Urinary Incontinence Post-Prostatectomy

By iMEDicare, Ltd as published in Issue 15 Winter 2012 of Prostate Matters, A Newsletter of the Prostate Cancer Support Federation in the U.K.

The prostate gland sits just below the bladder and completely encircles the urethra at the point where it leaves the bladder. When the prostate gland is removed in a radical prostatectomy or receives radiation therapy, damage can occur to the urinary sphincter. Depending on the extent of the damage, temporary or permanent incontinence can result. Following radical prostatectomy, the prevalence of incontinence at 1 month after surgery is high, ranging from 4% to 87%. However, UI tends to diminish over time, and recovery is observed in most cases in 1 to 6 months following surgery.

Stress incontinence, urine leakage with activity, is the most common type of incontinence after prostate surgery. It is usually caused by a weak or damaged urinary sphincter and results in urine leakage when you do anything that strains or stresses the bladder, such as coughing, sneezing, laughing, or exercising. Leakage may range from mild (a few drops with only the most vigorous activity) to brisk (leakage with almost any movement). Stress incontinence resolves in up to 97 percent of men affected after radical retropubic prostatectomy, but can take up to three years to resolve.

Regaining urinary control

– Kegel exercises are the deliberate tightening or clenching of the pelvic muscles. Performed regularly, they tone and strengthen the external sphincter, the rings of muscles responsible holding in urine.

– Your doctor may prescribe or recommend medications to help with incontinence. Anticholinergic drugs, which block messages to the bladder nerves and prevent bladder spasms, are sometimes recommended for urge incontinence.

– Biofeedback is a training program that can be used to reinforce the proper performance of Kegel exercises.

Until urinary control returns

– To control leakage, you can wear an absorbent pad inside your underwear or an Afex® Urinary Collection System. These aids are available via your GP or local continence department.

– Until urinary control has returned, avoid drinking excessive amounts of fluids.

– Limit alcohol and caffeine intake.

– Empty your bladder before bedtime or before strenuous or vigorous activity.

– Sometimes fat in the abdomen can put pressure on the bladder; losing weight may help improve bladder control.

Afex®: The Afex® system makes managing chronic male incontinence easier than ever. The 96% cotton boxer-briefs discreetly and securely hold a plastic ergonomic curved receptacle inside a front pocket that channels urine into a 500ml reusable collection bag. No tubes or straps are required – just attach the bag directly to the receptacle through the briefs for hours of use without maintenance or changing.

It’s very comfortable, and lot drier than pads. It gave me the freedom to do a lot of things that I used to do.

– Tommy Boyce, Age 76

The standard set shown here [above] is designed primarily for active daytime use. For long-term sitting, one can use the Afex® Sedentary and for wheelchair users, Afex® Mobility Assisted. Free samples and home assessment available from www.iMEDicare.eu (U.K. customers only)

Or on 02082075627.
Available from your GP on NHS prescription (U.K. customers only).