Urinary Incontinence After Prostate Surgery: Everything You Need To Know

Incontinence After Prostate Surgery

Undergoing a prostatectomy (removal of the prostate due to cancer) can be difficult. And for many men, finding that they are incontinent post surgery may come as a shock.

But rest assured that there are many treatments available to manage incontinence treatment after surgery. Read below for some of the most common questions we receive about incontinence after prostate surgery.  

What causes incontinence after prostate surgery?

Urinary incontinence is a potential side effect of prostate removal surgery. The prostate surrounds the bladder. Removing it, or using radiation to treat it, can sometimes cause damage to the nerves and muscles of the bladder, urethra, and or sphincter, which controls the passage of urine from the bladder. This can result in urinary incontinence.

Is Incontinence Normal After Prostate Surgery?

Approximately 6-8 percent of men who have had surgery to remove their prostate will develop urinary incontinence. (Cleveland Clinic) The good news is that most men will eventually regain bladder control with time.

How bad is incontinence after prostate surgery?

The degree of incontinence varies from person to person and can be anywhere from full on incontinence, to light dribbles. And, the amount you leak right after surgery will likely lessen as you continue with your recovery and any additional bladder or pelvic floor treatments you may be doing.  

How long will I have incontinence after prostate surgery?

Most men who experience a loss of bladder control have symptoms for 6 months to 1 year post prostate surgery. However, a small percentage of men may continue to experience problems past the one year mark.

Does incontinence go away on its own after prostate surgery?

For most men, urinary incontinence will go away within about 1 year. 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.

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.

How can I improve incontinence after prostate surgery?

Want to stop incontinence after prostate surgery? Kegels may be your answer! As mentioned above, kegels are a common treatment option for incontinence after prostate surgery.  Among other things, the pelvic floor muscles help control bladder and bowel function and, like other muscles of the body, if they get weak they are no longer able to do their job effectively.  To improve muscle function, kegels must be done regularly, every day. The good news is that they can be performed pretty much anywhere, anytime, and in a variety of positions (sitting, standing, lying down, etc.). For a complete guide on performing a men’s kegel, click here.)

Biofeedback can sometimes be used to determine if you are performing a kegel properly. And, electrical stimulation may also be used to help re-teach the muscles to contract.

What treatments are available to me if my incontinence doesn’t go away after a year?

While kegels and behavioral therapy work well for most men with mild to moderate leaking, they may not be completely effective for some. Luckily, there are still some options for treating bladder leakage after prostate surgery.

Another surgery is sometimes needed when bladder leaks persist for more than a year after surgery. This may consist of having a urethral sling procedure, or an artificial urinary sphincter.

With a urethral sling procedure, a synthetic mesh tape is implanted to support the urethra. Up to an 80% improvement has been seen with this procedure and some men stop leaking completely.

An artificial urinary sphincter is used in patients who have more severe urinary incontinence that is not improving, or for those patients who may have had a lot of damage to the sphincter muscle after prostate surgery. An artificial urinary sphincter is a mechanical ring that helps close the exit from the bladder.

As will all surgeries, these come with pros and cons and potential complications. Be sure to discuss these options with your doctor. 

Incontinence after prostate surgery forums.

Going through prostate cancer and having your prostate removed can be a physically and emotionally trying time in life. Many men are unprepared for the extent to which they may experience bladder leaks after prostate removal and it can be disheartening to have undergone surgery only to experience a loss of bladder control for a period afterward.

Fortunately, this is usually resolved within a year. During that time though, you may find that you need someone to talk to about your experience. Finding a forum or message board filled with people who can relate can help ease some of the tensions that you may be going through. 

The NAFC message boards are a great way to connect with others who may also be experiencing incontinence, due to prostate surgery or other conditions.  They’re free to join and the forum is anonymous so you can speak freely without the worry of feeling embarrassed or ashamed. NAFC is proud of this amazing group of individuals who visit the forums and courageously share their stories, offer support, and provide inspiration to each other. We encourage you to check it out!

Your Guide To Treating Incontinence

Your Guide To Treating Incontinence

For many of us, January is a time for setting resolutions – A blank slate where we can rewrite a new reality for ourselves. For those with incontinence, knowing where to start treatment can be one of the biggest challenges.  Luckily, we’re here to help.

Treatment for incontinence has come a long way in recent years.

