Tuesday, January 31, 2023

Frequent Urination After Radiation For Prostate Cancer

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Urinary Problems Are Treatable In Nearly Every Man And Woman

Urinary Incontinence after Radical Prostatectomy | Prostate Cancer Staging Guide

At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of urinary problems. We understand the challenges that urinary problems create for our patients, their relationships and their self-esteem. We help you find a treatment for your urinary problems that fit your needs, lifestyle, and your preferences.

Urologists are doctors specializing in the treatment of women and men with frequent urination, poor urine flow, frequent UTI, blood in urine, urinary incontinence, urinary problems caused by an enlarged prostate, prior surgery, neuropathy, chemotherapy, and radiation. By the virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man and women who desire an effective treatment for their urinary problems. We specialize in minimally invasive highly effective treatment for symptoms of bladder pain, urethral burning, pelvic discomfort, incomplete bladder emptying, urinary frequency, and urgency.

We offer medical and surgical treatment for erectile dysfunction.

New Study Compares Long

  • By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases

Prostate cancer therapies are improving over time. But how do the long-term side effects from the various options available today compare? Results from a newly published study are providing some valuable insights.

Investigators at Vanderbilt University and the University of Texas MD Anderson Cancer Center spent five years tracking the sexual, bowel, urinary, and hormonal status of nearly 2,000 men after they had been treated for prostate cancer, or monitored with active surveillance . Cancers in all the men were still confined to the prostate when diagnosed.

Dr. Karen Hoffman, a radiation oncologist at MD Anderson and the studys first author, said the intent was to provide information that could help men choose from among the various therapeutic options. Surgical and radiation techniques have changed significantly in the last few decades, and at the same time, active surveillance has become an increasingly acceptable strategy, she said. We wanted to understand the adverse events associated with contemporary approaches from the patients perspective.

Roughly two-thirds of the men enrolled in the study had favorable risk cancer, which is nonaggressive and slow-growing. A quarter of these men chose active surveillance, and the rest were treated with one of three different methods:

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Why Choose New York Urology Specialists For Treatment Of Urinary Problems

  • All treatment is performed by a board-certified urologist experienced in treating men with symptoms of frequent urination, urinary urgency, urinary incontinence and bladder pain 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 urinary problems in men and women
  • We offer treatment options for overactive bladder, UTI and urinary incontinence in our office which avoids the risks, costs, and recovery from general anesthesia.
  • Extensive Experience: Hundreds of men and women have treated successfully using medical therapy, Botox for overactive bladder, Interstim for frequent urination and tibial neuromodulation.

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Early Warning Signs Of Bladder Cancer

Blood in the urine : This is typically the first sign of bladder cancer. It may be present on a regular basis or disappear and reappear over the course of days or weeks. Sometimes blood is present in such a small amount that it cant be seen with the naked eye, called microscopic hematuria, buta urine test may be able to detect it.

Even a small amount of blood may cause the color of urine to change to orange, pink or, rarely, dark red. When blood causes urines color to change, its called gross hematuria.

Early-stage bladder cancer doesnt usually cause pain or other symptoms besides bleeding. But blood in the urine doesnt always mean theres a tumor in the bladder. Its more likely to be caused by a less serious condition, such as an infection. kidney stones, bladder stones, or noncancerous tumors or kidney diseases.

Its also important to note that blood from menstruation may show up in a womans urine test, which may cause a false-positive test result. In this case, doctors may recommend repeating the test.

Urination changes: Changes in urination are more commonly a sign of a less serious condition, such as a benign tumor, infection, urinary tract infection, bladder stones, an overactive bladder or, in men, an enlarged prostate. But they also may be another early sign of bladder cancer symptoms. These changes may include:

Incontinence Pads And Sheets

Lethal outcome after pelvic salvage radiotherapy in a patient with ...

You might need to wear pads when you first start going out. There are different types of pads. You might be able to get some pads for free on the NHS, although this may depend on the service in your area. Some GP practices have a continence nurse you can see.

It can also help to visit places where you know there are toilets. Or you can telephone beforehand to find out about toilets and how easy they are to get to.

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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.

Why Do Some Men Experience Urinary Incontinence Following Treatment For Prostate Cancer

When you urinate, the muscles in the bladder wall contract while the muscles that surround the urethra the tube that carries urine from the bladder out of the body relax. A prostatectomy can weaken the sphincter muscle that opens and closes to release urine and can cause damage to the nerves that control urination. Radiation, on the other hand, can shrink the capacity of your bladder resulting in spasms, which is why the type of incontinence can be somewhat different .

