‘just Cant Wait’ Card
You can get a card to show to staff in shops or pubs etc. It allows you to use their toilets, without them asking awkward questions. You can get the cards from Disability Rights UK or the Bladder and Bowel Community. They also have a map of all the public toilets in the UK.
You could get a key to disabled toilets if you need to access them quickly. You buy the RADAR key from Disability Rights UK. But this should only be used by people who need quick access to a disabled toilet due to a disability or medical condition.
Tips
- Find out where the toilets are.
- Take extra pads and spare underwear.
- Organise a Just cant wait card or key for disabled toilets if you need it.
- Do your pelvic floor exercises regularly.
What Can Help With Leaking Urine
There are treatments and products available that can help, and there are things you can do to help yourself. Your treatment options will depend on how much urine youre leaking, and how recently you had your prostate cancer treatment.
Treatments and products available that can help include:
- absorbent pads and pants
- bed protectors and handheld urinals
If you have sudden urges to urinate and sometimes leak urine before you get to the toilet , you may be offered bladder retraining.
If you still leak urine six to twelve months after surgery and pelvic floor muscle exercises havent helped, there are treatments available that might help. These may include:
- an internal male sling
- adjustable balloons
Talk to your doctor or nurse about treatments and products that may be suitable for you.
Absorbent pads and pants
These can be worn inside your underwear or instead of underwear to soak up any leaks. Some people find it helpful to wear close fitting underwear with pads. You may want to try female pads as your leaking improves, as these tend to be smaller and lighter and may fit better. Pads are usually very discreet, so people wont know youre wearing them. But you may feel more confident wearing dark trousers so it wont show as much if your pad does leak.
Pelvic floor muscle exercises
Read about pelvic floor muscle exercises.
Urinary sheaths
Bed protectors and handheld urinals
Penile clamps
Internal male sling
Like all treatments, there can be side effects.
Adjustable balloons
Exercise Your Pelvic Floor Muscles
Learning how to control the pelvic floor muscles can speed up the recovery process and reduce leakage. If you don’t strengthen these muscles, the leakage may persist.
Please note: Performing pelvic floor muscle exercises before and after prostate surgery is vital to your recovery. Resume pelvic floor exercises once the catheter has been removed to avoid bladder irritation and discomfort. It is recommended that you seek help from a mens, womens and pelvic health physiotherapist, Nurse Continence Specialist, or urology nurse to learn the correct technique.
More information about the pelvic floor muscles can be found on our pelvic floor and male pelvic floor pages. You can also learn more about pelvic floor friendly exercises at pelvicfloorfirst.org.au.
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How Long Does Incontinence Last After Prostate Cancer
Its rare that men experience long term incontinence after prostate cancer treatment. As a general rule, if your incontinence symptoms last over a year, you should contact a Doctor. There are a number of procedures that exist to restore continence if you do find yourself with long term incontinence.
Urinary Frequency And Urgency
Some men find they need to urinate more often after having radiotherapy , or get a sudden urge thats hard to ignore . You may also need to urinate more often at night . It usually only lasts for a few months after radiotherapy, but if it happens, it might help to drink less in the two hours before you go to bed, and to avoid drinks that irritate the bladder
A small number of men leak urine before they can reach the toilet . This happens when the bladder muscles twitch and squeeze without you controlling them. This pushes urine out before youre ready.
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What You Need To Know About The Prostate How Long Does Incontinence Last After Prostate Surgery
A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.
While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.
Is To See Your Health Care Practitioner
Heres a list of medical experts who can all assist with urinary leakage from a number of different perspectives and in different ways:
General Practitioners can assess, diagnose and treat urinary leakage. They have varying levels of knowledge and experience with incontinence. Some may choose to refer you to a continence health professional rather than diagnose and treat your condition. In many cases it is important to involve your GP in your continence care as they have good knowledge of your health history, including any medical conditions, surgery or medications you may be on, which may increase your chances of developing continence issues.
Urologists have a combination of medical and surgical training who treat men and women with kidney, bladder, and urinary problems.