Here’s a breakdown of steps you can take right now, as well as some more advanced options to look at for the future.

1. Manage incontinence with adult absorbent products.

Managing your incontinence is much different than treating your incontinence, but it is the logical first step. After all, you need to find some way to stay dry until you can properly address the issue. For most people, management will consist of a few things – finding a good absorbent product that works, and watching your food and drink intake to see if there are certain triggers that may make your incontinence worse. Management is a first step, but definitely not the last - while both of these can do wonders in helping you control the symptoms of incontinence, they’re not really addressing the true problem.

2. Behavioral Therapy

Along with diet and exercise, there are several other things you may want to try when treating incontinence. Bladder and bowel retraining – which literally involves training your muscles to hold urine or bowel movements for longer more controlled periods of time – are a good step to try and improvements can often be seen in several weeks.  In addition, many people see vast improvements from physical therapy. A qualified physical therapist (usually specialized in treating the pelvic floor) can give you an examination, pinpoint areas of weakness or tension, and provide a customized treatment plan designed to address your muscle strength or weakness. (Need help finding a PT? Check our Specialist Locator.)

3. Medications.

If behavioral modifications don’t yield the results your looking for, medications may be your next option. Most medications for bladder control work by relaxing the bladder muscles and preventing the spasms that sometimes accompany overactive bladder and incontinence. These work differently for everyone, and can sometimes produce unwanted side effects though, so talk to your doctor about your options before settling on one.

4. Advanced Therapy Options

If medications don’t work for you, or you don’t like the side effects that they present, there are still other options. InterStim and Botox injections are two of the more advanced, yet very effective procedures available.   InterStim, also known as sacral neuromodulation, works by stimulating the nerves that control your bladder, bowel and rectum, and the muscles related to urinary and anal functions (the sacral nerves). InterStim stimulates these nerves with a mild current, which helps your bladder/bowel/rectum work as they should.  Botox, treats overactive bladder symptoms by calming the nerves that trigger the overactive bladder muscle. Both procedures are fairly simple and take about an hour to complete.

5. Surgery.

For some, surgery may be an option. There are several types of surgeries that address stress urinary incontinence.  These procedures are intended to help correct a weakened pelvic floor, where the bladder neck and urethra have dropped. The most popular procedure is to use a sling, which serves as a “hammock” to support the urethra. Surgical slings may be used in both men and women who experience stress incontinence, and also women who have experienced pelvic organ prolapse. There are many types of sling procedures so be sure to talk to your doctor about your options and research what is right for you.

The most important thing to remember when exploring incontinence treatment is that you have options. Talk to your doctor about your wishes and work together to find a treatment that works for you.

Surgery For Overactive Bladder

Surgical Options For Overactive Bladder

Overactive Bladder at its best (is there really such a thing?) can be annoying. The constant running to the bathroom can be frustrating to say the least. But at its worst, OAB can be debilitating. Those with severe OAB make multiple trips to the bathroom a day and even night, and many times may have embarrassing accidents too.  It can cause anxiety in social situations, limit interaction with friends and family, and can even negatively affect a person’s work. If you think you’ve tried everything and it hasn’t worked for you, surgery may be an option.

Surgery is typically a last resort for most people and should be considered only after more conservative options, such as behavioral modifications, medication or even advanced therapies like Sacral Neuromodulation have failed.  The surgeries listed below are often done on women who no longer wish to have children, as childbirth can often remove many of the benefits of surgery.   

What types of surgeries are available?

Augmentation Cystoplasty

This procedure increases the size of the bladder, enabling the bladder to store more urine. A small amount of tissue is typically taken from the intestine and added to the wall of the bladder to make it bigger. In some cases, a catheter may be needed after this surgery has been performed.

Urinary Diversion

This procedure takes the tubes that lead from the kidneys to the bladder, and reroutes them through the abdominal wall to the outside of the body. Urine is then collected in an ostomy bag – a specially designed bag to be worn on the abdomen. While this option does require maintenance (emptying the bag, keeping the area clean and safe from infection) it does allow an active life post surgery. 

Sling Procedure

Vaginal sling procedures are surgeries that help control stress urinary incontinence, which happens when you leak urine upon coughing, laughing, sneezing, lifting or exercising. The basic concept of a sling is to place a strong piece of material beneath the urethra as a supporting “hammock”. During the procedure, physicians use a sling placed around the urethra to lift it, or the bladder, back into a normal position.

