The loss of urinary continence is one of the most common side effects after removal of the prostate gland and is due to the result of disruption or distress to the sphincter muscles that control the release of urine.
Because of the frequency of urinary functioning throughout the day, even temporary urinary incontinence can produce anxiety and stress for a man after prostate surgery. What used to be a bodily function that a man didn’t need to think much about now has become a potential embarrassing situation he must plan ahead for daily.
The good news is that urinary incontinence is usually short-term after surgery and usually consists of a slight drip or leak that can happen after strenuous exercise or when a man coughs, sneezes or laughs.
The length of urinary incontinence will vary for each man with recovery ranging from weeks to months. If a man had normal continence prior to prostate surgery he should expect to regain full urinary function with 12-13 months post-surgery. Permanent incontinence is rare particularly when performed by an experienced surgeon.
After prostate surgery, a man will have a catheter in the penis draining the bladder. Most men tolerate a catheter well but for some it can be annoying as it can cause a sensation of the need to urinate or cause irritation of the tip of the penis. Medication such as lidocaine jelly can be applied to the tip of the penis to make it feel more comfortable.
One thing that may help to regain urinary continence as soon as possible is to perform Kegel exercises which exercise the pelvic floor muscles. Kegel exercises are performed by contracting and relaxing the pubococcygeal muscles and other muscles of the pelvic floor. To perform these muscles, a man should try to stop the flow of urine midstream and are best performed when sitting. It is advisable to start practicing Kegel exercises before surgery as a type of pre-conditioning.
After surgery, once the catheter is removed, it is recommended for men to exercise the pelvic floor muscles by doing Kegel exercises as soon as possible. A suggested Kegel regimen includes:
· Contract the pelvic floor muscles
· Hold the contraction for two to three seconds, then relax
· Repeat 10 times
· Do this three times a day
Depending on the degree and length of incontinence, anticholinergics may be prescribed to reduce the sensation or frequency of urination. Other possible treatments to address incontinence might include using decongestants which have been shown to help some patients – use only with a physician’s guidance – and collagen injections which can help plump the urinary sphincter for increased urinary control.
It is rare for urinary incontinence to persist long-term but if it does, there are treatment options of various surgical procedures to help restore urinary control.