The prostate gland is responsible for secreting a slightly alkaline fluid, which makes up almost 25-30% of semen, by volume. Prostate cancer is one of the most common types of cancer seen in males. When this cancer is detected, then it is treated with the help of radiation or by surgical removal of the prostate. When the prostate is surgically removed, then there are many possible side effects that may be seen. One of these is incontinence, that is seen nearly in three out of every ten males that have undergone a prostatectomy. Given below are details regarding partial and total incontinence after a prostatectomy.
Types of Incontinence after Prostate Surgery
Urge incontinence is a type of urinary incontinence wherein there is involuntary loss of urine from the bladder due to the sudden and desperate urge to urinate. When there is an enlarged prostate before surgery, then the bladder tends to try to squeeze the urethra in order to overcome the obstruction brought about by the prostate gland. Thus, the urinary bladder tends to enlarge (hypertrophy) over time and contracts strongly.
Once the prostate is removed, the bladder still tries to forcefully squeeze out urine as and when it is produced or if the bladder becomes even halfway full. This leads to dripping of urine and an inability of the person to contain urine for a long duration till he can go to the toilet to relieve himself. Sometimes, if there is urge continence after prostate surgery, which does not improve even after a large amount of time, then this may be indicative of nerve damage during the surgery, due to which the urinary bladder is not able to contain urine.
Stress incontinence is a type wherein there is a slight leakage of urine whenever the person sneezes, coughs or when there is some kind of stress on the bladder. This can happen due to damage to the sphincter, which is a band of muscle that is present at the base of the bladder.
When a person sneezes or coughs, the bladder may exert excess pressure on the sphincter, due to which it may release some amount of urine. This type of incontinence may be either permanent or temporary in nature, reliant on the extent of nerve damage that has happened during the surgery. If it is temporary in nature, then once the prostate surgery recovery is complete, this problem will resolve on its own.
Mixed incontinence is when both stress and urge incontinence are seen. Usually, the symptoms of one type are stronger.
Treatment for Urinary Incontinence
The treatment options for urinary incontinence after surgical removal of the prostate are varied in nature. Most doctors prefer to first start off with behavioral techniques which aid in training men to control their flow of urine. There are exercises known as Kegel exercises which help to strengthen the muscles which are used to stop urination mid-stream.
There are many other preventive measures that can be taken, including decreased intake of diuretic agents, like caffeine, alcohol, beverages, etc. Avoiding fluids before bedtime also helps. Men can use incontinence pads or other such urinary incontinence products while undergoing treatment for this condition.
In case supportive measures fail, then medications can be prescribed, which act by increasing the bladder capacity and also by decreasing the frequency of urination. Surgical intervention is only opted for when all other options for treating urinary incontinence after prostate surgery fail. In surgical management of incontinence, an artificial sphincter may be inserted which is said to be very effective in controlling the flow of urine. In some cases, a bulbourethral sling may be used.
Urinary incontinence after prostate surgery is definitely a discomforting and embarrassing condition to deal with. However, you need to understand that this is a relatively common side effect of prostate surgery and there are many more like you grappling with this. Hence, by seeking timely treatment and by making a few lifestyle changes, this condition can definitely be managed, if not cured altogether.