How Bladder Training Can Help
After going through bladder training, you should be able to:
- Go longer periods of time between bathroom visits
- Hold more liquid in your bladder
- Have more control over the urge to go
Although you probably want to see results right away, be patient. Bladder retraining can take six to 12 weeks to be successful.
If youve been trying bladder training for several weeks and it still isnt working, check back in with your doctor. You might need to try other approaches, like medication or surgery.
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Post Prostatectomy Urinary Incontinence: How Its Treated
Despite improvements in surgical techniques, and robotic assisted prostatectomy in particular, there is still a risk of urinary incontinence following prostate cancer surgery. This type of incontinence is known as Post Prostatectomy Incontinence .
PPI can affect daily life from how able you are to work, to how confident you feel in social situations. It can feel embarrassing, stressful to manage, and incredibly isolating.
King Edward VIIs Hospital consultant urologist Mr Jeremy Ockrim takes some time out to discuss how treatment for prostate cancer can lead to urinary incontinence, and what the treatment options are.
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What Are Pelvic Floor Exercises And Can Improve Erection Quality
As we age, we lose muscle tone throughout your body. That includes the muscles that men need to maintain erections. However, there are physical exercises men can do to reduce erectile dysfunction. The best ones are known as pelvic floor exercises or kegels.
Those muscles are the core of how your body maintains blood flow to the penis and therefore keeps erections strong.
They put pressure on the veins in your penis, preventing blood from flowing back into the rest of your body. If they arent strong enough then even if you can get an erection, you wont be able to keep it.
The process starts with identifying the muscles you need to activate. Thats best achieved by lying down with knees bent and feet flat on the floor. Thats when you breathe out and squeeze your pelvic floor muscles for 3 seconds.
Its important that you identify the right group, at the base of your buttocks, on either side of your perineum. It can be easy to mistake other muscles, such as the legs or stomach for the pelvic floor.
Once you are confident you have the right muscle group, then doing the exercises in a seated or standing position three times a day can firm and strengthen the muscles, with a likely improvement within four to six weeks.
Some men find that after the initial strengthening that options like Pilates become appealing as not only are there many exercises which improve the pelvic floor, but they can improve overall posture and strength.
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Prostate Specific Antigen Blood Tests
- Have a PSA blood test done at the following times:
- 6 to 8 weeks after surgery
- 3 to 6 months after surgery
- 12 months after surgery
If you can, have your PSA blood test done at a MSK location. If you cant have it done at a MSK location, you can go to a medical office closer to where you live. Have the results faxed to your MSK doctors office.
MSK doctor: ___________________________
Does Incontinence Happen If I Treat Prostate Cancer With Radiation
Some men need radiation therapy after prostate removal. During radiation therapy, some of the normal tissues around the urinary sphincter, urethra and bladder may be exposed, causing irritation to occur post therapy, leading to incontinence. This typically subsides within a few months after radiation therapy, however if it persists, additional treatments described below may be helpful.
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Basic Men’s Kegel Exercise Routine For Incontinence After Radical Prostatectomy
In order to get the most from your kegels, you need to do 3 sets, 3 times a day. Just like lifting weights to gain strength for any other muscle group, you cannot expect to do these sometimes or every once in a while and get the outcomes you want. It can take up to 8 weeks to notice the effects of consistent exercise on muscle growth , and your pelvic floor muscles are no different, especially when they need to grow to fill a void.
3 Sets, 3 Times a Day
- 10 Kegels – Contract your pelvic floor muscles and hold for 10 seconds, then relax your pelvic floor muscles back to their resting position
- 10 Quick Flicks – Complete these are your 10 kegels for optimal effect. Contract and relax your pelvic floor muscles 10 times in just 10 seconds, each one should last no longer than 1 second
-FYZICAL Therapy & Balance Centers of Oklahoma City
FYZICAL Therapy & Balance Centers of Oklahoma City provides pelvic floor physical therapy in Lakeside, The Village, Nichols Hills and surrounding NW Oklahoma City. Our pelvic floor physical therapists are specially trained to treat all types of pelvic floor dysfunction including incontinence after radical prostatectomy in men. Our practitioners take a patient-centered individualized approach that focuses on your pelvic health needs. If you are unsure about your pelvic health, or you want to see the FYZICAL Difference for yourself, schedule a free consultation today.
Post A Question On Our Forum To Receive Expert Advice
Its rare that men experience long term incontinence after prostate cancer treatment. As a general rule, if your incontinence symptoms last over a year, you should contact a Doctor. There are a number of procedures that exist to restore continence if you do find yourself with long term incontinence.
