By Dr. David Samadi
One of the most significant concerns for men undergoing radical prostatectomy is the potential loss of urinary continence. This side effect can be distressing, considering the natural frequency of urination throughout the day. It transforms a once-automatic bodily function into a conscious challenge, impacting daily life significantly.
Urinary incontinence is when a man has the inability to control their urine flow, which is a common occurrence following prostate removal. Men preparing for surgery must discuss this possibility thoroughly to understand what to expect post-operation.
Typically, urinary incontinence after prostate surgery is temporary. It arises from disruption or damage to the sphincter muscles that regulate urine release, akin to the stress incontinence women may experience after childbirth. For most men, this manifests as minor leakage rather than complete bladder emptying, often occurring during strenuous activities or after sudden movements like sneezing, coughing, or laughing.
Understanding the Mechanism
The prostate gland, encircling the urethra, plays a role in urine control. Its removal during surgery can disrupt the bladder’s ability to retain urine effectively, leading to leakage.
Duration of Incontinence
Recovery from urinary incontinence varies for each individual. Men who had normal continence before surgery should regain control within three months, sometimes sooner. Long-term incontinence is uncommon after prostate surgery.
Treatment Options
Several approaches can help manage urinary incontinence post-surgery:
- Kegel exercises: These movements strengthen pelvic floor muscles, aiding in urinary control, and can be performed discreetly anywhere.
- Behavioral modifications: Adjusting fluid intake, avoiding caffeine, alcohol, or spicy foods, and urinating regularly rather than waiting for the bladder to fill can improve continence.
- Medications: Certain medications, like anticholinergics, can reduce the urge to urinate frequently, while decongestants may strengthen sphincter muscles. However, their use should be discussed with a healthcare provider.
- Surgical and other interventions: For persistent incontinence, surgical options such as placing a urethral sling or inserting an artificial sphincter device may be considered. Collagen injections can also provide short-term relief by bolstering the urinary sphincter.
If long-term incontinence persists despite these measures, your urologist may advise surgical interventions like placing a bladder neck sling or an artificial sphincter device. These options can significantly improve or even resolve incontinence in most cases.
In conclusion, while the prospect of urinary incontinence after prostate surgery is daunting, men need to understand that effective management strategies exist. By collaborating closely with healthcare providers and investigating appropriate treatments, many men can regain control over their urinary function and resume their daily activities comfortably.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board-certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.