Comparing Robotics Vs Open Continence Outcomes
There are few head-to-head comparisons of open versus robotic surgery performed by the same surgeon at the similar points in their learning curve or case experience. It would be easy to skew the comparison in favor of the robotic camp by cherry-picking a handful of favorable robotics series and several low quality open radical prostatectomy studies. It is more informative to take an honest look at all of the available literature and analyze the outcomes data from the highest quality available studies from the top robotic and open surgeons. When analyzing these data from high volume surgeons where the technique from case to case is nearly identical, we have technical data so-to-speak, that is, data which is more influenced by surgical modality and operative technique than by patient factors. We must also review, however, bread-and-butter studies, which are more representative of the experience the average patient will have in a general community surgeon practice. The reality is that many patients are not having their operation done at the high volume academic centers from the top tier surgeons who are writing the papers from which we are extracting this data.
How Do You Retrain Your Bladder After A Catheter Is Removed
Gradually increase the amount of time between bathroom breaks. Delay urination. When you feel the urge to urinate, hold it for another five minutes or so. Then gradually increase the amount of time by 10 minutes, until you can last for at least three to four hours without having to go to the bathroom.
Continuous Irrigation Of The Bladder After Prostatectomy
Prostatectomy is one of the most common surgical procedures performed in the prostate. It can be suprapubic prostatectomy or transurethral resection. It is a common procedure in cases of prostate cancer and benign prostatic hyperplasia.
You might need CBI in this case and other surgical procedures concerning the prostate. Remember that the male prostate is located in the bladder neck. By accessing to the prostate, other surrounding tissues will likely be affected. This is the prostatic fossa.
The manipulation of the prostate may also cause mild tearing in the bladder. Thus, continuous irrigation of the bladder is recommended in many cases. It is actually considered a routine post-operative procedure for some doctors. Still, if your doctor does not consider CBI necessary, he may have valid reasons, too .
We mentioned above the reasons why we typically advocate CBI after prostate surgery. In the case of prostatectomy, patients will already have a catheter placed after surgery. An additional reason in this particular case is to avoid collapsing the lumen of the catheter.
But if your doctor decided not to perform continuous irrigation, heres a list of possible reasons :
For all of the above, your doctor may or may not consider CBI in your case. If he does not use CBI, it is probably because your surgery had some bleeding. But if youre a candidate for CBI, rest assured it is for your sake.
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Restoring Sexual Function After Prostate Surgery
Prostate cancer affects nearly 1 in 7 men. Fortunately, its a very treatable condition, especially when its caught early. One of the most common treatments for prostate cancer or having an enlarged prostate is to undergo prostate surgery, also known as a prostatectomy. This surgery comes with a very high success rate, boasting a 10 year survival of nearly 90%, but just like any other surgery it will come with potential risks and side effects.
According to the Prostate Cancer Foundation, one of the most common side effects of a prostatectomy is erectile dysfunction. Luckily, there are plenty of ways to fight back against erectile dysfunction and restore sexual function while recovering from prostate surgery.
Incontinence After Prostate Surgery Forums
Going through prostate cancer and having your prostate removed can be a physically and emotionally trying time in life. Many men are unprepared for the extent to which they may experience bladder leaks after prostate removal and it can be disheartening to have undergone surgery only to experience a loss of bladder control for a period afterward.
Fortunately, this is usually resolved within a year. During that time though, you may find that you need someone to talk to about your experience. Finding a forum or message board filled with people who can relate can help ease some of the tensions that you may be going through.
The NAFC message boards are a great way to connect with others who may also be experiencing incontinence, due to prostate surgery or other conditions. Theyre free to join and the forum is anonymous so you can speak freely without the worry of feeling embarrassed or ashamed. NAFC is proud of this amazing group of individuals who visit the forums and courageously share their stories, offer support, and provide inspiration to each other. We encourage you to check it out!
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What If My Incontinence Persists
When bladder leaks persist more than a year, other treatments may be needed to improve the urinary control.
Though rarely needed, Dr. David Samadi and his team provide a range of treatment options for men experiencing long-term incontinence after prostate surgery.
A variety of surgical procedures can be used to restore urinary control should your symptoms last more than a year.
How Is Urinary Incontinence After Prostate Surgery Treated
If you find youre having issues with mild to moderate leakage after surgery, your healthcare provider might suggest starting with noninvasive therapies like medications or physical therapy exercises for the pelvic floor muscles. These treatments may also cut down on the number of times that you have to get up each night to pee.
