Coping with incontinence
Urinary incontinence is another troubling side effect that can occur after treatment for prostate cancer. While there are different types—and varying levels of leakage—it may generally be described as the inability to control or stop urine from flowing.
If your loved one leaks urine when he coughs, laughs or sneezes, it is called stress incontinence. This is common after treatment for prostate cancer, due to either damage or removal of a bladder sphincter, which is a muscular valve that keeps urine from escaping the bladder. Men have two bladder sphincters. One of them is typically removed during radical prostatectomy.
Other types of incontinence include:
- Urge: which is when a man has a sudden urge to urinate, and may not always make it to the bathroom in time
- Overflow: when a man has difficulty completely emptying his bladder. Urination may take a long time and he may have a weak stream of urine or dribbling
- Continuous: when a man loses all ability to control urination
Estimates of this problem after radical prostatectomy have been reported to range from as low as 2.5% to as high as 87%. These numbers may vary so much because there are differences in how incontinence is defined. It is a good idea to ask about your loved one's doctor's definition prior to treatment.
Recovery takes time
After surgery for prostate cancer, a man is expected to regain control of his bladder within a few months. Age is a factor, and whether he had any previous urinary problems. Other factors include whether he had nerve-sparing surgery, and still has both nerve bundles (both of which are reported to help with urinary control).
Recovery may occur gradually over time, to the point where he only dribbles a little. He may need to wear heavy pads or absorbent briefs at first, then just use a thin pad (he may even be able to use a woman's pantyliner) until he is completely dry. You can buy these pads at most supermarkets and drugstores. You can also consider buying a protective plastic sheet for your bed and a plastic chair pad (for when the catheter is first removed), which may also be available in some drug stores.
As your loved one gains more urinary control, certain types of activity, such as sneezing, coughing, laughing and even yelling, may cause him to dribble. He may also
leak urine during sex.
Some men find that they may dribble more at the end of the day. Caffeine can increase both frequency and urgency of urination, so it is a good idea to stay away from any drinks or foods that have caffeine. Not waiting until the last minute to urinate may also help.
Your loved one's doctor may also recommend Kegel exercises to help strengthen the bladder muscles.
If leaking continues
Unfortunately there are some men who do not regain complete urinary control. Urinary leakage can be a great source of frustration and embarrassment—perhaps even greater than impotence—because a man is reminded of his problem every day.
If this is the case, your loved one should speak with his doctor to see if there are any other physical issues causing urinary leakage. For example, after surgery for prostate cancer, some men develop scar tissue.
If the doctor determines there are no other problems, one of the following options may be suggested:
Artificial urinary sphincter
Always discuss everything you read on this web site with a qualified medical professional.
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Atiemo HO, Moy L, Vasavada S, Rackley R. Evaluating and managing urinary incontinence after prostatectomy: beyond pads and diapers. Cleveland Clinical Journal of Medicine. 2007;74 (1):57-63.
Grise P, Thurman S. Urinary incontinence following treatment of localized prostate cancer. Cancer Control. 2001;8(6):532-539.