After radical prostatectomy surgery, some men experience urinary leakage. This can be mild or severe and lasts for a long time.
It usually gets better over a period of time with conservative treatments like medication or physical therapy exercises for the pelvic floor muscles. If these fail, a surgery called urethral sling may be recommended. It's also advisable to wear incontinence underwear for men while you're recovering from surgery.
Symptoms
Urinary incontinence is a common side effect of surgery to remove the prostate. It usually goes away with time, but it can be frustrating to have a leaky bladder for a while after prostate removal.
The bladder is a hollow, balloon-shaped organ that stores urine until you have the urge to urinate. When you have the urge to urinate, your bladder muscles contract and force urine out through a tube called the urethra.
If the prostate is removed or the surgeon uses radiation to treat the cancer, there may be damage to the nerves and muscles around the urethra that allow urine to leak out. A part of the urethra and another set of muscles below the prostate (called the sphincter) help control the flow of urine.
Kegels or behavioral therapy may be used to retrain your pelvic floor muscles so you have better bladder control. If these techniques aren’t enough, your doctor may recommend a procedure like a urethral sling or an artificial urinary sphincter.
Diagnosis
Urinary incontinence is a common side effect of prostate cancer surgery and radiation therapy. It can be difficult to treat and can cause distress.
After prostate surgery, you may have a catheter in your bladder for two to three days. After this, you should be able to void without assistance.
If you continue to have urinary leakage after this time, your doctor may suggest a treatment plan. These options can include noninvasive treatments like medications and physical therapy exercises for your pelvic floor muscles.
Your doctor may also recommend biofeedback therapy to help you learn how to strengthen your pelvic floor muscles. This can help control your symptoms for longer.
If your symptoms last more than a year, you may need more invasive treatments to restore your urinary control. You will work with your urologist and medical team to determine which option is best for you.
Treatment
When you have prostate surgery to remove your prostate, your surgeon also has to remove one of the valves outside the prostate that open and close so that urine can flow out or stay in your body.
This is called a radical prostatectomy.
Many men who have prostate surgery experience urinary incontinence, but most regain control of their bladder within a few months. This happens because the nerves and muscles in your bladder are re-trained to work properly.
Your doctor may prescribe a medication that can help control incontinence, such as duloxetin or diltiazem. Pelvic floor muscle training is another option that can help improve your incontinence and bladder function.
Other treatments include cystoscopy and surgery to repair or replace the urethra. Your doctor may also recommend a urethral sling procedure or an artificial urinary sphincter. These treatments are often helpful for some men with more severe incontinence or if the damage to your sphincter muscle has been severe.
Side effects
There are a range of side effects from prostate cancer surgery, but you can usually recover from them. Regular check-ups are recommended to monitor your progress and help reduce the risk of side effects developing again.
During the operation, the surgeon will remove the prostate gland and some of its surrounding tissue. If possible, they will try to save the nerves attached to it that control your erections.
If they can't, your surgeon may use radiation therapy to treat the cancer. This can be either external beam radiation (EBRT) or brachytherapy, which uses small radioactive seeds to deliver high doses of radiation.
Irradiation of normal structures around the prostate causes a number of complications, including rectal bleeds and irritation. Other side effects can include a change in your penis length and lymphedema, which is a swelling of the legs and genital area. This can occur as a result of the removal of many lymph nodes near your prostate.
