Multidimensional Approach Can Help Men Better Manage Incontinence After Prostate Surgery

Treating incontinence is a collaboration.

by Dianna Malkowski, Physician Assistant & Nutritionist

Up to half of men will experience bladder leakage following prostate surgery. Fortunately, there are several approaches to incontinence management that are easy to put into practice and proven to be effective.

Incontinence following prostate surgery, while often temporary, can disrupt a man’s quality of life and cause anxiety, isolation and embarrassment. Learning to live with urinary incontinence often is a multifaceted approach.

Prostate cancer is the most prevalent male cancer. When cancer has not spread to other organs, surgery is often used to treat it. About one-third to half of men will experience urine leakage following prostate surgery.

There is no one right way to deal with incontinence. The key is to find the best approach for each individual. That may mean a combination of using the right absorbent products, strengthening exercises, bladder retraining and medication.

A urologist may prescribe any combination of the following treatments:

• Absorbent products come in an array of styles and absorbencies to fit every lifestyle. Active men who want something as close to regular underwear as possible can choose from washable, reusable briefs or premium disposable briefs like look and feel like cloth underwear. Those who need more absorbency can choose from guards, undergarments, underwear, adult diapers and more.

• Kegel exercises, when performed regularly, tone and strengthen the muscles responsible for holding in urine. Starting Kegels before a radical prostatectomy may result in quicker recovery of bladder control. Kegels are performed by tightening only the pelvic muscles, while keeping abdominal, thigh and buttock muscles relaxed. A doctor will prescribe the correct number of frequency, sets and repetitions.

• Bladder retraining, or learning to urinate on a set schedule, can be an effective treatment once pain is under control. A health care provider will develop a bladder retraining program that may include keeping a diary and working up to going longer periods between voiding.

• Medication may be prescribed based on an individual’s type of incontinence. A man with stress incontinence — the most common type following prostate surgery and characterized by leakage when coughing, sneezing, laughing or exercising — may be prescribed decongestants to tighten the urethra muscles. One with urge incontinence — when an overactive bladder contracts without warning — may be treated with anticholinergic drugs that block messages to bladder nerves and prevent spasms.

In cases where incontinence persists longer than 18 months, treatment options may include collagen injections, a catheter or surgery.

Read more here about the effects of prostate surgery, how to perform Kegel exercises and how to regain control. Or visit the Caregiver Resource Library for more than 1,400 links to educational resources for incontinence and other areas of interest to seniors and caregivers.

Dianna Malkowski is a Board Certified Physician Assistant and Mayo Clinic trained nutritionist specializing in diabetes, cancer, wound healing, therapeutic diets and nutrition support. She serves on the board of professional advisors for The CareGiver Partnership and enjoys working with patients and caregivers alike. Ask Dianna a question or call 1-800-985-1353.

Watch this video for tips on choosing the right incontinence products.