Why Do Prostate Cancer Treatments Cause Urinary Incontinence
It helps to know a bit about how the bladder holds urine. When urine is emptied into the bladder from the kidneys, it is stored inside the bladder until you have the urge to urinate. The bladder is a hollow, muscular, balloon-shaped organ. Urine flows out of the bladder, and leaves the body through a tube called the urethra. Urination happens when the muscles in the wall of the bladder contract, forcing urine out of the bladder. At the same time, muscles that surround the urethra relax and allow the flow of urine. The prostate gland surrounds the urethra. Because an enlarged prostate gland can obstruct the urethra, it can cause urination retention or other problems with urination.
Removing the prostate through surgery or destroying it through radiation can disrupt the way the bladder holds urine and can result in urine leakage. Radiation can decrease the capacity of the bladder and cause spasms that force urine out. Surgery can, at times, damage the nerves that help control bladder function.
Future Perspectives And Conclusions
Prostate cancer is one of the most problematic and frequently encountered malignancies in male patients. It often occurs when men are still in the active period of their lives. Consequently, there is a high demand for minimally invasive therapeutic approaches, susceptible of preserving urinary continence and sexual function. Unfortunately, stress urinary incontinence is a common adverse event in men with localized or locally advanced prostate cancer undergoing radical prostatectomy, but also secondary to radiotherapy and to cryosurgery .
Despite rehabilitative procedures such as pelvic floor muscle training, biofeedback, electrical stimulation, lifestyle changes, or a combination of these strategies, no fully efficient treatment alternative has yet been established for this pathology . On the other hand, it should be acknowledged that nursing care, including the understanding of the patient’s needs, education, and psychosocial support remain essential features while aiming to improve the quality of life of prostate cancer patients.
Why Has My Urinary Frequency Increased After Prostate Surgery
Answered by: Dr Rajesh Ahlawat | ChairmanDivision of Urology and Renal TransplantationMedanta Kidney and Urology InstituteMedanta, the Medicity
Q: I am a 62 years old male who was operated for enlarged prostate by cysto / TURP procedure eight months back. My urinary frequency and nocturia was 7-8 times a day and once at night. After the operation my symptoms worsened and I started urinating after every hour and I have to get up twice or thrice at night. The doctor has prescribed me Tropan. Is it safe to take Tropan for longer period of time?
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Urinary Incontinence After Radical Prostatectomy
Prostate Cancer surgery, specifically a radical prostatectomy is commonly used as a curative measure to treat prostate cancer, and surgeons aim to retain urinary continence and sexual function during the procedure of removing the prostate . A Radical Prostatectomy, however, remains a challenging urologic procedure because the prostate is in close proximity to the bladder, rectum, and neurovascular supply to the penis. An adequate resection of the prostate without damaging surrounding tissue presents tradeoffs between cancer control and preservation of functional outcomes such as continence and potency.
There are many different surgical techniques and approaches for radical prostatectomy. The technique, approach and skill of the surgeon will influence the rate of incontinence and recovery thereof. Initial urinary incontinence is present in up to 98% of patients post-prostatectomy . With correct management, the majority will achieve continence within a year. Approximately 90% of men will achieve continence 6 months after laparoscopic robotic prostatectomy and after that, there is a minimal improvement with only 4% more gaining continence after 6 months.
Aua Nomenclature: Linking Statement Type To Evidence Strength
Where gaps in the evidence existed, the Panel provides guidance in the form of Clinical Principles or Expert Opinions with consensus achieved using a modified Delphi technique if differences of opinion emerged.2 A Clinical Principle is a statement about a component of clinical care that is widely agreed upon by urologists or other clinicians for which there may or may not be evidence in the medical literature. Expert Opinion refers to a statement, achieved by consensus of the Panel, that is based on members clinical training, experience, knowledge, and judgment for which there is no evidence.
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Why Choose New York Urology Specialists For Treatment Of Urinary Retention Caused By Enlarged Prostate
- All treatment is performed by a Board-certified urologist experienced in treating men with symptoms of BPH using medical therapy, minimally invasive therapies, lasers and open surgery.
- We are one of the few practices in the region to offer a full range of options for treatment of BPH.
- We offer BPH treatment options under local anesthesia which avoids the risks, costs, and recovery from general anesthesia. Most men are able to return to office work and other normal activities the next day.
- Extensive Experience: Hundreds of men treated successfully using medical therapy, Urolift, lasers for BPH , Bipolar TURP, traditional TURP, open suprapubic prostatectomy, robotic suprapubic prostatectomy for BPH.
- We treat men with BPH who have heart problems , renal failure on hemodialysis, men on blood thinners such as aspirin, Lovenox, Coumadin , apixaban, rivaroxaban .
When it comes to experience and innovation New York Urology Specialists are a step ahead. Better Science Means Better Care. We specialize in minimally invasive highly effective treatment for symptoms of enlarged prostate and BPH. Many treatment procedures are performed in the convenience and privacy of office settings under local anesthesia.
