Treatment of urinary incontinence after prostate surgery

Treatment of urinary incontinence after prostate surgery

Complete removal of the prostate (prostatectomy) is often the only option
a permanent cure for localized prostate cancer. After the operation, many men complain of temporary incontinence, but in around 2% to 10% it persists after the prostate removal as a condition requiring treatment.

The causes of urinary incontinence after prostate removal

A prostate removal is always associated with a weakening of the sphincter. Urine loss occurs during exercise, sport and coughing. The doctor is talking about one here
Stress incontinence. The cause here is muscle and nerve irritation. These regenerate
usually after a few months. An anatomical change in the position of the urethra can also be a possible cause. In this case, the sphincter can no longer close properly after the prostate is removed. Injury to the sphincter during surgery is very rare and is the exception.

Diagnosis and therapy

If incontinence still persists after three months of prostate removal, the cause must be investigated. Bladder pressure measurement and cystoscopy are used as diagnostic procedures. The probes are also equipped with special mini cameras. The doctor demonstrates the function of the sphincter to the patient. The patient can follow what is happening live via a monitor and in this way learns how to correctly tense the sphincter (video endoscopy with biofeedback). The chance of regaining continence after prostate removal is generally very high. If there is still no success after a year, postoperative interventions can help:

  • Injections of the sphincter
  • Creation of an artificial sphincter
  • Implantation of urethral loops or microballoons

Pelvic floor training to support treatment

The best method to be able to hold urine again after the removal of the prostate is to train the pelvic floor. The focus is on strengthening the pelvic muscles. Learning in a special clinic or outpatient clinic promises the greatest success. The exercises can then be continued at home. To support successful healing, good cooperation between doctors from a clinical continence center and the treating urologist is necessary.

Conclusion

Even after prostate surgery, regaining continence and thus an improvement in quality of life is very likely.