There are many different types of sling procedures, as well as a number of different sling materials available, so talk to your doctor about your options, as well as the pros and cons for each one.

Is surgery for me?

The decision to have surgery can be difficult, as there are pros and cons with each procedure. But, if your OAB symptoms are severe, and you have tried all other options, surgery may be right for you. Be sure to talk with your doctor about all of your options, including what the procedure is like, the materials used, the pros and cons of different surgical options, and the recovery times for each.  It’s also important to talk with your doctor about what you can expect after surgery, as not everyone is completely cured from incontinence after these procedures.  A frank discussion with your doctor, and your own research on surgical options can help you decide if this is a path you would like to consider.

 Learn more about surgery options for OAB in our 6th and final video of our series on managing Overactive Bladder. 

Patient Perspective: Nick's Story

Nick's Story - Incontinence After Prostate Removal

In August of 2015, I underwent surgery to have my prostate removed.  I had been diagnosed with prostate cancer the year before and my doctor had been closely observing me since then. 

When it seemed that my cancer was growing more quickly than he liked, he suggested surgery.  “Afterall”, he said, “you’re only 63.  You can still have a long life without worrying about this.”

So, after a lot of research, I went for it.  I knew there would be complications afterward, but incontinence was not something that I had anticipated being that big of a deal.  I thought I’d probably have to wear diapers for a couple of weeks and that would be the end of it. 

Boy was I wrong. 

Nine months later and I was still having a difficult time making it to the restroom.  It was so embarrassing as a man to face this problem. I couldn’t do the things I wanted to because I was scared of having an accident or a leak, and I felt ashamed of the bulky diapers that I was forced to constantly wear. 

I finally made an appointment with a surgeon in May to discuss a sling procedure and will be having the procedure done next month.  I’m hopeful that this will be a solution for me so that I can get on with my life and get back to doing the things that are important to me. 

Nick W., Houston, TX

What To Expect After Pelvic Floor Reconstruction

What to expect after pelvic floor reconstruction surgery for pelvic organ prolapse

The decision to undergo pelvic reconstructive surgery to correct pelvic organ prolapse (POP) can be difficult. Women often wait years dealing with symptoms of POP before they commit to surgery. Aside from decreasing symptoms of prolapse, a desired outcome of pelvic floor reconstruction is for the woman to be able to return to her active life. Likely, the surgeon has provided some information about do’s and don’ts, but this is usually related to immediately post-surgery.  Most pelvic floor surgeries require an initial 6 to 8 week rest period —keeping activity very light—no sexual intercourse, no heavy lifting, no running etc.

But after the initial rest period, then what? Are there activities to avoid or limit? How much is “too much” to lift?  Should anything be avoided altogether? Medical literature tells us that 30% of women may require a second surgery at some point in the future due to failure of the first or because of another pelvic problem.1 Yet, there is little information on improving outcomes in order to prevent another surgery. Most surgeons use a common-sense approach in advising their patients, and if a woman has specific questions or concerns, she is always advised to ask her surgeon. The surgeon has the best understanding of how the procedure went and in what shape the woman’s pelvic tissues are.

The primary cause of POP is trauma to the pelvic floor muscles (PFM,) connective tissue or “fascia” and ligaments. These structures become unable to support the pelvic organs. The majority of women undergoing surgery sustain tissue injury from childbirth trauma.  More rarely, women may develop severe prolapse due to extreme increases in intra-abdominal pressure (IAP) for other reasons.  Examples include illnesses that cause chronic coughing or performing frequent Valsalva maneuvers (straining) such as with chronic constipation.

In attempting to identify risk factors and make post-surgical recommendations, research has determined that indeed, the two things that increase IAP and vaginal pressure (VP) the most are coughing and Valsalva maneuvers. Most of these studies compared pressure measurements during everyday activities like supine lying, standing, lifting, running, coughing and straining. According to the research, many things increase IAP; just getting out of bed will mildly increase IAP, as will lifting moderate weight and running. One study went so far as to say that many post-surgical guidelines are “needlessly restrictive.”5 The researchers found that in subjects without pelvic floor problems tasks such as lifting eight to 20 pounds off a counter, lifting 13 pounds from the floor, walking briskly, performing crunches all produced no more increase in IAP than getting out of a chair. They summarized that “how lifting is done impacts intra-abdominal pressure.” The good news is, that the research, found that unless a woman has a chronic cough condition or habitually performs Valsalva maneuvers, everyday stressors like standing, walking, lifting normal weight, sexual intercourse and running should be okay post pelvic surgery.