Medicare and major insurances accepted. We offer .
Frequent Urination After Surgery
I had my prostate removed in January. I’m healing very well except that I need to get up frequently during the night to urinate. Sometimes it is three or four times a night, which is worse than before the surgery. I try not to drink anything for a few hours before going to sleep, but still often need to go anyway. Wondering if anyone has had a similar experience and thoughts on improving the situation.
Hello JoBu.
You would expect some incontinence immediatety after surgery, I don’t know if you did. I had to wear incontinence pads for at least two months, especially at night. Now 7 years on, I don’t need pads but I still have some minor leaks, e.g. when crouching down with a full bladder. Some men never regain full control at all
It sounds as if you have regained sone control, but possibly not full control. If you did the Kegel exercises before and after surgery I suggest you carry on with these. When you do wee also, don’t just let it flow, stop and start. I found this helpful with control.
There is another possibility, if you have any of the following symptoms,
Mention it to your urologist at your next follow up appointment, or see your GP if it’s causing problems.
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What Types Of Incontinence Can Happen After Rp
There are two main types of urinary incontinence after RP:
- Urgency incontinence is when you feel the need or urge to urinate but cannot make it to the toilet in time. This is often due to bladder spasms and medication can help. This type of incontinence is caused by changes in the way the bladder behaves after surgery.
- Stress urinary incontinence is leakage of urine with movement or effort and can happen when you cough, sneeze, lift something heavy, change position, or exercise. This type of incontinence may be caused by damage to your external sphincter muscle. Almost all men will have some degree of SUI right after their urinary catheter is taken out. A urinary catheter is placed short term to collect urine during and while recovering from surgery. You may be taught how to do pelvic floor exercises to help with urinary control.
Excessive Urination After Surgery
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Conservative And Pharmacologic Therapy
Although there is conflicting evidence regarding the importance of conservative treatment after post-prostatectomy urinary incontinence , pelvic floor muscle training is still considered as the first treatment choice . Duloxetin, a serotonin/norepinephrine reuptake inhibitor, either alone or in combination with PFMT, may hasten recovery of urinary incontinence but is often associated with severe gastrointestinal and central nervous side effects . However, neither PFMT nor duloxetine may cure male stress urinary incontinence.
How Common Is Urinary Incontinence After Prostate Surgery
If you have a radical prostatectomy, a tube called a catheter will be placed inside your bladder to allow urine to drain. When the catheter is removed, most men will have some difficulty controlling their urine flow.
For most men, the urinary leakage will improve in the months following surgery. In an NHS trial, 46% of men needed to use absorbent pads six months after having a radical prostatectomy. But, one year on from having the procedure, this figure had improved to 17%.
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Who Is At Higher Risk For These Problems
More invasive procedures carry a higher risk for urinary control issues postoperatively. Many factors can influence urinary control after surgery, including underlying medical conditions, medications, diet, and daily activity. Many of these factors are modifiable, and improvement is often achieved by a comprehensive and motivated approach.
It is important to ask your urologist about urinary control when considering prostate surgery, and to discuss pre-existing urinary control issues. Patient education and motivation are among the most important factors in improving urinary control after prostate surgery.
Factors Influencing Nocturia After Radical Prostatectomy
Multiple regression analysis showed that preoperative IPSS storage subscores were negatively associated with nocturia after radical prostatectomy . Preoperative and postoperative voiding symptoms showed no such associations. Moreover, pre-operative nocturia status was not associated with postoperative nocturia. Age, BMI, preoperative prostate-specific antigen levels, Gleason score, T stage, and prostate volume likewise had no associations with postoperative nocturia.
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What Can You Do To Prevent Prostate Cancer
The high lifetime risks of prostate cancer development, the morbidities associated with treatment of established prostate cancer, and the inability to eradicate life-threatening metastatic prostate cancer offer compelling reasons for prostate cancer prevention.
However, because the cause of prostate cancer is uncertain, preventing prostate cancer may not be possible. Certain risk factors, such as age, race, sex, and family history, cannot be changed. Nevertheless, because diet and other lifestyle factors have been implicated as a potential cause, living a healthy lifestyle may afford some protection.
- Proper nutrition, such as limiting intake of foods high in animal fats and increasing the amount of fruits, vegetables, and grains, may help reduce the risk of prostate cancer.
- The following supplements should NOT be used to prevent prostate cancer:
- Vitamin E
5-alpha reductase Inhibitors :
What Is The Difference Between Robotic And Laparoscopic Radical Prostatectomy
Both are minimally-invasive techniques of performing radical prostatectomy for cancer. In laparoscopic radical prostatectomy, the surgeon stands by the operating table and himself manipulates the instruments. In robotic prostatectomy the surgeon is seated at a robotic console near the patient from where he drive the robotic instruments to perform the operation. The robot faithfully and accurately reproduces the surgeons sophisticated maneuvers.
