Urinary incontinence -- the involuntary loss of urine -- is one of the potential side effects of prostate cancer surgery. The urinary sphincter may be damaged during prostate removal, compromising a man's to hold on urine. This condition can be temporary, although about 5% of men have permanent urinary incontinence following prostate surgery. This quality-of-life issue can be managed.
Kegel exercises can help the muscles damaged during surgery relearn the process of holding in urine. These exercises can be learned and practiced before prostate surgery and continued while the urinary catheter is in place, usually a period of about three weeks. Kegel exercises strengthen the pelvic muscles. Squeeze your buttocks while tightening down on your pelvic muscles, just as you would if you were needing to hold in urine while waiting for a place to use the restroom. Kegel exercises should be done in five-minute periods hourly. Keep doing the exercises as long as urinary incontinence is a problem.
Your doctor can prescribe an anticholinergic medication to relax the bladder and reduce urinary incontinence. Ditropan XL, Detrol LA, and the Oxytrol patch are the most common. Ditropan and Detrol are oral, taken once daily. Oxytrol is a patch that lasts two weeks before changing. The medications' time-release mechanism works over a 24-hour period to eliminate bladder urgency. Urinary incontinence medications can cause constipation, dry mouth and blurry vision in some men.
A penile clamp is one option for restricting the constant flow of urine that can follow prostate cancer surgery. Various clamps are available, including clamps that conform to the shape of the penis. Place the clamp halfway down the penis and tighten it to compress the urethra and stop the urine flow. Remove the clamp hourly to empthy the bladder. Leaving the clamp on for long periods of time can result in bladder infections and damage to the penis.
Protective undergarments for adult men can protect clothing from unexpected leakage during recovery from prostate surgery. Choose from either pads inserted into your regular undergarments or full-size undergarments with velcro fasteners and elastic leg fittings. Undergarments are available in the pharmacy section. These are usually used only in the early recovery stage after the catheter is removed.
If urinary incontinence persists, you may choose a corrective follow-up procedure. Ask your urologist about inserting an artificial urinary sphincter or a "male sling." The artificial sphincter, made of silicone, is surgically placed around the urethra at the neck of the bladder. A pump inserted in the scrotum activates the sphincter and increases control. If you choose the male sling, the surgeon will, in an outpatient procedure, attach a polyester strip to your pubic bone. The sling elevates the urethra to limit leakage.
Ask your doctor about the potential for practicing biofeedback to gain greater contol of your pelvic strength. Consider collagen injections to strengthen the tissues around the neck of your bladder. These can be repeated on an outpatient basis.