Gynecologists specialize in preventing and treating illnesses of the female reproductive organs. If you are incontinent, your general practitioner may refer you to a gynecologist for urinary incontinence treatment.
Urogynecologists are gynecologists who have undertaken further advanced specialist training to deal with the complexities of vaginal prolapse and types of bladder dysfunction including urinary leakage.
Pharmacists can offer advice on medications that may cause or aggravate incontinence. They may also be able to provide you with continence product advice, free information resources, and the details of local continence service providers.
Stages of Urinary incontinence
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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.
The Procedure That Got Me Dry Again After Nine Years Of Incontinence
Like many men, Peter Barton had to deal with urinary incontinence after prostate surgery and was among those who dont see the problem improve over time. After years of using pads as the problem got worse, Peter decided to try a surgical treatment the male sling.
PETER: As a fit farmer aged 65 it was a great shock when I was diagnosed with prostate cancer back in 2008. My wife and I examined all the options for treatment and opted for robotic assisted surgery, which was then still in its early development in the UK.
The surgery went well. My excellent urologist had said that wed just got the tumour before it had broken out of the prostate and my family were much relieved as he confirmed the cancer was unlikely to return.
I was out of hospital in two days but had to wear a catheter for two weeks these were pretty miserable weeks. It wasnt painful at all, but it was awkward. It kept getting caught up on things and was constantly leaking. Things improved when the catheter was removed however I was left incontinent.
For the next nine years life was good but, although I followed instructions about pelvic floor exercises, which I know work for some men, my incontinence slowly worsened. For the first year or two I was using a size one pad the lightest. After two years, Id moved on to the number two and by the last few years I was on a number three, which needed changing several times a day. Each of these can hold a considerable amount of urine.
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Urinary 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.
Why Does Incontinence Happen After Prostate Cancer Surgery
There are two sphincter muscles that help men control their urine, also called being continent. These sphincters are:
- The internal urethral sphincter: You do not control your internal sphincter. It is found at the bottom of the bladder, called the “bladder neck. This is removed during a radical prostatectomy . The prostate cannot be taken out without also taking out the sphincter.
- The external urethral sphincter: The external sphincter is found below your prostate. You can control your external sphincter and use it to stop your urine stream. You can strengthen this sphincter with pelvic floor muscle exercises .
Normally, an intact, healthy external sphincter is enough to help you remain continent after surgery. However, RP can damage nerves, blood supply, supporting structures, or the muscle which can affect the external sphincter. This damage can lead to incontinence.
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Dealing With Prostate Cancer
Being diagnosed and living with prostate cancer can change how you feel about life. If you or your loved one is dealing with prostate cancer you may feel scared, stressed or even angry. There is no right way to feel and everyone reacts differently.
Visit our wellbeing hub for information to help support you in looking after your emotional, mental, and physical wellbeing. If you are close to someone with prostate cancer, find out more about how you can support someone with prostate cancer and where to get more information.
Future Perspectives And Conclusions
Prostate cancer is one of the most problematic and frequently encountered malignancies in male patients. It often occurs when men are still in the active period of their lives. Consequently, there is a high demand for minimally invasive therapeutic approaches, susceptible of preserving urinary continence and sexual function. Unfortunately, stress urinary incontinence is a common adverse event in men with localized or locally advanced prostate cancer undergoing radical prostatectomy, but also secondary to radiotherapy and to cryosurgery .
Despite rehabilitative procedures such as pelvic floor muscle training, biofeedback, electrical stimulation, lifestyle changes, or a combination of these strategies, no fully efficient treatment alternative has yet been established for this pathology . On the other hand, it should be acknowledged that nursing care, including the understanding of the patient’s needs, education, and psychosocial support remain essential features while aiming to improve the quality of life of prostate cancer patients.
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Surgical Treatment For Enlarged Prostate
- Transurethral resection of the prostate . In this surgery, the inner portion of the prostate is removed. Used 90% of the time, this is the most commonly used surgical procedure for BPH.
- Open prostatectomy . The surgeon makes an incision and removes the enlarged tissue from the prostate.