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Comparing Robotics Vs Open Continence Outcomes
There are few head-to-head comparisons of open versus robotic surgery performed by the same surgeon at the similar points in their learning curve or case experience. It would be easy to skew the comparison in favor of the robotic camp by cherry-picking a handful of favorable robotics series and several low quality open radical prostatectomy studies. It is more informative to take an honest look at all of the available literature and analyze the outcomes data from the highest quality available studies from the top robotic and open surgeons. When analyzing these data from high volume surgeons where the technique from case to case is nearly identical, we have technical data so-to-speak, that is, data which is more influenced by surgical modality and operative technique than by patient factors. We must also review, however, bread-and-butter studies, which are more representative of the experience the average patient will have in a general community surgeon practice. The reality is that many patients are not having their operation done at the high volume academic centers from the top tier surgeons who are writing the papers from which we are extracting this data.
The Long Wet Road Back To Normal
Incontinence after radical prostatectomy sucks. But for nearly all men, it goes away. For the very small percentage in whom it doesnt, there is help.
JP Mac is an Emmy award-winning animation writer who worked for Warner Bros. and Disney, and a novelist. He is also very funny.
So, when he wrote a short ebook about his experience with prostate cancer including his diagnosis in 2014 at age 61, the rush to find the right treatment and get it done before his health insurance was going to expire, his laparoscopic-robotic prostatectomy and the complications afterward, and his five-month battle to recover urinary continence after the surgery he could legitimately have written a soap opera, or maybe even a tear-jerker but he didnt.
Instead, his ebook has a title that sounds like 1950s pulp fiction: They Took My Prostate: Cancer, Loss, Hope. Its not Prostate Cancer Lite, and it doesnt minimize what he or anyone else has gone through to get back to normal after radical prostatectomy. Far from it in fact, his short, hopeful essay is a testament to what it takes to recover from this difficult but life-saving surgery: a balanced perspective, a good sense of humor, a great support system, and plain old hard work and persistence.
Heres a message you hardly ever hear about prostate cancer, or any illness, for that matter: Its okay to laugh! That doesnt mean its not scary, and that it doesnt wear you down, or that youre not afraid you wont ever get back to normal.
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What If The Incontinence Does Not Improve Or Is Bothersome
If you have a bothersome amount of incontinence or if it does not improve with the above measures, many men will benefit from seeing an incontinence practitioner. There is a wide range of treatments available.
Once you decide to see an incontinence practitioner, be prepared to answer questions regarding the type of symptoms you are having, the number and type of pads you might be using, and previous treatments you have had for prostate cancer and for incontinence. You should be honest about how much the incontinence bothers you, and how willing you are to have additional treatments, potentially including surgical procedures.
During your first visit, the incontinence specialist will take your history and perform an exam. You will likely be asked to give a urine sample to rule out infection or blood in the urine. A “bladder scan” is often done in the office to see if you are completely emptying your bladder when you urinate.
The incontinence specialist will likely discuss more conservative treatments at first. A more rigorous pelvic floor exercise program might be recommended. You may also be given a biofeedback machine that allows you to see how strong your pelvic floor muscles are. The specialist may also discuss various medication therapies.
How Long Will I Be Incontinent After Prostate Surgery
There are two types of surgery for urinary incontinence : the urethral sling and the artificial urinary sphincter. Usually, the incontinence needs to last for about one year after the prostatectomy to be sure there is not going to be further improvement before your healthcare provider suggests this type of therapy.
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Urinary Control Or Continence
Loss of continence is one of the most stress-producing potential side effects of radical prostatectomy because urinary functions are so frequent throughout the day and dysfunction brings into embarrassing highlight what was for most of a mans life an unconscious function requiring little attention.
What Happens With Incontinence After Radical Prostatectomy
Without a prostate to support your urethra and bladder, your pelvic floor muscles have to compensate. They need to get strong enough so that you can make up for some of the lost support that occurs after the radical prostatectomy. In order to gain strength in your pelvic floor, you need to do your pelvic floor muscle contractions or Kegels.
Just like a bodybuilder is going to go do exercises for the whole body so that they have a good tone, that’s what you’re doing for your pelvic floor. You are bulking up your pelvic floor to give yourself support, so that you stop leaking.
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How Long Does It Take For Nerves To Heal After Prostate Surgery
How long does nerve regeneration take? Recovery of potency may be very rapid in younger patients and is sometimes immediate. However, for most patients the recovery is gradual and can take up to 3 years to plateau, although typically a patient sees a return to erectile function after about 12 months.
