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New options put a permanent end to post-prostatectomy urinary incontinence — guest post by Dr. Kurt McCammon

Posted Jan 29 2012 5:40pm

For many men, stress urinary incontinence (SUI) is a common side effect of prostate cancer treatments1a. Unfortunately, amidst the flurry of questions and concerns surrounding the cancer diagnosis, many men don’t even recall hearing this part of the conversation when they discuss treatments with their doctor. Let’s face it, most everyone’s ability to process new information shuts down as soon as they hear the word “cancer,” and understandably so.

Fortunately, prostate cancer is entirely treatable in the vast majority of cases. However, the treatment is not without potential side effects, and stress urinary incontinence is one of the most common1a. For most men, it’s a temporary problem. But for some, the leakage can become a permanent, life-altering issue.

Many men resolve themselves to thinking they must just learn to live with incontinence. After all, the prostate surgery likely saved their life, so how could they complain about leaking urine once in a while?

The fact is that SUI isn’t just a nuisance. It can actually cause other health-related issues and can completely destroy a man’s self-confidence and social life1. For example, the constant worry about odor and leakage can cause a man to withdraw from activities he once loved,including exercise and intimacy with his partner1. Another problem can result with long-term use of absorbent pads, which can cause skin breakdown that can lead to troublesome and painful skin infections2. The problem can negatively impact not only a man’s relationships but also his health—lack of exercise can lead to weight gain and other health problems.

Fortunately, there are permanent solutions to post-prostatectomy SUI that can put an end to these troublesome symptoms and help prostate cancer survivors reclaim the active, vibrant life they once knew.

A male urinary sling can permanently restore continence for most men with mild to moderate

English: Incontinence pad for men.

Image via Wikipedia

stress urinary incontinence (SUI). The sling is made of sterile surgical mesh (the same type that is used to repair hernias), which works like a hammock to lift and support the urethra, restoring their natural position and their ability to maintain continence. The sling is completely concealed within the body and seems to be well-tolerated by most men3. Sling placement takes less than an hour and, in most cases, can even be performed as an out-patient procedure1b.

For men with more severe SUI, an artificial urinary sphincter offers a greater level of control in a permanent solution1c. Also concealed entirely within the body, the artificial sphincter consists of a small cuff placed around the urethra that, when inflated, applies pressure to prevent urine from escaping. The device is discreet and simple to use, restoring continence with very little impact on your normal restroom routine.

The artificial urinary sphincter implantation procedure also takes about an hour and can be performed as an outpatient procedure1d. The system is an effective long-term treatment for incontinence, having been used for almost 40 years to permanently restore continence for thousands of men worldwide 4,1

If you have been dealing with post-op SUI for more than 12 months, it’s time to talk to your doctor about the minimally-invasive treatment options available to you. You may even want to involve your significant other in the conversation, as SUI no doubt has an effect on your close relationships. The truth is that SUI is often quite problematic for wives in traditional households—in many cases, she’s the one buying the absorbent products and doing the laundry. Partners can often provide valuable insight for the doctor into the severity of the problem.

I recommend making an appointment with your urologist,primary care doctor or family physician to talk specifically about your UI problem. Perhaps out of embarrassment, or not wanting to “disappoint” their doctor with a complaint about an unwelcome side effect of a life-saving procedure, many patients fail to mention this problem on follow-up visits. You, as the patient, need to be your own advocate. Physicians who’ve never experienced the problem of SUI often don’t realize just how life altering it can be.

Once you’ve evaluated the options and chosen the one that’s best for your unique situation, you will be amazed with the difference it makes in your everyday life. I’ve seen an extraordinary number of patients for whom these procedures have made a tremendous impact in their quality of life. With the wide availability of treatments, there’s no reason to suffer in silence any longer.

Kurt A. McCammon, M.D., FACS, is a practicing urologist specializing in male incontinence and voiding dysfunction and chairman and program director of the Urology Residency Program at the Eastern Virginia Medical School in Norfolk, Va. Earning his medical degree from the Medical College of Ohio in Toledo, followed with residency training in urology at Eastern Virginia Medical School and a fellowship in adult and pediatric genitourinary reconstructive surgery.

 

This article was written with assistance from American Medical Systems to provide general information about male urinary incontinence and treatment options. For more information about male urinaryincontinence and treatment options available through AMS please visit .

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  1. Hunskaar S., Sandvik H. One hundered and fifty men with urinary incontinence. Scand J Prim Health Care 1993; 11: 193-196
  2. Rackley R., MD. et al. Nonsurgical Treatment of Urinary Incontinence. http://emedicine.medscape.com/article/452289-overview; downloaded May 31, 2011.
  3. Klingler H.C., Marberger M. Incontinence after radical prostatectomy: surgical treatment options. Current Opinion in Urology 2006; 16: 60-64
  4. Venn S.N., Greenwell T.J., Mundy A.R. The Long-Term Outcome of Artificial Urinary Sphincters. Jol. of Urol. 2000; 164: 702-707.

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