Women seen by a specially trained pelvic physical therapist (PT) after surgery are taught strengthening exercises and postural strategies, as well as how to lift correctly. If risk factors are present the woman may need extra help to learn how to care for her pelvic floor during stressful activities, this may include diet counseling and information on sexual positions to limit stress to the PFM.

Here is a list of some things PT’s might teach their patients post surgery:

Posture

PFM works best when the spine, pelvis and hips are in good alignment. If a woman’s back is too rounded, the normal bony structure of the pelvis can’t act to support the pelvic organs as intended. If the back is too arched, the pelvic muscles can become overstretched and strained. Normal spinal posture is a simple and effective way to support the pelvic organs. Learn how to maintain good posture with your normal daily activities, such as sitting at a computer, lifting, squatting etc.

Diet

To avoid constipation and straining (Valsalva) with bowel movements, drink plenty of water, eat a balanced, healthy diet with whole grains and fresh vegetables and learn about soluble and insoluble fiber. If constipation exists, it needs to be assessed to determine the type of constipation, and then be properly treated.Toilet Posture: We know that the vast majority of people evacuate their bowels best when in a squatting position. Most modern toilets don’t accommodate for this. Try placing a phone book or two under the feet to elevate the legs. Or try this device, which allows for a nice squatting position when on the toilet:  spine in neutral, but hips flexed and knees above the hips.

Restful Rescue Poses

There are excellent resting positions that utilize gravity to encourage organs to “reposition” back into the pelvic cavity. Here’s one: lie on your back and place a pillow or small wedge under the pelvis to invert your pelvic region. Place pillows under your knees as well and one pillow (or none) under the head. It’s a lovely position to rest in, and for those doing a strengthening program, it’s a great position for that too. If you want to go all out, place a heating pad over your tummy, turn the lights low, play soothing music and rest for a blissful 20 minutes or so. 

Biomechanical Considerations for Sexual Intercourse

Let’s face it, the majority of women going through POP surgery are sexually active. Sex must be addressed and often it’s the PT who spends the time with the patient and can make the best recommendations. For example, if a woman has pain with vaginal penetration, she may need to perform special stretching exercises to open the vaginal introitus and the PT can advise on intercourse positions that will least stress the PFM. Menopausal women may also need to discuss additional local estrogen and lubricant with your surgeon or physical therapist.

Pelvic Bracing

This is a technique of co-contracting one’s lower abdominal muscles, deep back stabilizing muscles, with the PFM. When done correctly it can limit the stress on the pelvic organs during activities of increased IAP, like lifting or squatting. It sounds complicated but it’s really not. Women should learn to do this in any position. First, attend to your PFM by giving them a gentle squeeze (feel the perineum lift) followed immediately by a relaxation (feel the perineum release down.) Starting from a relaxed place, gently draw the PFM upward as you gently draw the navel inward. Imagine you are trying to lift your vagina like an elevator as you feel your lower tummy gently flatten. Do this gently, not full force. You should be able to breathe normally as you do this. You’ll feel the two muscle groups acting together to tighten the lower belly and “brace” the pelvic floor. The deep back muscles should activate when you do this providing posterior support simultaneously. Hold this co-contraction for a few seconds then release. If you have trouble with this, seek out a pelvic floor PT in your area to help you learn. Learning how to brace during functional activities sometimes requires a bit of training, so again, seeking a specialist may be indicated if you are someone who has risk factors.

Pelvic Floor Muscle (PFM) Strengthening.

Often called “Kegels,” PFM strengthening involves exercising the PFM by contracting them for short or long periods of time—usually from two to four seconds to train the “fast twitch” muscle fibers, and five to 30 seconds to train the “slow twitch” muscle fibers.  Sometimes these exercises are done in conjunction with other muscle groups. The muscle fibers of the pelvic floor are 70% slow twitch and only 30% fast twitch. This means that the PFM are much better at endurance events than brute strength activities. They act more as supportive postural muscles; however we occasionally need a quick strong contraction to avoid leaking with a sneeze. Correct PFM strengthening incorporates exercises for both types of muscle.

