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 Percentage of men who may develop impotence Percentage of men who may develop incontinence Radical prostatectomy 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?
Treating Male Incontinence By Strengthening The Pelvic Floor
A common misconception is that men dont have a pelvic floor, which isnt the case! Like women, men also have a pelvic floor, which among other things, is responsible for bladder control. The pelvic floor is made up of a complex set pelvic floor muscles, which, when exercised, can be strengthened for greater control.
There are many ways to manage and treat incontinence in men Post Prostate Cancer surgery including:
- Pelvic Floor Exercises
- Pelvic Floor Stimulation
INNOVO offers a compelling Urinary Incontinence treatment option for men. Easy to use, comfortable to wear, and clinically proven to work, INNOVO is a completely non-invasive male incontinence treatment that helps you safely and effortlessly strengthen and re-educate the entire network of pelvic floor muscles through gentle muscle stimulation.
Using INNOVO for just 30 minutes p/day, five days p/week has been proven to treat bladder weakness, and in as little as 4 weeks1. There are no probes to insert, just pull on the shorts, connect the controller and let INNOVO do the hard work for you. And best of all, it actually works. A clinical study found that:
- 80% of users saw a significant reduction in leaks after just 4 weeks3
- 87% of users were defined as either dry or almost dry after 12 weeks4
- 90% of users would recommend the therapy to others5
INNOVO is suitable for use by women and men of all ages, and effectively treats stress, urge and mixed incontinence in the privacy of your home.
Is It Possible To Treat Urinary Incontinence After A Prostate Surgery
Professionals suggest noninvasive surgeries and muscle strengthening exercises for the pelvis if the problems persist. These therapies and solutions help reduce the number of times you need to go to the bathroom to urinate. However, this solution works best for people who have mild symptoms.
Patients who cannot stop urine from leaking may need surgery besides using pads, incontinence wipes, or similar products for the problem. Let us take a look at these solutions in detail.
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How Can Prostate Surgery Affect Urination
Prostate surgery may be a partial or radical prostatectomy, which is the removal of some or all of the prostate gland, respectively. This is a very delicate operation, and the urethra, bladder, rectum, or urinary sphincter may become damaged in the process.
Moreover, the nerves and muscles in the area may also become damaged. All of this can cause urine to leak, especially when stress is put on the area. You can easily see why stress urinary incontinence is so common after having prostate surgery.
What A Prostatectomy Entails
A prostatectomy is the partial or full removal of the prostate gland. It is a common treatment for prostate cancer that hasnt spread outside the prostate. Men with benign prostatic hyperplasia, a non-cancerous enlarged prostate, may also have this surgery.
The prostate sits just below the bladder. The urethra the tube that carries urine out of the body runs directly through the prostate. Pressure from the prostate helps hold urine in the bladder.
The result is a lack of control over urine flow, or incontinence. In general, older men have more problems than younger men with incontinence after prostatectomy.
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Is It Normal To Have Urinary Frequency After A Turp
Urinary frequency after TURP is a common occurrence. Yes in many cases it will settle down, but in others it may not. That is why some men have serious long-term side effects.
TURP Surgery What is a TURP ? Transurethral Resection of the Prostate , is a surgical procedure used to treat urinary symptoms due to BPH .
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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.
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What Kinds Of Surgeries Treat Urinary Incontinence After Your Prostate Is Removed
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.
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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Does Incontinence Go Away On Its Own After Prostate Surgery
For most men, urinary incontinence will go away within about 1 year. The time frame varies depending on how severe your incontinence is, and what types of treatments youre using to manage it. Some men may recover from leaks within weeks, whereas others will take months for the bladder leaks to subside. Performing pelvic floor exercises, also known as Kegels, which help strengthen the muscles that are located in the base of the pelvis between the pubic bone may help to speed the recovery process along.
Do All Men Have Incontinence After Radical Prostatectomy Surgery
No, most men see a quick improvement in continence over the first several months after the catheter is removed, but incontinence can remain troublesome in some men 1 year after surgery. Most surgeons will consider a man continent if they do not regularly use incontinence pads and only have occasional dribbling with lots of activity. Most importantly, however, is how bothersome your urinary incontinence is to you, as our goal is to improve your quality of life as much as possible.
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Urinary Incontinence And Prostate Problems
When the urine reaches the bladder from the kidneys, it gets stored in small valves, called sphincters, that only open when your body signals them to do so. Surgeons need to remove one of the valves when they remove the prostate during the procedure.
Although one valve is enough for the body to control urination, men usually have urinary trouble after prostate surgery. Almost 6-8 percent of men experience this problem after prostate surgery.
Treating Post Prostate Surgery Urinary Leakage
Your treatment for post prostate surgery urinary leakage will depend on the length of time the problem persists and the degree of leakage you experience. No matter the severity of your condition, Tampa General Hospitals urology experts are equipped to find the best solution for you. Men with mild to moderate leakage after the surgery are often recommended the following treatment options:
- Physical therapy
- Pads or adult diapers
If the problem persists or the leakage worsens, surgery may become an option. There are two low-risk surgical procedures used to treat this kind of urinary incontinence:
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Practice Good Toilet Habits
Go to the toilet when your bladder feels full dont get into the habit of going just in case. After prostate surgery you may find that you do not experience the sensation of a full bladder. The sensation of a full bladder will gradually return as you are able to hold on longer. It is important to practice holding on to increase the amount of urine your bladder can hold.
