Prostate Predicaments Part 1: Managing Urinary Issues
By Corey Heerschap, RN, NSWOC, WOCC(c), MScCH
It’s prostate cancer month—a time to spread awareness of a disease that affects 1 in 7 Canadian men.1 This two-part series will focus on the issue of urinary and fecal incontinence many men face during and after prostate cancer surgery and treatment.
Urinary Incontinence following prostate surgery has been reported in a wide range of men undergoing surgery: anywhere from as low as 1% to as high as 87%.2 Episodes of incontinence are common after surgery and for most, they last a few months; however, for some these periods of incontinence can last much longer.2
After prostate surgery men with urinary incontinence may experience two types of incontinence: stress and urge incontinence, or a mix of the two 2:
Stress Incontinence: This occurs when the pressure in your abdomen increases such as when you cough, sneeze, or laugh. The pressure squeezes urine out of the bladder and because the muscle that controls urine flow is weakened, urine leaks.3
Urge Incontinence: This occurs when the muscles around the bladder contract without you meaning for them too leading to feelings of an urgent need to urinate.3
If you are experiencing urinary incontinence after prostate surgery, you should be assessed by a healthcare professional to determine the cause of your urinary incontinence and the best way to manage it.2 This assessment can be completed by your surgeon, family physician, or by someone who specializes in urinary incontinence.
Urinary incontinence after prostate surgery can be difficult to manage both physically and emotionally. Martin, a patient who is managing his urinary incontinence after prostate surgery, describes his story and how he managed these changes.
Your continence specialist may recommend several treatment methods for managing your urinary incontinence.4 For the first 6-12 months non-surgical, conservative treatment methods are often the first used. 6 This may include pelvic muscle exercises which help to strengthen the muscles that support the bladder and prevent urine leakage.5 If you’ve not responded to other treatment methods after this time, surgical methods may be discussed with your physician. Medications for urge incontinence are another option to discuss with your physician.4
Your healthcare professional may suggest devices that contain urine while protecting your skin from irritation. Disposable absorbent pads or briefs are options to manage leaks.4 Meticulous skin care is important to prevent skin issues due to moisture resting against the skin.4 This can be done using a perineal skin cleanser, moisturizers, and skin protection such as barrier creams..4 In cases of severe urinary incontinence some may benefit from other devices such as a condom catheter.4 These options should be discussed with your healthcare provider or continence specialist.
Hopefully this information will help you seek access to treatment options and resources to help you live your life to the fullest. Stay tuned for part two on incontinence following prostate cancer treatment.
1Fradet, Y., Klotz, L., Trachtenberg, J., & Zlotta, A. (2009). The burden of prostate cancer in Canada. Can Urol Assoc J, 3(3 suppl 2), S92-S100.
2Chul Kim, J., & Jun Cho, K. (2012). Current trends in the management of post-prostatectomy incontinence. Korean J Urol, 53(8), 511-518.
3Mirza, M., Griebling, T.L., & Wallace Kazer, M. (2011). Erectile dysfunction and urinary incontinence after prostate cancer treatment. Seminars in Oncology Nursing, 27(4), 278-289.
4Cameron, A.P., Jimbo, M., & Heidelbaugh, J.J. (2013). Diagnosis and office-based treatment of urinary incontinence in adults. Part two: treatment. Ther Adv Urol, 5(4), 189-200.
5Moore, K.C., & Lucas, M.G. (2010). Management of male urinary incontinence. Indian J Urol, 26(2), 236-244.
6Chughati, B., Lee, R., Sandhu, J., Te, A., & Kaplan, S. (2013). Conservative treatment for postprostatectomy incontinence. Rev Urol, 15(2), 61-66.