Male Incontinence after prostate surgery

Prostate surgery can lead to temporary urinary incontinence in numerous men. However, there's no need to worry, as these symptoms typically get better with time. If you or a loved one has had prostate surgery and is facing bladder control issues, it's time to address the situation.

In this article, we've teamed up with MoliCare to delve into the causes of incontinence following prostate surgery, such as benign prostate enlargement, prostate cancer, and weakened pelvic floor muscles. We'll also provide advice on how you can aid your recovery, including hygiene practices and pelvic floor exercises.

Don't let urinary incontinence limit you any more. Equip yourself with the information required to restore bladder control and enhance your quality of life.

Urinary incontinence is a frequent outcome of prostate surgery, especially in older gentlemen. Fortunately, in numerous instances, incontinence post-prostate surgery self-resolves with time. Meanwhile, there are tailored products available to assist in symptom management, allowing you to live life unrestricted, such as MoliCare men's incontinence pads.

Surgery may be required due to a benign or malignant enlargement of the prostate. Both these types will be discussed in this article.

If the prostate needs surgical removal, it can impact sections of the urethra and its sphincter muscle. The sphincter muscle at the bladder's outlet controls bladder opening and closing. Damage to this muscle can lead to sphincter dysfunction.

Yet, the impact on the sphincter muscle varies significantly based on the individual's age, existing conditions, the surgical method employed, and the prostate's size.

If the muscle is injured during surgery, stress incontinence frequently occurs. In this context, 'stress' denotes the rise in pressure triggered by sneezing, coughing, laughing, or lifting heavy items, resulting in involuntary urine loss. Stress incontinence is the primary type of urinary incontinence post-prostate surgery, although urge incontinence (or overactive bladder) can also manifest. Individuals may feel a persistent urge to urinate even when the bladder is not substantially filled.

Regrettably, it is anatomically challenging to avoid urethral damage during prostate surgery due to the prostate encircling the upper section of the urethra and portions of the sphincter muscle. Fortunately, the external sphincter is typically unaffected and can be enhanced through specific exercises. This aids in reducing incontinence gradually.

Along with prostatectomy, treatment with radiotherapy can also weaken the bladder muscles and lead to male urinary incontinence. 

An enlarged prostate often manifests as problems when urinating. The growth of the prostate constricts the urethra further and further, which can lead to overflow incontinence or urge incontinence.

This occurs with both benign and malignant enlargement.

Whilst the prostate in young men is roughly the size of a walnut, the quantity of prostate cells gradually rises throughout a man's life. Consequently, the prostate enlarges and progressively constricts around the urethra. This alteration is unrelated to prostate cancer but can impact continence. It is commonly linked with the subsequent symptoms:

• Frequent urge to go to the toilet, also at night
• Problems with starting to urinate
• A weak urine stream and a feeling that the bladder is never completely emptied
• Or even unwanted loss of urine

Treatment for benign enlargement of the prostate varies depending on individual symptoms and prostate size. Options include medications or prostate surgery. Your doctor will furnish you with the essential details.

The risk factors for benign enlargement of the prostate includes: 

• The use of hormones,
• Hereditary factors,
• An unhealthy diet,
• Smoking 
• Alcohol consumption 

Prostate cancer is the most prevalent form of cancer in men. As per the German Cancer Society, approximately 60,000 men are diagnosed with this cancer annually. Prostate cancer is uncommon in younger males, with the risk rising significantly with age.

There are various approaches to treating prostate cancer. One choice is the surgical procedure radical prostatectomy (removal of the prostate). The chances of recovery are promising with this treatment if the cancer has not already spread. Thus, it is often the optimal treatment choice for numerous patients, despite the potential risk of bladder function impairment resulting in urinary incontinence. Nonetheless, permanent incontinence is infrequent and mainly occurs in severe cases.

Following surgical therapy, many men initially experience challenges in bladder control. After approximately 3 months, half of men still face these issues, though the prevalence decreases in the following months. At the 18-month mark post radical prostatectomy, 4 to 21 out of 100 men report ongoing urine leakage, especially during instances of stress like coughing, sneezing, or laughing. The increased abdominal pressure exacerbates the condition. Even after 5 years, around a quarter of those affected rely on incontinence aids like pads or disposable pants. In about 7% of cases, urinary incontinence becomes a permanent condition.

Along with incontinence erectile dysfunction can also develop after prostate surgery. As with incontinence, the symptoms improve in many men after a few months, however.

Mild or moderate incontinence after prostate surgery can be remedied by slim incontinence pads, making life much more pleasant. The MoliCare MEN products are especially slim and designed for the male anatomy, providing both protection and a secure feeling.

With more severe bladder weakness it is important that even larger volumes of urine are captured and do not leak out. The disposable MoliCare® MEN PANTS have a soft, leak-proof inner cuff, are worn like normal underwear and offer additional leak protection.

Since a portion of the sphincter muscle typically remains post-surgical prostate removal, it can be trained to compensate for the extracted muscle. However, identifying its location and strengthening it can be challenging. Therefore, collaborating with a qualified physiotherapist, especially initially, is recommended. Gather essential information during your hospital stay.

In essence, the pelvic floor can be visualised as a layer of muscle that provides support for the organs in the abdominal cavity, with openings for the urethra and bowel. The more conditioned this muscle is, the greater pressure it can endure, especially when the bladder is stressed.

This aids in enhancing bladder control. Pelvic floor exercises are simple to grasp and can be seamlessly incorporated into daily life. Progress is typically noticeable within a couple of weeks, so remain patient and continue training.

After prostate surgery, urinary incontinence can pose a significant challenge. Coping with the prospect of dealing with urine leakage can be distressing. However, it is not inevitable. Although addressing the condition is crucial, resigning yourself to having pelvic floor incontinence following prostate surgery is neither beneficial nor wise. If your urologist has prescribed exercises to address the issue, there is no cause for concern – you are heading in the right direction!

Sources

1.       https://gesund.bund.de/prostatahyperplasie-gutartig#definition

2.       https://prostata-hilfe-deutschland.de/gutartige-prostatavergroesserung-bph/

3.       https://www.gesundheitsinformation.de/gutartige-prostatavergroesserung.html

4.       https://www.prostata-hilfe-deutschland.de/prostata-wissen/inkontinenz-prostatakrebs-behandlung