Up to 10% of men will experience some degree of urinary incontinence (involuntary leakage of urine) after prostate cancer surgery.
"It occurs because part of the continence mechanism may have to be removed to treat the prostate cance," says Benjamin McCormick, MD, a urologic surgeon at University of Utah Health.
This can leave the patient with something called stress incontinence. There are three main types:
- Stress incontinence, which is urine leakage associated with activity.
- Overflow incontinence, where the bladder is full but there's no sensation, so it spills over.
- Urge incontinence, also known as an overactive bladder.
Stress Incontinence Surgery
There are no bladder control medication to treat stress incontinence, but there are medications for urge incontinence. McCormick suggests that if there's a component of urgency, medications should be tried first.
There are two main surgical treatments available to men for stress incontinence treatment:
- Urethral Sling: This is not bladder lifting surgery, rather it's a sling placed around the urethra to lift it back into a normal position and apply pressure for better urine retention.
- Artificial Sphincter: A fluid-filled cuff wraps around the urethra to keep urine from leaking out until you squeeze the scrotal pump to open the cuff.
Both urinary incontinence surgery methods are outpatient or same-day procedures. They differ in that the sling provides immediate improvement in incontinence, while artificial urinary sphincter (AUS) surgery can treat more severe incontinence, but is activated after healing occurs.
"There's an activation button on the pump placed in the scrotum that we gently press at about six weeks," McCormick says.
Each bladder leakage surgery methods can make a significant difference. They are both highly successful in reducing the amount of incontinence; up to 85-90% effective in curing or greatly improving incontinence.
Candidates for Surgery
The sling procedure is recommended for someone with mild incontinence who are using one to three pads per day to deal with leakage.
For moderate to severe incontinence, AUS may be the best method.
"Going from soaking maybe five to 10 pads a day to only using one pad and getting back out there to play golf again or whatever you enjoy, there can be such a huge quality of life improvement for patients," McCormick says.
Regardless of method, urinary incontinence treatment for older adult patients is the same as for those who are middle-aged.
Over the Counter for Bladder Control
For incontinence care at home, a Cunningham Clamp can be used temporarily. The device is a soft clip that stays on the penis and can help hold back urine. The user decides when to remove it to relieve themselves.
Stress incontinence can also be improved by simple, light pelvic exercises to help restore flexibility and muscle strength. It's also helpful to drink enough water and avoid caffeine and alcohol.
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