Prostatectomy Surgery & Urinary Incontinence- what you need to know

Treating Urinary Incontinence Post Prostate Cancer Surgery

It’s Movember, and it’s time to band together to raise awareness & much needed funds for Men’s Health, with a particular focus on Prostate Cancer. Here we address the link between Prostate Cancer & Urinary Incontinence, and how to treat leakage quickly, efficiently & non-invasively in Prostatectomy patients.  

The Prostate Gland and its function 

The prostate gland is a male reproductive organ whose main function is to secrete prostate fluid, one of the components of semen. The muscles of the prostate gland also help propel this seminal fluid into the urethra during ejaculation.

What is Prostate Cancer?

Cancer of the Prostate is the most commonly diagnosed form of cancer found in men in the UK with over 41,000 cases reported on average each year1. Prostate Cancer begins when cells in the prostate gland start to grow uncontrollably, but fortunately, it’s one of the most treatable malignancies if it’s caught early. Surgery is a common choice for treating and removing prostate cancer if it is thought to not have spread outside the prostate gland.

 

41,000+

cases of Prostate Cancer are reported each year

69%

of Prostatectomy Patients will experience Urinary Incontinence post surgery

88%

will still suffer from Urinary Incontinence at least 12 months after surgery

Prostate Cancer Surgery

The main type of Prostate Cancer Surgery is Radical Prostatectomy, where the surgeon removes the entire prostate gland as well as some of the surrounding tissue. Whilst surgery is a common treatment route for Prostate Cancer patients, there are two main side effects, Urinary Incontinence & Erectile Dysfunction.

Common Side Effects of Prostate Cancer Surgery

Urinary Incontinence

Urinary Incontinence is a bothersome complication of radical prostatectomy surgery, and studies have shown that it is experienced in as many as 69%2 of post-prostatectomy patients, with up to 88% of patients still suffering up to 1 year later3.

There are three types of male incontinence:

  1. Stress Incontinence: leakage is brought on by coughing, laughing, sneezing or exercise. Stress Incontinence is the most common type experienced after prostate surgery. During surgery, the prostate gland and some of the surrounding tissue is removed, causing bladder-neck weakness resulting in less resistance to bladder pressure and control over the pelvic floor3, resulting in bladder leakage.
  2. Overflow Incontinence: Men with this type of incontinence have trouble emptying their bladder. They take a long time to urinate and have a dribbling stream with little force. Overflow incontinence is usually caused by blockage of the bladder outlet (benign prostatic hyperplasia, prostate cancer, or narrowing of the urethra), or when the muscle that expels urine from the bladder is too weak to empty the bladder normally. Overflow incontinence may also be a side effect of certain medications.
  3. Urge Incontinence: Is experienced when men have a sudden need to urinate. This happens when the bladder becomes too sensitive to stretch as it fills with urine.


Other common diseases that affect the prostate, and consequently urinary incontinence include

  • BPH (Enlarged Prostate): results in frequent urination and a reduced urinary stream, affecting almost 50% of men beyond middle age5
  • Prostatitis: an inflammatory disease affecting about 1 in 15 mainly younger and middle-aged men, which is characterized by symptoms of pain and discomfort around the anus, scrotum and the area in between (the pelvic floor)5.

Erectile Dysfunction

Prostate Cancer Surgery can damage the nerves and blood vessels that are needed for an erection, causing problems with impotence6.

 

How long does it take to overcome incontinence after undergoing prostate cancer surgery?

A study showed that 88% of post-prostatectomy patients suffering from stress incontinence were still suffering up to 1 year later2.

However, as Post Prostate Cancer Surgery patients will experience different degrees of side effects, so do they recover from these side effects at variable rates. In most cases, the recovery time for Urinary Incontinence Post Prostate cancer surgery ranges from 6-12months in most cases7, with continence improving progressively up until 2 years post-surgery8.

Impact of Male Incontinence on Quality of Life

Depression and decreased quality of life have been found to co-occur in patients struggling with incontinence8. Fear of leaks in public and the required changes & limitations that incontinence has on daily life can have a big impact on well-being.

It can make such a difference to be able to carry out previously enjoyed activities, especially after going through the trauma of cancer. Whether it be golfing with friends, have a pint down at the pub, or going for your morning run, you can get back to normal life by treating Urinary Incontinence head on. 