‘just Cant Wait’ Card
You can get a card to show to staff in shops or pubs etc. It allows you to use their toilets, without them asking awkward questions. You can get the cards from Disability Rights UK or the Bladder and Bowel Community. They also have a map of all the public toilets in the UK.
You could get a key to disabled toilets if you need to access them quickly. You buy the RADAR key from Disability Rights UK. But this should only be used by people who need quick access to a disabled toilet due to a disability or medical condition.
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Continence And Bladder Function
Terry achieved continence 9-10 weeks after the catheter was removed. He stopped using pads at night during week eight, and 10 days later stopped using a pad in the day. Overall, he was continent fewer than 12 weeks after the operation.
Now, six months after surgery, Terrys bladder capacity is now around 400ml and his urine flow is excellent. There is no hesitancy or intermittent stream and no post-micturition dribble. He occasionally experiences urinary urgency but does not see it as a problem as he can hold on until he reaches the toilet.
Terry is positive about the future and, between PSA tests and hospital appointments, we are living life to the full. He feels his bladder function is good but knows the importance of continuing with the pelvic floor muscle exercises.
What Is Urinary Incontinence
Urinary incontinence is the involuntary leakage of urine.
In some cases, leakage only occurs in men when they jump, cough, sneeze or laugh. In other cases, leakage can be more severe or continuous, or may occur because they cant get to the toilet in time.
Stress Urinary Incontinence or stress incontinence, is a type of urinary incontinence that happens with physical movement or activity. SUI occurs when control over the external urethral sphincter is damaged or weakened.
Urge incontinence is when you feel the sudden need to urinate but you dont always make it to the toilet in time. It can happen as a result of damage to the bladder or nerves that control the bladder.
Either way, it will be a relief to know that urinary incontinence, no matter how severe, can be treated.
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Are There New Techniques That Minimize The Chance Of Becoming Incontinent
When removing the prostate, surgeons attempt to conserve as much of the area around the sphincter and the bladder muscles around the urethra as possible, hence curbing damage to the sphincter.
Surgeons have likewise fine-tuned the procedure of putting radioactive seed implants, utilizing advanced computer system forecasts that permit the seeds to damage the prostate while limiting damage to the bladder.
Still, at this point, any male who is going through radiation or surgical treatment to deal with prostate cancer needs to anticipate establishing some issues with urinary control.
Some men will have just temporary issues managing their urine, and lots will gain back complete control of their bladder in time.
What If These Treatments Do Not Work
If these interventions do not work, you may be referred to a urologist for additional tests on your bladder and sphincter. These tests will determine what type of incontinence you have, how well your bladder is working, and what other treatments might be best for you. This often involves a urodynamic test and a cystoscopy. Both of these procedures are performed in the office, usually during the same visit. They provide your urologist with specific information to help find which procedure might be best for you.
The urodyamics test involves placing a very small catheter in your bladder. This catheter fills the bladder with fluid and measures bladder activity and pressure during filling and voiding . You will also be asked to cough and strain so your provider can see if and how easily you leak urine.
A cystoscopy may also be performed to look at the urethra, the anastomosis , and the bladder. After these tests, your provider will go over the results with you and recommend which treatments are best suited for your condition.
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Thread The Needle: 1 X 15 Reps
Again, more mobility for your thoracic spine but this time by adding in rotation movements. This exercise will feel great in your upper back to reduce joint stiffness. If you have a foam roller this can be helpful to get more range of movement. Push down on it with the back of the forearm during the rotation movement.
Table : Impotence And Incontinence
The reported statistics on the likelihood of developing impotence or incontinence after prostate cancer treatment vary widely, as shown by the ranges below.
Procedure 30%50% 2%
How did the operation go? And when did it become apparent that you might take longer to recover than you had been led to believe?
The operation went fine. I went back to work very quickly, and in most respects I felt fine. I was incontinent immediately after surgery, but I was led to believe that the problem would straighten itself out within a few weeks or months. But it didnt.
Did you share your concerns about incontinence with your surgeon?
I did, during follow-up visits after the surgery. I probably visited him three to four times during the first six months after surgery. He told me the problem would get better, and for the first month or two, I believed that. But as time went on, nothing was getting any better.
And he didnt seem to care. In a typical visit, I waited a half hour or an hour to see him for literally five minutes, and then he moved on to the next person. So I finally gave up on him.
What sort of problems were you experiencing?
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