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If Youre Getting Radiation Therapy To The Abdomen

If you are getting radiation to your stomach or some part of the abdomen , you may have side effects such as:

Eating or avoiding certain foods can help with some of these problems, so diet planning is an important part of radiation treatment of the stomach or abdomen. Ask your cancer care team about what you can expect, and what medicines you should take to help relieve these problems. Check with your cancer care team about any home remedies or over-the-counter drugs youre thinking about using.

These problems should get better when treatment is over.

Managing nausea

Some people feel queasy for a few hours right after radiation therapy. If you have this problem, try not eating for a couple of hours before and after your treatment. You may handle the treatment better on an empty stomach. If the problem doesnt go away, ask your cancer care team about medicines to help prevent and treat nausea. Be sure to take the medicine exactly as you are told to do.

If you notice nausea before your treatment, try eating a bland snack, like toast or crackers, and try to relax as much as possible. See Nausea and Vomiting to get tips to help an upset stomach and learn more about how to manage these side effects.

Managing diarrhea

Advanced Prostate Cancer Symptoms

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Men with advanced prostate cancer may experience additional symptoms. Thats because the cancer has spread from the prostate to other parts of the body, such as the bones or lymph nodes.

A wide range of treatment options are available for managing advanced cancer. These treatments kill cancer cells, but they may also help patients manage pain.

Signs of metastatic prostate cancer may include:

  • Swelling in legs or pelvic area
  • Numbness or pain in the hips, legs or feet
  • Bone pain that persists or leads to fractures

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What Are The Different Surgeries For Incontinence

There are three main types of surgery for men who have incontinence after an RP:

  • Urethral bulking procedures are done endoscopically . A material is injected just under the lining of the urethra. This makes the urinary passageway smaller. It is often done as an outpatient procedure, either with or without anesthesia. You can often return to normal activity right away. Your body often reabsorbs the material over time so it needs to be repeated every 9-15 months. The side effects can be bleeding, urinary tract infection, and temporary urinary retention . Rarely, patients may feel that their incontinence is made worse by the procedure.
  • Male perineal sling procedures are done in the operating room under anesthesia. A small incision is made in your perineum . A strip of mesh is placed under the urethra and is used to elevate and slightly press on the urethra. You will be asked to limit your activity for 4-6 weeks after surgery to allow the sling to scar into place so it does not move after the procedure. There is little discomfort or pain after the procedure. Success tends to be best in men with minimal to moderate incontinence . Side effects can be bleeding, skin or mesh infection, pain, erosion into the urethra , inability to urinate , and no improvement in continence.
  • Why Does Incontinence Happen After Prostate Cancer Surgery

    There are two sphincter muscles that help men control their urine, also called being continent. These sphincters are:

    • The internal urethral sphincter: You do not control your internal sphincter. It is found at the bottom of the bladder, called the “bladder neck. This is removed during a radical prostatectomy . The prostate cannot be taken out without also taking out the sphincter.
    • The external urethral sphincter: The external sphincter is found below your prostate. You can control your external sphincter and use it to stop your urine stream. You can strengthen this sphincter with pelvic floor muscle exercises .

    Normally, an intact, healthy external sphincter is enough to help you remain continent after surgery. However, RP can damage nerves, blood supply, supporting structures, or the muscle which can affect the external sphincter. This damage can lead to incontinence.

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    Whos At Risk For Urinary Incontinence

    A mans risk for urinary incontinence varies depending on what type of prostate cancer treatment he undergoes. About 6 to 8 percent of men who have a complete prostatectomy experience some incontinence, while it affects 8 to 10 percent of men after radiation therapy. Its important to know that most often it is not a permanent problem. How long it takes to resolve can vary, so patience and open dialogue with your doctor are key to managing the symptoms.

    Most often, urinary incontinence after prostate cancer treatment is not a permanent problem. David Cahn, M.D.

    Can Urinary Incontinence be Treated Successfully?

    If youre in the minority of men for whom incontinence sticks around, dont lose hope. Depending on what is causing your problem, there are many treatment options. Medications, bladder retraining, collagen injections, and procedures such as urethral sling surgery and artificial urinary sphincter can all help to restore normal urinary control. The first step, though, is being willing to talk about it.

    Learn more about prostate cancer and prostate cancer treatment or find a physician at Colorado Urology.

    Surgically Removing The Prostate Gland

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    A radical prostatectomy is the surgical removal of your prostate gland. This treatment is an option for curing prostate cancer that has not spread beyond the prostate or has not spread very far.

    Like any operation, this surgery carries some risks.

    A recent trial showed possible long-term side effects of radical prostatectomy may include an inability to get an erection and urinary incontinence.