 

Treating Male Incontinence by Strengthening the Pelvic Floor

A common misconception is that men don’t have a pelvic floor, which actually isn’t the case! Like women, men also have a pelvic floor, which among other things, is responsible for bladder control. The pelvic floor is made up of a complex set pelvic floor muscles, which, when exercised, can be strengthened for greater control.

There are a number of ways to manage and treat incontinence in men Post Prostate Cancer surgery. Here we outline some of the preferred options:

Pelvic Floor Exercises (Kegel Exercises)

Pelvic Floor exercises, also known as Kegel Exercises, involve repetitive voluntary contraction and relaxation of the pelvic floor muscles. These exercises need to performed multiple times per day for several months initially to be efficient.

A study by Van Kampen et al. found that 88% of men who performed pelvic floor exercises were completely continent 3 months following prostatectomy, compared with only 56% of men who did not engage in such exercises10.

Biofeedback

Biofeedback devices are inserted rectally and teach the user pelvic floor muscle control via pelvic floor exercises. Biofeedback measures the strength of the pelvic floor contractions, enabling the patient to strengthen the pelvic floor correctly over time.

Pelvic Floor Stimulation (INNOVO® & Probes)

Pelvic Floor Stimulation involves the electrical stimulation of the pelvic floor muscles using either a probe based device (inserted rectally in men) or a non-invasive, external stimulator such as INNOVO®. Electrical Muscle Stimulation (EMS) painlessly strengthens the pelvic floor muscles by stimulating the nerves within the pelvic floor to contract (automating the manual pelvic floor exercises mentioned earlier).

EMS devices enable those with limited ability to contract their pelvic floor, to achieve a perfect contraction – the INNOVO® device delivers 180 perfect contractions in each 30-minute session, with results seen in as little as weeks in the majority of users*.

Pre-operative training of the pelvic floor has also been shown to limit the impact of prostate cancer surgeries on urinary incontinence also11, so it’s worth thinking about preventative pelvic floor strengthening using INNOVO® as early on as possible.

Pelvic Floor Stimulation using INNOVO® can be carried out in the comfort and privacy of your home.

Behavioural changes are also needed to help to recover and to be continent: The above treatment methods have been shown to be vastly improved when behavioural changes such as limiting the intake of fluids or bladder irritants such as alcohol and caffeine.

 

Other ways to manage incontinence

The above treatment methods have been shown to be vastly improved when behavioural changes such as limiting the intake of fluids or bladder irritants such as alcohol and caffeine.

Incontinence Pads are also commonly used to manage Urinary Incontinence in Men post prostate cancer surgery. Whilst these pads are useful in temporarily managing leaks, they can be extremely costly overtime and do nothing to help address the root cause of the problem.

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INNOVO® treats Urinary Incontinence in Prostatectomy Patients

Don't let urinary leaks hold you back from doing what you used to do. See results in as little as 4 weeks.

Try our Pads Cost Calculator

Try our Pads Calculator to find out how much you’re spending each year, just managing leaks*. Just enter the number of pads you use on a daily basis, or near enough, and we’ll calculate what it’s costing you. (*Calculation based on market average pad cost of £0.50 p/pad)

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Real Users. Real Results

People like you are overcoming their battle with Urinary Incontinence brought on Prostate Cancer Surgery every single day.

Grow that mo'!

Would you like to donate to Movember and help raise much needed funds for Men's Health? Then grow that mo', and if you haven't got a mo' to grow, that donate to someone who does! 

1 British Journal of Nursing, 2013 (Urology Supplement), Vol 22, No 9

2 www.ncbi.nlm.nih.gov/pmc/articles/PMC4274175

3 Groutz A, Blaivas JG, Chaikin DC, et al. The pathophysiology of post-radical prostatectomy incontinence: a clinical and video urodynamic study. J Urol. 2000;163:1767–1770

4 Colley, Wendy (2014), Nursing Times, Incontinence Following Prostate Cancer Surgery

5 www.theprostatecentre.com/prostate-information/prostate-awareness/common-prostate-diseases

6 Prostate Cancer UK, 2017

7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274175/

8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC194226/

9 https://www.ncbi.nlm.nih.gov/pubmed/16686718

10 Van Kampen M, De Weerdt W, Van Poppel H, et al. Effect of pelvic-floor re-education on duration and degree of incontinence after radical prostatectomy: a randomised controlled trial. Lancet. 2000; 355:98–102

11 http://www.europeanurology.com/article/S0302-2838(15)01102-1/pdf