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!

What To Do About An Enlarged Prostate?

What To Do About An Enlarged Prostate

Enlarged prostates are common as you age. Men aged 60 and older have a 50/50 chance of having an enlarged prostate and those who are 85 have a 90% chance. Those may be scary stats, but what exactly does having an enlarged prostate mean? Is it something to worry about? And if so, what are the treatment options? Keep reading to learn more about this very common condition and what it may mean for you.

Anatomy Review – function of the prostate

The main function of the prostate glad is to serve as a reproductive organ. It is responsible for producing prostate fluid, which is one of the main components of semen. The prostate gland muscles also help to transport semen into the urethra during ejaculation.  

The prostate gland sits just below the bladder, where the bladder and urethra (the tube that inside the penis that carries urine and semen out of the body) connect. In early life, it’s about the size and shape of a chestnut, and grows to different sizes throughout a man’s life. 

What causes the prostate to get enlarged?

As men age, the prostate gland grows. It’s estimated than as many as 17 million men have an enlarged prostate, or symptoms of Benign Prostate Hyperplasia (BPH). While it’s unclear why the prostate begins to grow, its thought that an excess of certain hormones may be to blame.

Symptoms of an enlarged prostate include the following:

  • A weak or interrupted urinary stream

  • The sudden urgency to urinate

  • Frequent urination

  • An inability to empty the bladder during urination

  • Trouble initiating urine flow, even when you feel like your bladder is full.

Should I worry? 

Even if your prostate becomes enlarged, it may never become an issue for you. The problems start when the prostate begins to constrict or block the urethra. This can compromise the bladder’s ability to effectively empty, causing chronic retention of urine. And, because the bladder still continues to send signals that it needs to empty, urgency and frequency can occur (this is also known as overactive bladder).  If left for too long, the bladder may become distended, making it even harder for it to empty completely. 

For these reasons, it’s important to see your doctor right away if you start experiencing any of the symptoms listed above. Additionally, the symptoms of an enlarged prostate can also mimic those of other conditions, such as bladder cancer or overactive bladder. Your doctor will be able to help diagnose your condition to determine an appropriate treatment.

What’s the treatment for an enlarged prostate?

There are many treatment options for enlarged prostate, depending on your symptoms.

Active surveillance, or “watchful waiting” is a term used to describe the act of monitoring your condition regularly for any changes. This approach is often used for men whose symptoms are mild and not too bothersome. 

There are several medications that are approved for BPH, but most of them fall into two categories: Alpha blockers and inhibitors. Both are effective at treating BPH and sometimes are even prescribed in combination with each other.  

Non-invasive treatment options include things like laser therapy, which decreases the size of the prostate by removing some of the tissue, or laser vaporization, which enlarges the prostate obstruction and opens the urethra.  Transurethral microwave therapy or transurethral needle ablation are other non-invasive treatment options that destroy excess prostate tissue that is causing blockage.

Finally, surgery is also commonly used to help relieve symptoms of an enlarged prostate. The most common form of surgery is transurethral resection of the prostate, or TURP. This surgery requires no incisions, relying instead on a surgical instrument inserted through the tip of your penis and the urethra. Using this tool, the doctor is able to trim excess prostate tissue that may be preventing the flow of urine. 

Other less common surgeries are also used to both trim excess tissue from the prostate, or to decrease pressure on the urethra in order to make urinating easier. You can read more about additional surgical options here.

Ask The Expert: Are There Other Things Besides Prostate Trouble That Can Cause Incontinence In Men?

Prostate Trouble and Incontinence

Each month, we ask our expert panel to answer one of our reader's questions. To learn more about the NAFC Expert Panel, and how to submit your own question, see below.

Question: Are There Other Things Besides Prostate Trouble That Can Cause Incontinence In Men?

AnswerProstate problems in men typically get the blame for incontinence issues for good reason – many men experience issues with their prostate (BPH, prostate cancer) which can often cause incontinence, even if it’s just for a brief time. But there are other conditions that may be contributing to the root of the issue as well. Being overweight can put extra pressure on the bladder, which may cause leaks. Certain foods can also irritate the bladder, causing incontinence – especially if you’re already prone to the condition.  Additionally, neurological conditions, such as Parkinson’s or diabetes can lead to neurogenic bladder, where the brain is unable to communicate properly with the bladder. Even still, urinary tract infections or blockages can lead to bladder troubles.

The most important thing to consider is that incontinence is generally a symptom of something else, and can almost always be treated. If you’re experiencing bladder leaks, see your doctor today and ask for help. Your doctor will be able to dig deeper to find the root cause of your incontinence and work with you to find a solution.   

Are you an expert in incontinence care? Would you like to join the NAFC expert panel? Have a question you'd like answered? Contact us!

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. 

Know The Symptoms Of Prostate Cancer

Know The Symptoms Of Prostate Cancer

Know The Symptoms Of Prostate Cancer

Apart from skin cancer, prostate is the most common cancer among men.  And while a large number of men are diagnosed with the condition each year, the survival rate for prostate cancer is generally high if caught early on. There are no warning signs, which is why it is important for men to begin getting screened for prostate cancer at age 50.  However, common symptoms often emerge once the cancer has already started.  These may include any of the following:

  • Frequent urination
  • Weak urine stream
  • Inability to empty the bladder
  • Leaking urine
  • UTI’s, which may feel like a burning sensation during urination or ejaculation
  • Blood in the urine or semen
  • Erectile dysfunction
  • Bone pain or discomfort, especially in pelvis or lower part of the body

It’s important to note that many of the above symptoms can have other causes too.  Enlarged prostate can cause many of the same symptoms as prostate cancer due to the extra pressure placed on the urethra.  Talk to your doctor about any symptoms you’re experiencing so he or she can determine the appropriate course of action.

Need help finding a physician? Use the NAFC Specialist Locator to find one near you.

The Basics of Benign Prostate Hyperplasia

BPH

The prostate is a walnut shaped gland responsible for producing semen in a man’s reproductive system. Enlargement of this gland is pretty typical, as most men experience some enlargement of the prostate as they age. Statistically, about 50% of men experience symptoms of an enlarged prostate by age 60, and 90% of men report symptoms by age 85.

You might be wondering, "If it’s so common, what’s the big deal about having benign prostatic hyperplasia (BPH)?"

To begin with, a healthy prostate is important in supporting sperm nourishment and transport. When a man ejaculates, the prostate produces the semen that propels the sperm. In a post-pubescent male, the prostate is about the size of a walnut and stays that way until age 40. For a still unknown reason, the prostate experiences a second growth spurt and can grow to the size of an apricot or even a lemon.

When you take into account that the prostate gland is located just below the bladder at the site where the urethra connects, you can start to see how this can become a serious issue. The enlarged prostate begins to interfere with the urethra, the tube inside the penis that carries urine and semen out of the body. The pressure can block the natural flow of urine (and semen) causing irritation. If left untreated, this condition can lead to more serious problems.

There is not a consensus among physicians on exactly why the prostate begins to grow again, though it is widely speculated that an excess of certain hormones may be the catalyst. One study has shown a high correlation between DHT levels (dihydrotestosterone) in the blood and enlarged prostates. Conversely, men with low DHT levels do not experience enlarged prostates.

The best way to combat this growth is to talk to your doctor. Click here to read about some of the potential exams, treatments, and solutions.