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Continence After Prostate Cancer

Urinary incontinence after robotic prostate removal surgery is almost always short term. The impaired urinary control that most men experience after prostate surgery is very similar to the stress incontinence that women have after childbirth. The sphincter muscles that manage the release of urine may be temporarily disrupted or damaged during surgery.

Should you be worried about incontinence after prostate cancer surgery?

Most often, the short-term incontinence that men experience after prostate cancer surgery involves slight dripping or leaking, particularly during strenuous activity. Sometimes even a cough, sneeze, or laugh can trigger unwanted bladder emptying.

In the hands of an experienced surgeon, most patients can regain urinary control in just two to three months. These results are more often noticeable in patients that choose robotic surgery as a form of treatment. The high precision of the robotic arms allow the doctor to avoid the urinary sphincter during surgery, which significantly improves urinary outcomes, with much faster results. Additionally, by leaving the dorsal vein complex stitch until the end of surgery, the doctor is in complete control of the length of the urethra, thereby reducing leaking after surgery.

How to regain urinary continence after surgery?

  • Kegel Exercises – Dr. Samadi recommends kegel exercises to every man after robotic prostate surgery. This simple exercise involves repetitive sets of clenching and releasing the muscles that stops the flow of urine. Research indicates that men who begin these exercises prior to surgery see improved recovery results afterwards.
  • Continence Medication – Some patients may be advised to take prescription medications such as anticholinergics to alleviate the frequent sensation of having to urinate. For some, decongestants can help strengthen sphincter muscles, but should only be used under physician advisement.
  • Collagen Injections – Collagen injections can also provide short-term relief from issues of incontinence after prostate cancer. Urine control is improved by plumping the urinary sphincter through a series of collagen injections.
  • Surgery For Incontinence – Long-term incontinence after prostate removal is rare. Dr. Samadi and his team of specialists will assist men with long-lasting incontinence through a range of treatment options. Several surgeries are available for restoring urinary control in patients whose symptoms persist for a year or more.

Bibliography

  1. Prostate Cancer: Urinary Incontinence, WebMed, Web, 8 Jul 2018
  2. Risk of Urinary Incontinence Following Prostatectomy, PubMed Abstract, Web, 16 Dec 2009
  3. Conservative Treatment for Postprostatectomy Incontinence, PubMed Abstract, Web, 15 Feb 2013, 61-66
  4. Urinary Incontinence, Patient Satisfaction, and Decisional Regret, Urologia Internationalis, Web, 19 Dec 2017

Dr. David Samadi | Robotic Prostate Surgeon