Pelvic Floor Therapy
After radical prostatectomy most men are faced with bladder incontinence.
What is incontinence after prostate surgery?
Urinary incontinence is when you can’t control urination (peeing). It often occurs in males after surgery for prostate cancer like a prostatectomy (removal of your prostate) or radiation therapy.
After prostate removal surgery, urinary incontinence is usually temporary. It may take a few months up to a year, but eventually, you should be able to control when and how you pee.
What causes incontinence after prostate surgery?
When your pee drains into your bladder, it’s kept inside by two valves (sphincters) that stay closed until your body “tells” them to open when you pee. There’s an internal and an external valve.
If you have surgery to remove your prostate, the internal urine valve has to be removed as part of the prostate surgery. The external urine valve that you control to let urine out or stop your flow will still work.
Usually, having one working valve (the external valve) is enough to keep your urine control, but this depends on your pelvic floor muscles and nerves also working well.
On the other hand, radiation therapy for prostate cancer can also affect your sphincter and bladder because radiation damages and irritates healthy tissue in the area. This can impact how well they function.
How is incontinence after prostate surgery treated?
How your healthcare provider treats incontinence mainly depends on how severe your symptoms are and how long it lasts. It also depends on what type of incontinence you have (stress, urge or both).
If you find you’re having issues with mild to moderate leakage after surgery, your healthcare provider might suggest starting with noninvasive therapies like medication or physical therapy exercises for your pelvic floor muscles. People who have leakage lasting longer than three months or more severe symptoms may need surgery. Your provider usually recommends the noninvasive therapies first before recommending surgery.
At-home remedies for incontinence after prostate surgery
There are several types of incontinence products, like absorbent pads or diapers, that you can purchase at your local supermarket or drugstore. Devices like an incontinence clamp can also help, but you should discuss using one with your provider. It works by clamping your urethra so pee doesn’t leak.
How can I strengthen my bladder after prostate surgery?
Exercises that strengthen your pelvic floor, called Kegels, are often the first line of treatment for incontinence. Your healthcare provider may recommend Kegels to improve how your pelvic floor muscles work. Some providers combine Kegels with a therapy called biofeedback.
Your pelvic floor muscles are a group of muscles that hold pelvic organs up like a hammock. They also support healthy bladder and bowel function. If you’re born with a prostate, you may not have ever strengthened your pelvic floor before (because you didn’t need to). However, when your prostate is removed, you now have to rely on your pelvic floor muscles. That’s why pelvic floor exercises are very important after prostate removal surgery.
Pelvic floor strengthening works very well for people with mild to moderate leakage. If your symptoms don’t improve, your provider may recommend additional treatments.
