The loss of urinary continence is one of the most common side effects
after removal of the prostate gland and is due to the result of
disruption or distress to the sphincter muscles that control the release
of urine.
Because of the frequency of urinary functioning throughout the day,
even temporary urinary incontinence can produce anxiety and stress for a
man after prostate surgery.
What used to be a bodily function that a man didn't need to think much
about now has become a potential embarrassing situation he must plan
ahead for daily.
The good news is that urinary incontinence is usually short-term after
surgery and usually consists of a slight drip or leak that can happen
after strenuous exercise or when a man coughs, sneezes or laughs.
The length of urinary incontinence will vary for each man with recovery
ranging from weeks to months. If a man had normal continence prior to
prostate surgery he should expect to regain full urinary function with
12 to 13 months post-surgery.
Permanent incontinence is rare, particularly when performed by an experienced surgeon.
After prostate surgery, a man will have a catheter in the penis
draining the bladder. Most men tolerate a catheter well but for some it
can be annoying as it can cause a sensation of the need to urinate or
cause irritation of the tip of the penis. Medication such as lidocaine
jelly can be applied to the tip of the penis to make it feel more
comfortable.
One thing that may help to regain urinary continence as soon as
possible is to perform Kegel exercises which exercise the pelvic floor
muscles. Kegel exercises are performed by contracting and relaxing the
pubococcygeal muscles and other muscles of the pelvic floor.
To perform these muscles, a man should try to stop the flow of urine
midstream and are best performed when sitting. It is advisable to start
practicing Kegel exercises before surgery as a type of pre-conditioning.
After surgery, once the catheter is removed, it is recommended for men
to exercise the pelvic floor muscles by doing Kegel exercises as soon as
possible. A suggested Kegel regimen includes:
- Contract the pelvic floor muscles
- Hold the contraction for two to three seconds, then relax
- Repeat 10 times
- Do this three times a day
Depending on the degree and length of incontinence, anticholinergics
may be prescribed to reduce the sensation or frequency of urination.
Other possible treatments to address incontinence might include using
decongestants which have been shown to help some patients — use only
with a physician's guidance — and collagen injections, which can help
plump the urinary sphincter for increased urinary control.
It is rare for urinary incontinence to persist long-term but if it
does, there are treatment options of various surgical procedures to help
restore urinary control.
Patients newly diagnosed with prostate cancer can contact world
renowned prostate cancer surgeon and urologic oncologist, Dr. David
Samadi, for a free phone consultation and to learn more about prostate
cancer risk, by calling 212-365-5000 or visiting prostatecancer911.com.
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 and professor of urology at Hofstra North Shore-LIJ
School of Medicine. He is a medical correspondent for the Fox News
Channel's Medical A-Team Learn more at roboticoncology.com. Visit Dr. Samadi's blog at SamadiMD.com. Follow Dr. Samadi on Twitter, Instagram, Pintrest and Facebook.
Patients newly diagnosed with prostate cancer can contact world
renowned prostate cancer surgeon and urologic oncologist, Dr. David
Samadi, for a free phone consultation and to learn more about prostate
cancer risk, by calling 212-365-5000 or visiting prostatecancer911.com.
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