    Before having any treatment, 67% of men said they could get erections firm enough for intercourse.

    When the men who had a radical prostatectomy were asked again after 6 months, this had decreased to 12%. When asked again after 6 years, it had slightly improved to 17%.

    For urinary incontinence, 1% of men said they used absorbent pads before having any treatment.

    When the men who had a radical prostatectomy were asked again after 6 months, this had increased to 46%. After 6 years, this had improved to 17%.

    Out of the men who were actively monitored instead, 4% were using absorbent pads at 6 months and 8% after 6 years.

    In extremely rare cases, problems arising after surgery can be fatal.

    Itâs possible that prostate cancer can come back again after treatment. Your doctor should be able to explain the risk of your cancer coming back after treatment, based on things like your PSA level and the stage of your cancer.

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    Read Real Stories Of Men Who Underwent Treatment Of Enlarged Prostate At New York Urology Specialists

    We offer treatment for prostate problems, including slow urine stream, frequent urination at night, difficulty emptying the bladder, and other problems to patients within driving distance to our offices as well as from other states and countries. Our patients come from New York, New Jersey, Pennsylvania, Connecticut, and over 70 countries worldwide.

    Does Prostate Cancer Have Any Symptoms

    Most men with early prostate cancer dont have any signs or symptoms.

    One reason for this is the way the cancer grows. Youll usually only get early symptoms if the cancer grows near the tube you urinate through and presses against it, changing the way you urinate . But because prostate cancer usually starts to grow in a different part of the prostate, early prostate cancer doesnt often press on the urethra and cause symptoms.

    If you do notice changes in the way you urinate, this is more likely to be a sign of a very common non-cancerous problem called an enlarged prostate, or another health problem. But its still a good idea to get it checked out. Possible changes include:

    • difficulty starting to urinate or emptying your bladder
    • a weak flow when you urinate
    • a feeling that your bladder hasnt emptied properly
    • dribbling urine after you finish urinating
    • needing to urinate more often than usual, especially at night
    • a sudden need to urinate you may sometimes leak urine before you get to the toilet.

    If prostate cancer breaks out of the prostate or spreads to other parts of the body , it can cause other symptoms, including:

    • back pain, hip pain or pelvis pain
    • problems getting or keeping an erection
    • unexplained weight loss.

    These symptoms can all be caused by other health problems. But its still a good idea to tell your GP about any symptoms so they can find out whats causing them and make sure you get the right treatment, if you need it.

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    What Are The Causes Of Frequent Urination In Men With Enlarged Prostate

    The most common cause of frequent urination and man with an enlarged prostate is incomplete bladder emptying. As a result, if the urinary bladder empties only halfway, it takes only a short period of time sometimes as little as 20 minutes to a few hours depending on how much you drink for a bladder to fill up again.

    Enlarged prostate blocks urine flow, the urinary bladder needs to push hard to overcome resistance from the prostate to empty urine. This makes the bladder irritated and leads to frequent and premature urge to urinate. These symptoms of overactive bladder are a result of prostate obstruction. Prostate enlargement can also cause intermittent urination and inconsistent urine flow.

    In the long-term, enlarged prostate can lead to the thickening of the bladder wall due to the need to push hard. This can lead to a decrease in the bladder ability to store a high volume of urine. The bladder cannot hold as much urine as it used to in the past. As a result, the small capacity bladder fills fast and men feel the need to urinate frequently.

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    Male Incontinence After Prostate Surgery Or Radiation

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    Incontinence is one of the major complications after a prostate cancer treatment. The rates of incontinence after radical prostatectomy are estimated to be between 5% up to 35% and after radiation therapy between 5 to 10%.

    Risk factors for incontinence after prostate cancer treatment include the patients age as well as prior urinary symptoms. Generally older patients tend to have a higher risk of incontinence than younger patients and patients who have had prior urinary symptoms are at higher risk for having incontinence also.

    Probably the two most important factors are the extent of cancer and the experience of the surgeon doing the radical prostatectomy. More aggressive cancers often require a wider resection to be cancer free. The wider resection increases chances of damage to the urinary sphincter which in turn increases the chances of incontinence. Surgeon experience is critical as well with high-volume prostatectomy surgeons having better outcomes than low-volume prostatectomy surgeons. One of the best ways to minimize the chances of incontinence after your surgery is to pick the right surgeon before surgery.

    Other tests that can be useful include cystoscopy and videourodynamics to evaluate sphincter and bladder function.

    In patients who have a predominance of urge incontinence medical treatment such as overactive bladder medications or even Botox injected into the bladder can be useful.

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