- Laser surgery Laser surgery uses laser energy to destroy prostate tissue and shrink the prostate.
- Transurethral incision of the prostate . This surgery does not involve removing prostate tissue. A few small cuts are made in the prostate gland to reduce the prostates pressure on the urethra, making urination easier.
Does Coffee Make Incontinence Worse
Caffeine irritates the bladder and can make incontinence worse. Coffee has the biggest effect, so stop drinking it or switch to decaffeinated coffee. Fizzy drinks, tea, green tea, energy drinks and hot chocolate also contain caffeine, so cut down on these too and replace them with water and herbal or fruit teas.
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What If My Diaper Rash Doesnt Go Away
With proper treatment and a good hygiene plan in place, a diaper rash should go away within a couple of days. If it doesnt or if your rash is extremely painful, you have a fever, or it hurts to urinate or pass stool, make an appointment with your doctor to see if there is an underlying cause for the rash.
Why Does Incontinence Occur After Prostate Surgery
The prostate gland actually sits at the base of the bladder. The urethra runs through the center of the prostate gland. Where the bladder and urethra join, there is a ring of muscles called the bladder neck sphincter. These muscles are vital for our bladder control in staying continent. The bladder neck sphincter closes to prevent urine leaking out, but opens to allow urine to pass. Temporary incontinence occurs due to distress to the bladder neck sphincter during the surgery.
Have you had a Robotic Prostatectomy? Read all about Managing Incontinence Post Surgery
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Post A Question On Our Forum To Receive Expert Advice
Its rare that men experience long term incontinence after prostate cancer treatment. As a general rule, if your incontinence symptoms last over a year, you should contact a Doctor. There are a number of procedures that exist to restore continence if you do find yourself with long term incontinence.
What Types Of Incontinence Can Happen After Rp
There are two main types of urinary incontinence after RP:
- Urgency incontinence is when you feel the need or urge to urinate but cannot make it to the toilet in time. This is often due to bladder spasms and medication can help. This type of incontinence is caused by changes in the way the bladder behaves after surgery.
- Stress urinary incontinence is leakage of urine with movement or effort and can happen when you cough, sneeze, lift something heavy, change position, or exercise. This type of incontinence may be caused by damage to your external sphincter muscle. Almost all men will have some degree of SUI right after their urinary catheter is taken out. A urinary catheter is placed short term to collect urine during and while recovering from surgery. You may be taught how to do pelvic floor exercises to help with urinary control.
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How Do I Clean My Urinary Catheter
- Do not use very hot or cold water when you shower.
Cleaning your skin and catheter out of the shower.
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Biofeedback For Incontinence After Protatectomy
Biofeedback is a widely used technique that helps people understand how to control their body functions, including the urinary control. It has proved its efficiency in helping many men regain their urinary control.
Biofeedback therapy uses computer graphs and audios to make it easier for you to locate the muscles you a are working on. It is a teaching tool that instructes you how to strengthen your muscles.
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Surgically Removing The Prostate Gland
A radical prostatectomy is the surgical removal of your prostate gland. This treatment is an option for curing prostate cancer that has not spread beyond the prostate or has not spread very far.
Like any operation, this surgery carries some risks.
A recent trial showed possible long-term side effects of radical prostatectomy may include an inability to get an erection and urinary incontinence.
Before having any treatment, 67% of men said they could get erections firm enough for intercourse.
When the men who had a radical prostatectomy were asked again after 6 months, this had decreased to 12%. When asked again after 6 years, it had slightly improved to 17%.
For urinary incontinence, 1% of men said they used absorbent pads before having any treatment.
When the men who had a radical prostatectomy were asked again after 6 months, this had increased to 46%. After 6 years, this had improved to 17%.
Out of the men who were actively monitored instead, 4% were using absorbent pads at 6 months and 8% after 6 years.
In extremely rare cases, problems arising after surgery can be fatal.
Its possible that prostate cancer can come back again after treatment. Your doctor should be able to explain the risk of your cancer coming back after treatment, based on things like your PSA level and the stage of your cancer.