Some women actually do too much exercise and develop tight, painful muscles. Sometimes, after a pelvic surgery, a woman might actually feel “tight” or “tense” inside. This is from the surgery, not because the muscles magically strengthened from the procedure. If after surgery you have symptoms of pain (either at rest or with an activity like sex), urinary urgency or frequency, then tell your doctor. Kegels would not be appropriate for you. If this is the case be sure to talk to your doctor for other options, such as biofeedback.

Other women need to exercise to develop more muscle tone and strength. The trick is to ensure there is balance between strength and flexibility. If you are still leaking or feel weak, then strengthening may be helpful.

Physical therapists with a pelvic floor specialization are trained to assess the whole person to determine an appropriate exercise routine, and women are advised to be evaluated before undertaking a rigorous strength program.

Incontinence During Sex - It Happens To Men Too

Incontinence During Sex Happens To Men Too

Prostate cancer is one of the most common types of cancer in men. According to the American Cancer Society, 1 in 7 men will get prostate cancer in their lifetime (only skin cancer has a higher rate).  And, while many men will go on to survive prostate cancer, the side effects of treatment can be difficult to deal with for many.

A common treatment for prostate cancer is a radical prostatectomy, or the complete removal of the prostate.  This is generally considered a good approach especially if the cancer is contained within the prostate gland and has not spread.  However, one side effect of this procedure is often incontinence.

Stress urinary incontinence, the type of incontinence that happens when you place pressure on the bladder, is common for men who have had their prostate removed or are undergoing other treatments for prostate cancer.  Treatment can sometimes weaken the bladder muscles, causing leakage when a man sneezes, coughs, exercises, or even during sex.  This can be extremely embarrassing for men, and can be discouraging when going through the healing process of having a prostatectomy. The good news is that many men regain full control of their bladder with time after a prostatectomy.

here are 4 tips that may help you avoid some awkward situations in the bedroom:

  • Try to watch your fluid intake in the hours leading up to sex.

  • Avoid consuming bladder irritating food and drinks, such as caffeine, chocolate, or alcohol.

  • Prior to sex, completely empty your bladder.

  • Keep a thick towel nearby in case of any accidents

While this problem can be an embarrassing one, keep in mind that many men deal with this in the months after prostate cancer treatment and with time, this condition should improve.  If you still experience problems a few months after your treatment, talk to your urologist about treatments for incontinence.  He or she can help you navigate the many options available to you and find one that fits best with your needs.

Prostate Cancer: The Case For Watchful Waiting

Prostate Cancer; The Case For Watchful Waiting

Prostate cancer is one of the leading cancer causes of death in men in the US.  The American Cancer Society estimates that approximately 1 in 7 men will be diagnosed with prostate cancer in his lifetime.  But, while this is a widespread condition, and treatment is sometimes warranted, the medical industry has begun to see a shift in the prostate cancer treatment, choosing to actively monitor patients over time instead of choosing to perform surgery or conduct radiation immediately.  This treatment path is called “watchful waiting”, and is becoming more and more common for men with prostate cancer.

To understand why watchful waiting is becoming a more popular trend, let’s back up a bit and explain a little more about the diagnosis of prostate cancer.  The average age of men diagnosed with prostate cancer is 66 years old.  Common treatment options for prostate cancer have included medication, surgery to remove the prostate, chemotherapy, radiation, and even hormone therapy.  And while these treatments have become more and more effective over the years, they cause unwanted side effects (such as incontinence and impotence) and pose serious risks (like blood clots in the legs and lungs, heart attack, pneumonia, and infections.)

There has been much debate around whether or not the benefits of treatment outweigh the added side effects and risks that are introduced when one undergoes these types of therapies.  Additionally, it is not clear if these treatment options will completely eliminate the cancer.  For those patients who are low risk, the benefit of aggressive treatment compared to the potential side effects may just not be worth it. 

What types of patients may be good candidates for watchful waiting?  Those who are not seeing any symptoms from the cancer, those whose cancer is small, and located only in the prostate, and those whose cancer is expected to grow slowly all may benefit from this type of treatment. 

Additionally, older men who have a life expectancy of less than 10 years may not benefit from the added years that surgery can offer, making them a better candidate for watchful waiting. 

