Urinary incontinence is changes in or loss of control of the bladder, leading to urine leakage. It can be a side effect of a number of problems associated with prostate cancer and its treatment, such as:
- BPH (benign prostatic hyperplasia), which is a common condition characterized by an enlargement of the prostate gland. BPH increases in prevalence as men age.
- radical prostatectomy, which is removal of the entire prostate. During the removal, a major nerve may be damaged, leading to short-term or permanent loss of the nerve function.
- radiation, a treatment that can also lead to bladder problems, as radiation can damage healthy tissues as well as the tumor.
Perhaps the most common type of incontinence after prostate surgery is stress incontinence. With this type of incontinence, any activity that temporarily increases the pressure within the abdomen (and consequently the bladder), such as coughing, sneezing, or laughing, may cause urine to escape - even if the bladder isn't full.
Pelvic muscle exercises (PMEs), also known as Kegel exercises, are a popular treatment for stress incontinence. Essentially, they involve tightening the pelvic floor muscles as if you're trying to control urination or defecation.
Another option to tone and tighten the pelvic muscles involves electrical stimulation via a small rectal probe. These devices passively exercise the pelvic floor muscles using electrical pulses. The electrical pulses should not feel painful.
Another common type of incontinence after surgery is urge incontinence, which is the involuntary loss of urine associated with a strong desire to urinate. In other words, you may not be able to get to a toilet in time, due to strong and involuntary contractions of the bladder muscles.
Medications used to treat urge incontinence generally work by relaxing the bladder muscles to stop the abnormal contractions. They include anticholinergics, such as oxybutynin and tolterodine, and muscle relaxants such as flavoxate.
Overflow incontinence happens when urine leaks out of an overfilled bladder. This occurs when the bladder cannot empty normally, which may happen if an enlarged prostate or scar tissue narrows the opening of the bladder so urine cannot easily drain out.
Men with overflow incontinence may need to learn how to insert a flexible tube, or catheter, to empty their bladder so it doesn't get too full. Surgery may be needed to remove scar tissue or growths that are preventing the bladder from emptying normally. Medications can be used to treat an enlarged prostate and make it easier to urinate.
If you've been having problems with bladder control or urine leakage, talk to your doctor. Your doctor may recommend that you keep a diary or a record of some kind to see how often you go to the toilet, your fluid intake, and how often you are leaking urine. Your doctor can also recommend treatments to help with your symptoms. So don't suffer in silence - there's a lot that can be done to help.