Post-Prostatectomy Urinary Incontinence: Causes and Concerns

excuse me?

Why am I still experiencing urinary leakage 17 months after prostate removal, approximately 10 times a day? Is it normal for my genitalia to feel shorter?

ho, 50~59 year old female. Ask Date: 2006/08/09

Dr. Lin Wenxu reply Urology

Based on your statement, I suspect that you might be a patient with prostate cancer who has undergone a prostatectomy.
If that is the case, the likelihood of experiencing urinary incontinence post-surgery is quite high, although the severity can vary.
According to textbooks, only about 10% of patients who undergo this type of surgery experience no urinary incontinence at all.
Fortunately, most patients have mild incontinence that can be managed through pelvic floor muscle training and oral medications (25% may experience complete urinary incontinence or other severe forms of incontinence).
I recommend that you visit a urology clinic for a detailed examination and further treatment.

Reply Date: 2006/08/09

More Info

Post-prostatectomy urinary incontinence (UI) is a common concern among men who have undergone prostate surgery, particularly radical prostatectomy for prostate cancer. This condition can significantly affect a patient's quality of life, leading to emotional distress and social withdrawal. Understanding the causes and concerns associated with post-prostatectomy urinary incontinence is crucial for both patients and healthcare providers.

Causes of Post-Prostatectomy Urinary Incontinence
1. Surgical Technique: The type of surgical technique used can greatly influence the likelihood of developing urinary incontinence. Nerve-sparing techniques tend to preserve the nerves responsible for bladder control, while non-nerve-sparing techniques may increase the risk of UI.

2. Anatomical Changes: The removal of the prostate alters the anatomy of the pelvic region, which can affect the bladder and urethra. This change can lead to difficulties in controlling urination.

3. Muscle Damage: During surgery, the pelvic floor muscles and the external urinary sphincter may be damaged. These muscles are essential for maintaining urinary continence, and any injury can lead to leakage.

4. Age and Pre-existing Conditions: Older age and pre-existing conditions such as diabetes or prior pelvic surgery can increase the risk of urinary incontinence post-surgery.

5. Radiation Therapy: If radiation therapy was part of the treatment plan, it could also contribute to urinary incontinence due to damage to the bladder and surrounding tissues.

Concerns Associated with Post-Prostatectomy Urinary Incontinence
1. Quality of Life: The emotional and psychological impact of urinary incontinence can be profound. Many men experience embarrassment, anxiety, and depression due to their condition, which can lead to social isolation.

2. Physical Health: Frequent urination (as you mentioned, approximately 10 times a day) can lead to skin irritation and infections, particularly if the individual is using pads or other absorbent products.

3. Sexual Function: Many men report changes in sexual function following prostate surgery, including penile shortening and erectile dysfunction. These changes can further exacerbate feelings of inadequacy and distress.

4. Management Options: It is essential to discuss management options with a healthcare provider. These may include pelvic floor exercises (Kegel exercises), medications, lifestyle modifications, and in some cases, surgical interventions such as artificial urinary sphincters or slings.

5. Long-term Outlook: While some men may experience improvement in urinary control over time, others may continue to have issues long after surgery. It is important to have realistic expectations and to seek help if incontinence persists.

Conclusion
In summary, post-prostatectomy urinary incontinence is a multifactorial issue that can arise due to surgical technique, anatomical changes, muscle damage, and other factors. If you are experiencing significant leakage and changes in your sexual function, it is crucial to consult with a urologist or a healthcare provider specializing in male pelvic health. They can provide a comprehensive evaluation and discuss potential treatment options tailored to your specific needs. Remember, you are not alone in this experience, and there are resources and support available to help you manage these challenges effectively.

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