These methods can sometimes help men who have mild to moderate leakage. Men who have persistent leakage or a more severe problem may need surgery if they do not want to continue to use pads.
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Questions To Ask Your Doctor Or Nurse
- Is the treatment Im having for prostate cancer likely to cause any urinary problems?
- What type of urinary problems might I get?
- What should I do if I cant urinate?
- Will my urinary problems get better?
- What treatments are available?
- What are the risks and side effects of treatments for urinary problems?
- What can I do to help myself?
- Where can I get pads and other products?
Why Is A Simple Prostatectomy Performed
There are varying degrees of prostate enlargement.
If your prostate grows only slightly, many minimally-invasive surgeries can remove part of the gland, such as transurethral resection of the prostate .
However, if your prostate becomes very large , your surgeon will need to perform a simple prostatectomy. This involves removing the inner core of your prostate gland. Most men who undergo this type of surgery are age 60 or older.
Special diets, changes in drinking habits, and medications are often tried before surgery is recommended.
Your doctor may recommend a simple prostatectomy if your prostate is very large and you are suffering from:
- extremely slow urination
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Continence After Prostate Cancer Surgery How Long Does It Last
A prostatectomy is a procedure that can affect a man both physically and emotionally. Undergoing such a surgery may come with various reasons for anxiety and fear. Incontinence may be one of them.
The prostate is an important gland in the body that regulates many physical functions, including the urinary and sexual functions. Once removed through radical prostatectomy, negative side-effects may result. The most common reasons for concern are:
- Urinary incontinence
- Sexual dysfunction
Practice Good Toilet Habits
Go to the toilet when your bladder feels full dont get into the habit of going just in case. After prostate surgery you may find that you do not experience the sensation of a full bladder. The sensation of a full bladder will gradually return as you are able to hold on longer. It is important to practice holding on to increase the amount of urine your bladder can hold.
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How Can I Improve Incontinence After Prostate Surgery
Want to stop incontinence after prostate surgery? Kegels may be your answer! As mentioned above, kegels are a common treatment option for incontinence after prostate surgery. Among other things, the pelvic floor muscles help control bladder and bowel function and, like other muscles of the body, if they get weak they are no longer able to do their job effectively. To improve muscle function, kegels must be done regularly, every day. The good news is that they can be performed pretty much anywhere, anytime, and in a variety of positions . For a complete guide on performing a mens kegel, click here.)
Biofeedback can sometimes be used to determine if you are performing a kegel properly. And, electrical stimulation may also be used to help re-teach the muscles to contract.
What Are The Different Surgeries For Incontinence
There are three main types of surgical treatments for men who have incontinence following a RP:
Talk to your urologist for more details about your options and the risks and benefits of your situation.
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Risks Of Prostate Surgery
The risks with any type of radical prostatectomy are much like those of any major surgery. Problems during or shortly after the operation can include:
- Reactions to anesthesia
- Blood clots in the legs or lungs
- Damage to nearby organs
- Infections at the surgery site.
Rarely, part of the intestine might be injured during surgery, which could lead to infections in the abdomen and might require more surgery to fix. Injuries to the intestines are more common with laparoscopic and robotic surgeries than with the open approach.
If lymph nodes are removed, a collection of lymph fluid can form and may need to be drained.
In extremely rare cases, a man can die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team.
How Long Does Urinary Incontinence After Prostate Surgery Last
It’s impossible to say exactly how long it lasts. The chances of you having urinary problems may be influenced by your age, weight and the physical characteristics of your urethra .
However, a majority of men are eventually continent after a radical prostatectomy. In many cases, men are able to go safely without any kind of incontinence product after about three months. This is especially true of men who are healthy overall and fall into the age range of 40 to 60 years. If you are having persistent problems, its important to know that there are ways to treat urinary incontinence after prostate surgery.
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Bleeding After Prostate Surgery
Bleeding after prostate surgery is among the most common problems. To prevent the problem, a drain system is installed in the surgical area, and in addition to this system, some treatments are also performed to prevent bleeding. Although bleeding after prostate surgery is not a sign of important problems, you should definitely contact your physician if the condition has become chronic.
There is a number of risks that can occur after prostate surgery. These risks may include urination problems, urinary incontinence, bleeding, and sexual dysfunction. In this article, we will talk about the bleeding problem faced after prostate surgery.
Urinary Dysfunction After Prostate Cancer Treatment
The term urinary dysfunction includes:
Urinary incontinence, which can range from some leaking to complete loss of bladder control
Irritative voiding symptoms or urinary bother, including increased urinary frequency, urgency, and pain upon urination
Bladder obstruction caused by an enlarged prostate is the typical reason for these symptoms initially. However, after therapy, they are typically caused by damage to the nerves and muscles used in urinary control.