However, if the cancer is growing steadily, or spreading beyond the prostate, more aggressive treatment is usually recommended.  Men who are diagnosed young may also benefit from more aggressive treatment, as there is a greater chance that the cancer may grow worse over a longer span of time.

Whatever stage you are at, only you and your doctor can decide what is best for you.  Be sure to talk with him or her about the risks and benefits associated with each treatment path prior to making a final decision. 

Can OAB Be Treated With Surgery?

Can OAB Be Treated With Surgery?

When Dalia was 28, she had her first child. She’d had a normal pregnancy, and like many of her friends, had some light leakage after birth, but nothing serious.  Baby #2 followed two years later, and baby #3 one year after that.  It was then that she really began to see a difference in her bladder control. “It was like the flood gates had suddenly opened,” Dalia said.  “Any little thing could trigger an urgent bathroom visit.” 

Concerned, Dalia went to her doctor to ask what could be done.  After trying several options that had no effect, or uncomfortable side effects, her doctor finally suggested surgery.  “I was really nervous at first – surgery sounds like such a scary word,” she said. 

After reviewing all the options, Dalia’s doctor recommended Interstim to treat her incontinence. Interstim therapy is a form of sacral nerve stimulation, where a device is implanted, usually in the buttocks and helps to block the messages sent by an overactive bladder to the brain, telling the brain that you need to use the restroom. 

After the procedure, she saw immediate improvement. “I can’t believe that I waited as long as I did to have this done,” she said. “It’s been a life changer.”

Many women like Dalia suffer from overactive bladder – the urgent and frequent need to use the restroom.  It is estimated that over 33 million people in America struggle with the condition.  And while there are many treatment options available, they don’t always work for everyone.  Initial treatment options like physical therapy, diet regulation, and bladder retraining can do wonders for many, and medications can often help those suffering from OAB.  However some still don’t find relief from these options, and some medications can cause unwanted side effects.  Luckily, there are several surgical options that are effective in improving OAB symptoms. 

What are my options?

Sacral Nerve Stimulation. 

This procedure, like the one Dalia had, regulates the nerve impulses in the bladder.  A small pulse generator is implanted under the skin and blocks messages sent by your bladder to your brain, regulating the nerve impulses in your bladder and reducing the need to urinate unnecessarily. The device can remain in place for as long as you need it, and the process is an outpatient procedure that uses local anesthesia and mild sedation.

Augmentation Cystoplasty.

Augmentation Cystoplasty, is a procedure that increases the size of the bladder.  Often used in severe cases after other treatments have failed, it enables the bladder to store more urine. Your doctor will take a small piece of tissue from your intestine and add it onto the wall of the bladder to enlarge it.  In some cases, a catheter may be needed to empty the bladder after this procedure has been performed.

Urinary Diversion.

Urinary Diversion reroutes the tubes that lead from the kidneys to the bladder to outside of the body through the abdominal wall.  Urine is then collected in an ostomy bag – a specially designed bag to be worn on the abdomen.  This option does require some maintenance, however it allows you to live an active life post surgery. 

Talk To Your Doctor.

Surgery is a common approach for many who have failed on other treatment plans, and your doctor will be able to help you find the best option.  It is important to talk with your doctor to determine not only what type of surgery might work best for you but also when might be the best time to have it.  For example, women who are still interested in having children may wish to wait, since childbirth may compromise any surgery that has already been performed.  Additionally, be sure to ask your doctor about what you can expect post surgery – some surgeries are designed to treat specific symptoms of incontinence, so you may still need medication or physical therapy to treat the other symptoms you experience.

If you are considering surgery, a urological surgeon can help talk through your options.  Visit the NAFC Specialist Locator to find one near you.  

What To Expect With A Hysterectomy

What to expect with a hysterectomy

A hysterectomy is a surgical procedure done to remove a woman’s uterus. There are several potential reasons a woman may need a hysterectomy:

  • Uterine Fibroids that cause bleeding, pain and other problems

  • Abnormal vaginal bleeding

  • Chronic pelvic pains

  • Endometriosis

  • Cancer of uterus, ovaries or cervix

This operation is either done to remove the part or the entire uterus after going through a rigorous and thorough checkup. In United States, 1 out of 3 women have gone through hysterectomy by the age they are 60.  It is the second most common surgery in women, followed only by cesarean delivery.  The majority of this operation is done to treat noncancerous conditions in women.

