal urinary function within three months, if not sooner. Most men will not experience long-term incontinence after prostate surgery.
What can a man do to treat urinary incontinence after prostate surgery?
- Kegel exercises
Performing Kegel exercises can be used successfully to help men control their ability to hold in their urine. These easy-to-perform moves help strengthen the pelvic floor muscles and can be done anywhere.
- Behavior modification
Drink fewer fluids, avoid caffeine, alcohol or spicy foods, and avoid drinking fluids before bedtime. You should also urinate regularly and not wait until the bladder is completely full. For some men, losing weight may improve urinary control.
There are a variety of medications that can increase bladder capacity and reduce the frequency of urination that a man can discuss with his doctor. Anticholinergics are one such type of medication that can reduce the sensation or number of times a man needs to urinate during the day. For other men, decongestants can help strengthen sphincter muscles, but these should only be used after consulting with a physician and under his or her care.
- Surgery, injections, and devices
Even though long-term incontinence after prostate removal is rare, long-lasting incontinence can be treated through a range of different treatment options. When and if this happens, a man should thoroughly discuss with his doctor which option is best for him.
One option is surgery. Several surgeries are available for restoring urinary control in patients who experience symptoms that last for a year or more. One type of surgery involves placing rubber ring around the tip of the bladder to help hold in urine.
Collagen injections can also provide short-term relief from issues of incontinence after prostate cancer. This treatment improves urine control by plumping the urinary sphincter through a series of collagen injections.
Other devices that may help could be an artificial sphincter. This patient-controlled device is made of three parts: a pump, a pressure-regulating balloon, and a cuff that encircles the urethra and prevents urine from leaking. This has either cured or greatly improved the condition in 70 to 80 percent of patients who elected for the surgery. Another device is a bulbourethral sling, which is a sling-like a device used to suspend and compress the urethra. It is made from synthetic material or from the patient’s own tissue and is used to create the urethral compression necessary to achieve bladder control.
Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital. He is a medical correspondent for the Fox News Channel’s Medical A-Team. Follow Dr. Samadi on Twitter, Instagram, Pintrest, SamadiMD.com, davidsamadiwiki, davidsamadibio and Facebook