Managing Stress Urinary Incontinence
While your body is healing after the surgery, you will want to wear absorbent pads in order to prevent urine leakage onto your clothing or the bed. Patients who are overweight are encouraged to lose weight since excess weight can press on the bladder and worsen stress urinary incontinence.
Engaging in light physical activity is usually recommended by doctors. Diuretics such as coffee, tea, and alcohol should be reduced or avoided altogether. If your urinary incontinence also happens at night, it is recommended to avoid consuming liquids two hours before bedtime.
Special exercises to strengthen the pelvic muscles, such as Kegel exercises, can also help with improving bladder control. Your doctor can explain how and how often to do these exercises.
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Questions To Ask Your Doctor Or Nurse
- Is the treatment Im having for prostate cancer likely to cause any urinary problems?
- What type of urinary problems might I get?
- What should I do if I cant urinate?
- Will my urinary problems get better?
- What treatments are available?
- What are the risks and side effects of treatments for urinary problems?
- What can I do to help myself?
- Where can I get pads and other products?
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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Problems After High Intensity Focused Ultrasound
Youre more likely to get urinary problems after HIFU if youve already had other treatments for prostate cancer. Possible urinary problems include:
- difficulty urinating
- urine infections.
Difficulty urinating
HIFU usually causes the prostate to swell for a week or two, so youll have a catheter to drain urine from your bladder until the swelling has gone. HIFU can also cause the urethra to become narrow, making it difficult to empty your bladder .
Leaking urine
HIFU can cause some men to leak urine when they cough, sneeze or exercise . This may be more likely if youve already had radiotherapy. There are ways to manage leaking urine.
Urine infections
Some men get a urine infection after HIFU. If this happens, youll be given a course of antibiotics to clear the infection.
‘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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What Treatment Is Available
Youll likely start preemptive treatment with pelvic floor muscle trainingexercises that strengthen the muscles that control urinationbefore surgery. These exercises should also be done right after surgery and continued during recovery.
Kegel exercises, for example, are an important part of strengthening muscles that control urine flow. A physical therapist can help patients learn how to tighten and relax these muscles. Physical therapy may also include strengthening core muscles, including muscles in the back and abdomen that also help control urine. Once you learn these exercises, you can do them throughout the day.
For men who have significant stress incontinence that continues past six to 12 months, two surgical procedures may help.
- Male urinary sling procedure may help with mild to moderate incontinence.
- Artificial urinary sphincter surgery is used for men with more severe incontinence.
Male urethral sling surgery: This is often the first surgery to treat mild incontinence, or incontinence that requires no more than two to three absorbent pads per day. During this procedure, a man-made tape, called a mesh, is placed around the urethra to move it into a position that makes it easier to control urine flow. Repositioning the urethra gives a more natural sensation of the urge to pass urine. This procedure can be done through a small incision in the perineum or in the groin. This surgerys success rate is good, but results may decline over a number of years.
Current Management Of Post
- 1Urology Department, Uniklinik RWTH Aachen, Aachen, Germany
- 2Maastricht University Medical Center , Maastricht, Netherlands
- 3Bucharest University Emergency Hospital, Bucharest, Romania
- 4Division of Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
- 5Mainz University Hospital, Mainz, Germany
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How Long Does It Take For Turps To Come Out
TURP recovery is usually complete after two months. Men who still have trouble voiding urine may need to stay on medications or undergo additional surgeries. Occasional checkups with a doctor are important to keep a close eye on changes in prostate health.
If you have no control post op it could be one of four things going on: You could be in retention causing urinary frequency, urgency and incontinence.
How Does The Smart Technique Spare The Urinary Function
Employing the da Vinci System, he uses his own SMART to remove the prostate and spare urinary and sexual functions. At the beginning of surgery, Dr. Samadi does not suture the dorsal vein complex, allowing him to control the length of the urethra. The more urethra he can leave, the less incontinence and leaking a man will experience after surgery. Further, with robotic surgery a catheter is only needed for roughly one week following surgery, so the patient is more comfortable and there is less trauma to normal urinary function. Sexual performance is also preserved because Dr. Samadi does not open the endopelvic fascia during surgery. Leaving this tissue intact spares the nerve bundles that control sexual function.
A study was published on this subject, explaining urinary incontinence after prostate surgery.
It is important to accept that most men will experience some degree of urinary incontinence after prostate surgery. This is not an indication of long-term damage. Regaining urinary control can take several weeks or months and some men dont reach their full recovery capacity for a year or more. Age, weight and previous urinary issues are also factors in recovery time. Patients of Dr. Samadis who experienced normal continence prior to surgery can expect to regain urinary control within 12 to 13 months.
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How Might Surgery For Prostate Cancer Cause Urinary Incontinence
There are several different treatment options for men with prostate cancer and not all men with prostate cancer need to have surgery.
The main options for men with aggressive prostate cancer are:
- Surgery to remove the prostate, which is called radical prostatectomy
- External radiotherapy
- High Intensity Focussed Ultrasound .
Each case is different and your specialist doctor will discuss your options with you.
Treatment to remove or destroy the prostate can damage nerves and the external urethral sphincter . This then causes stress incontinence.
Damage to the bladder following treatment for prostate cancer can also cause bladder storage problems resulting in urge incontinence symptoms.