Urinary incontinence following radical prostatectomy occurs due to damage of the distal urethral sphincter mechanism during surgery causing post-operative weakness. This means that the muscle that holds the entrance to the bladder closed to prevent the leakage of urine is not strong enough to perform its function properly.
This kind of incontinence is characterised by involuntary leakage of urine, especially during activities that increase pressure in the abdomen including laughing, coughing and heavy lifting.
Regardless of how experienced the surgeon is and regardless of what surgical technique was used, severe urinary incontinence will occur in at least 3% of cases.
It is completely normal to experience a degree of sphincter weakness incontinence once the catheter is removed after surgery.
Symptoms may include stress incontinence, frequency, urgency, urge incontinence, post-micturition dribble, nocturia and nocturnal enuresis. The severity of incontinence varies: some men will have very little bladder control, some men will only have minor leaking for a few days.
Incontinence after prostate cancer treatment.
Pelvic floor retraining.
Treatment for post-operative incontinence is by intensive pelvic floor retraining. It is useful for men to learn how to perform pelvic floor exercises prior to surgery. Before undergoing surgery with Doctor Katelaris you will have an appointment with our practice nurse, Ms Libby King.
She will instruct you in the correct technique before the operation, when you are without pain or discomfort. Strong muscles pre-operatively also help after surgery as you will know how to use your pelvic floor muscles effectively thereby reducing or even preventing post-operative incontinence.
Following surgery, a catheter will be indwelling for 1 – 2 weeks. You should not perform pelvic floor exercises until the catheter is removed, then daily pelvic floor retraining will help reduce the duration and severity of post-operative incontinence.
With daily training and the passage of time, most men regain bladder control over a three – six month period.
If your post-prostatectomy incontinence does not resolve, other surgical treatments are an option. These include implantation of an artificial urinary sphincter or a male sling.