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What Is A Urethral Sling Procedure And How Does It Help With Urinary Incontinence
In the urethral sling procedure, a synthetic mesh tape is placed around part of the urethra, moving the urethra into a new position. This is a minimally invasive procedure, which means that the surgeon only has to make a small incision in the perineum .
Your provider may recommend a urethral sling procedure if you have mild to moderate urinary incontinence after a radical prostatectomy that hasnt improved using other more conservative measures. It’s highly successful in helping men overcome incontinence, or reduce episodes of leaking urine.
Before the surgery, the provider may do some tests, including the following:
- A urodynamic study, to test how well the bladder is working.
- A 24-hour pad test .
- A cystoscopy, a test in which the doctor looks inside the bladder with an instrument called a cystoscope.
You dont have to donate any of your own blood before surgery.
Will I Need Continence Pads
During the first few weeks after a prostatectomy, almost all patients experience some urinary incontinence. This is because removing the prostate disturbs the area between the bladder and urethra, which carries urine out of the body. During surgery, the bladder is pulled down to join the urethra and in so doing, restoring continuity. The bladder neck muscle is sometimes also weakened during surgery. We recommend that you buy continence pads before surgery and bring them into hospital with you. They can be purchased in high street pharmacies.
At the Birmingham Prostate Clinic, we specialise in nerve-sparing laparoscopic surgery which significantly reduces the impact upon the bladder. This means that many patients are dry within weeks of surgery. However, we recommend that all patients buy male incontinence pads before surgery and bring them into hospital when they come in for surgery. The results of our study of nerve-sparing prostate surgery show 82 per cent of men no longer need pads three months after surgery and this figure increases to 92 per cent six months after surgery. For the small number of men who have longer term continence problems or require further support, we can refer you to your local continence service.
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Why Does It Happen
- At the point where the bladder and urethra join, there is a ring of muscles known as the bladder neck sphincter, which opens and closes like a camera shutter. The bladder neck sphincter is closed most of the time to prevent urine leaking out, but when it gets a signal from the brain, it opens to allow urine to be passed.
- If the bladder neck sphincter is damaged during prostate cancer surgery, this can lead to urinary incontinence.
- Another sphincter is part of another set of muscles below the prostate called the pelvic floor. These muscles are also involved in bladder control.
Most men regain their bladder control over time and are fully recovered within 6 to 12 months. It is important to get professional advice to help cope bladder weakness during this time.
The Takeaway: There Are Many Options At Restoring Sexual Function During The Recovery Of Prostate Surgery The Most Common Will Be The Use Of Oral Medications That Help Relax Penis Muscles And Increase Blood Flow But In The Event That These Are Ineffective Or Not An Option There Are Other Choices Available
For the most part, restoring sexual function is most easily achieved with the help of prescription medication such as Viagra®, Levitra, or Cialis®. In more extreme cases, there may be further surgery required, penile injections, or prosthetics. Ultimately, it will all come down to the specific person and their circumstances, risk factors for erectile dysfunction, lifestyle, and results of the prostate surgery itself.
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Can I Travel With A Urostomy
Yes, it just takes a little planning. Make sure to take about double the supplies you think youâll need.
If youâre traveling by car:
- Have a good idea of where you may stop for bathroom breaks.
- Donât leave your supplies in a hot car — they could melt.
If youâre flying:
- Travel with a doctorâs note saying you have a urostomy. This can clear up any questions as you go through security.
- Ask airport screeners for privacy.
- Put your supplies in your carry-on bag.
Problems After Prostate Cancer Treatment
Many men get urinary problems as a side effect of their treatment. This is because prostate cancer treatment can damage the nerves and muscles that control when you urinate .
If youre starting treatment for prostate cancer, ask your doctor about the possible side effects. Each treatment can cause different urinary problems. Your chances of getting each side effect will depend on the treatment youre having, and on whether or not you had urinary problems before starting treatment.
If youve already had prostate cancer treatment and you have urinary problems, tell your doctor or nurse. They can suggest treatments and lifestyle changes to help manage them.
Depending on the type of problems youre having, ways to manage them can include lifestyle changes, pelvic floor muscle exercises, bladder retraining, medicines or surgery. For practical tips read our How to manage urinary problems guide.
Watch Paul’s story below for one man’s experience of managing urinary problems after prostate cancer treatment.
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