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What Can Help With Radiation Cystitis
There are treatments that can help with radiation cystitis, as well as things you can do yourself.
Lifestyle changes
Drink plenty of fluids , but try to avoid fizzy drinks, drinks containing caffeine such as tea, coffee and cola and alcohol, as these can irritate the bladder.
Although the evidence for this isnt very strong, some men find that drinking cranberry juice helps. But you should avoid cranberry juice if youre taking warfarin to thin your blood.
Bladder wash
If your symptoms are severe, your doctor may suggest a treatment called a bladder wash, such as Cystistat®. This is a liquid medicine that coats and protects the lining of the bladder, making it less irritated. A small tube is passed up your penis and fills your bladder with the liquid medicine. You then go to the toilet to empty your bladder.
Incontinence After Prostate Surgery: Everything You Need To Know
Alan was 68 years old when he had a prostatectomy. My doctor thought it was the best way to treat my prostate cancer and I agreed, he said. We talked about the risks involved, how to prepare for the surgery, and what would happen during the surgery, but it was what happened after prostate surgery that I didnt expect. He never told me about the potential for bladder leaks.
I thought it was probably normal to have some incontinence after prostate surgery, but 6 weeks after I had the catheter removed, I was still unable to stand up without leaking urine. Ill never forget the day I had my catheter taken out. I came home, had a beer to celebrate, and immediately it all just rushed out of me when I stood up a half-hour later. I just didnt expect this to happen and was really worried that it was going to become a permanent part of my life.
I went in for a checkup, and thats when my doctor told me that this is a common side effect for some men. He told me that the leaks would likely recover with time, and he went through my options and discussed what I could do to help speed up the recovery process, which was helpful. I just wish he would have told me all this sooner, before the surgery. At least then, I could have known what to expect.
Alans story isnt uncommon. Undergoing a prostatectomy can be difficult. And for many men, finding that they are incontinent post-surgery may come as a shock.
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How Do I Know If Its Frequent Urination
The characteristics of frequent urination are easy to spot. If you feel the need to pee more than four to eight times in one day, odds are that you have issues with frequent urination. Your healthcare provider may ask you a few questions to confirm this symptom. These could include questions like:
- What medicines are you taking?
- How much fluid do you usually drink?
- Are you drinking more than usual?
- Do you drink alcohol or caffeine?
During a visit, the healthcare provider may also take a urine sample to test for bacteria and white blood cells. UTIs are typically discovered this way. An ultrasound could be used to look for tumors or other structural issues that might be causing frequent urination. Another test you may have is a cystoscopy, which is used to look inside your bladder.
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Biofeedback For Incontinence After Protatectomy
Biofeedback is a widely used technique that helps people understand how to control their body functions, including the urinary control. It has proved its efficiency in helping many men regain their urinary control.
Biofeedback therapy uses computer graphs and audios to make it easier for you to locate the muscles you a are working on. It is a teaching tool that instructes you how to strengthen your muscles.
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Improve Bladder Control Regain Your Continence Sooner After A Robotic Prostatectomy
Kegel exercise strengthens the group of muscles called the pelvic floor muscles These muscles contract and relax around the bladder and the bladder opening at your command. When these muscles are weak, urine leakage may result. You can exercise these muscles just like any other muscle in your body, and building them up may help reduce your symptoms. It is important that you perform these exercises correctly and consistently to gain maximum benefit after prostate cancer surgery.
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Changes In Nocturia After Laparoscopic Radical Prostatectomy And Robot
No postoperative changes in the frequency of nocturia were reported by 43.8% of the patients . In 33.3% of the patients , postoperative nocturia was more frequent than preoperative nocturia . Improvements were reported by 22.9% of patients , in whom the number of episodes of nocturia decreased from 3.0±0.7 to 1.0±0.7.
Overall changes in nocturia after radical prostatectomy. Preoperative and postoperative frequency of nocturia in patients who experienced exacerbated nocturia after radical prostatectomy. Preoperative and postoperative frequency of nocturia in patients who experienced improved nocturia after radical prostatectomy.
One episode of nocturia was reported by 35.7% of the patients who exhibited the same number of nocturia episodes after radical prostatectomy. Two and three episodes of nocturia were reported by 35.7% and 23.8% of such patients, while 4% reported no episodes of nocturia either preoperatively or postoperatively.
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Urinary Frequency And Urgency
Some men find they need to urinate more often after having radiotherapy , or get a sudden urge thats hard to ignore . You may also need to urinate more often at night . It usually only lasts for a few months after radiotherapy, but if it happens, it might help to drink less in the two hours before you go to bed, and to avoid drinks that irritate the bladder
A small number of men leak urine before they can reach the toilet . This happens when the bladder muscles twitch and squeeze without you controlling them. This pushes urine out before youre ready.