Even though a hysterectomy is a fairly safe surgery, there are certain side effects associated with it. Some of these include problems related to anesthesia, infection, bleeding, blood clots, injury to internal organs and loss of ovarian functions, which means no menstruation. Some women also experience less interest in sex, which can be treated with hormone therapy. And, if this surgery is done before a woman reaches menopause, she may experience menopausal type symptoms, such as hot flashes, mood swings, and vaginal dryness.

A common side effect of having a hysterectomy is incontinence. After the surgery, nerves of the bladder may be damaged because of their nearness to uterus. This can cause stress incontinence, the involuntary release of urine during things like exercise, sexual activity, sneezing or coughing – all of which put increased pressure on the abdomen. Fortunately, there are many treatment options available, so if you have incontinence as a result of a hysterectomy, talk to your doctor about what you can do.  Physical therapy, medication, and in extreme cases, even surgery can be used to treat the problem.

While many women are happy to be relieved of the symptoms they experienced prior to a hysterectomy, the changes to a woman’s body after surgery can be drastic. A full recovery after hysterectomy generally takes 6-8 weeks, after which it is advised to start doing regular activities with caution. The body may need additional time to adjust to changes in hormone levels. 

Even though this is a common surgery, having a hysterectomy is a major decision for most women. There are several procedures commonly used for hysterectomy like abdominal, vaginal or laparoscopic. Your doctor will be able to walk you through the pros and cons of each option, and help you decide on what is best for you. Visit the NAFC Specialist Locator to find a specialist in your area.

With Incontinence Treatment, Educating Yourself Is Half The Battle

Millions of Americans experience some form of incontinence.  And, while this condition affects both genders, if you are a woman, you are more likely to suffer from incontinence than men due to things like pregnancy, childbirth, and menopause. 

There are several different types of incontinence you may experience:

  • Stress Urinary Incontinence:  SUI occurs when any extra pressure placed on your bladder or abdomen causes you to leak urine.  Things like sneezing, laughing, or certain exercise all may trigger SUI.   
  • Urge Incontinence: Also known as Overactive Bladder, Urge Incontinence is the sudden, frequent feeling that you need to use the restroom. 
  • Mixed Incontinence: Many people suffer from both Stress Urinary Incontinence and Urge Incontinence combined.
  • Urinary Retention: This type of incontinence occurs when you are unable to completely empty your bladder, leading to leaks. 

The good news is that all of these conditions are treatable.  And now, more than ever, there are countless options for treatment, so if you haven’t yet found something that works for you, try again!  Here are some popular treatment options:

  • Absorbent products: Probably one of the most widely used treatment options, absorbent products are a good first line treatment for those who experience leaks.  There are many different types and fit is very important, so expect to try out a few and see what works best for you. And whatever you do, don’t use sanitary pads in place of absorbent products specifically designed for leaks – the two are made of different materials and sanitary pads are not designed to hold urine, so leaks are likely to occur if you use them for that purpose.
  • Behavioral Therapy:  Before trying out medication or other procedures, you may want to tweak some of your behaviors to see if they have any effect.  Things like altering your diet to eliminate bladder-irritating foods, starting a physical therapy routine, or practicing bladder retraining can all have an effect on managing your symptoms.
  • Medications: There are a number of medications that may help you with bladder control.  Most medications work by calming the bladder and reducing the spasms that sometimes happen and cause leakage.  Talk with your doctor about the different types and learn what may work best for you.
  • Non-invasive procedures: If you’ve tried medications and have not seen results, or experienced unwanted side effects, you may want to give a non-invasive procedure a try.  InterStim, Botox, and PTNS are all simple procedures that can be administered in a urologist’s office and can have a significant effect on symptoms and quality of life.  Talk with your doctor to learn more about these procedures and what you can expect if you choose to go this route.
  • Surgery:  Several surgical options exist for those experiencing urinary incontinence.  Surgery is often a more permanent solution, and is a common approach for many who have failed on other treatment plans.  But, it’s not for everyone, and may not always eliminate all your symptoms.  Be sure to talk to your doctor (usually a urological surgeon) about what may work for you and what you can expect after surgery.

Finding the best treatment plan for you requires you to play an active role.  Know your options and educate yourself about the different treatments available so you are better able to discuss them with your physician and make an informed decision together. 

To find a specialist in your area, visit the NAFC Specialist Locator and make an appointment today!