Types of urinary incontinence after prostate surgery
There are three main types of incontinence that may occur after prostate surgery:
Stress incontinence: This is the most common type, affecting up to 30% of men after surgery. Leakage occurs with increased pressure on the bladder, such as coughing, sneezing, lifting heavy objects, or exercise.
Urge incontinence: This condition affects up to 10 percent of men and involves a sudden, strong urge to urinate that may be difficult to control. The leak may occur before reaching the toilet.
Mixed incontinence: a combination of stress and urgency incontinence.
How common is urinary incontinence after prostate surgery?
The likelihood of experiencing incontinence after prostate surgery depends on several factors, including:
Surgical technique: The goal of nerve-sparing surgical techniques is to preserve the nerves responsible for bladder control. This can significantly reduce the risk of incontinence.
Continence before surgery: Men who have good bladder control before surgery are more likely to regain it more quickly after surgery.
Age and general health: Younger, healthier men tend to regain bladder control faster.
Short term (3-6 months): Up to 70% of men may experience some degree of incontinence.
Long-term (12-18 months): The percentage of men with incontinence is significantly reduced. Studies show that 10-15% of men may still experience some leakage.
treatment options
The good news is that for most men, urinary incontinence will improve over time. Here's what you can expect:
Early recovery: After surgery, a catheter is placed to drain urine for several days while the surgical site heals. As the catheter is removed, you may experience some temporary leakage. This is normal and should gradually improve.
Pelvic floor exercises (Kegels): These exercises strengthen the pelvic floor muscles, which can significantly improve bladder control. A pelvic floor physiotherapist will guide you in doing Kegels correctly.
Lifestyle modification: Certain lifestyle changes can help manage incontinence. This may include limiting caffeine and alcohol, which can irritate the bladder, and managing fluid intake to prevent bladder fullness, which can put pressure on the urethra.
Treatment options for persistent incontinence
If incontinence persists for more than 12-18 months, your doctor may recommend other treatments:
Medications: Depending on the type of incontinence, some medications can help relax the bladder muscles or strengthen bladder contractions.
Bulking agents: These are injectable substances that are placed around the urethra to help create a tighter seal and prevent leakage.
Urethral Sling: This is a minimally invasive surgical procedure in which a sling is placed under the urethra to provide additional support and prevent leakage during stress incontinence.
Artificial Urinary Sphincter (AUS): This is a surgically implanted device that helps control the flow of urine. It is usually used for severe incontinence that does not respond to other treatments.