Male incontinence affects millions across the UK, with many experiencing it following prostate cancer surgery – the most common cancer in UK men, 47,000 are diagnosed annually.
Below, we’ve outlined the basics of male incontinence following prostate cancer surgery, detailing why it happens, the most common forms of incontinence and what you can do about it.
Why does male incontinence occur after prostate cancer surgery?
To understand why male incontinence can occur following prostate cancer surgery, it is important to understand a little more about your anatomy.
Men have two sphincter muscles, which work to keep men continent. These are the internal urethral sphincter and external urethral sphincter. The former can be found at the bottom of the bladder and is referred to as the ‘bladder neck’, however, this isn’t under your control and is removed during surgery, as the prostate cannot be removed without removing this too.
The external urethral sphincter is found below the bladder and can be controlled by you. This is the muscle you use when stopping the flow of urine. While an external sphincter can be enough to remain continent following surgery, damage or dysfunction can be caused during radiation therapy. This can prevent the bladder from fully recovering, causing it to spasm, forcing urine out.
What types of male incontinence occur after surgery?
Following surgery for prostate cancer, two main types of male incontinence can occur. These are:
- Urgency incontinence – this type of incontinence is when you feel the sudden ‘urge’ to go to the toilet but can’t make it on time.
- Stress urinary incontinence – this is when urine leaks due to exertion or effort, often brought on by coughing, sneezing, heavy lifting, changing seating positions or exercise.
Do all men experience incontinence after prostate cancer surgery?
The simple answer to this is no, not all men experience incontinence following prostate cancer surgery. However, you must prepare yourself for some level of incontinence if you know you’ll be having surgery, as most men will experience some form of incontinence. Most men, however, will see an improvement after the first few months.
Despite this, male incontinence can remain an issue for some for more than a year following surgery.
Male incontinence exercises and prevention after treatment?
There are newer techniques that could help men regain control of their bladder and make an improvement to their quality of life following prostate cancer treatment. These are:
- Pelvic floor exercises – more of a behavioural technique, if you’re experiencing male incontinence, this is the place to start, as it can help you train your bladder and take control of holding in your urine. Known as Kegel exercises, these are designed to strengthen the muscles you use when urinating.
- Supportive care – another behavioural technique, this looks to make a change to your behaviour such as avoiding caffeine, alcohol, spicy food and drinking fewer fluids. You’ll also be encouraged to urinate more regularly, rather than waiting until the last minute. Sometimes, losing weight can help.
- Medication – if the above techniques don’t work, there are several medications that can be prescribed. These can help to increase bladder capacity and decrease the frequency of urination.
- Neuromuscular electrical stimulation – this is used to help retrain weak urinary muscles to strengthen them while improving bladder control. This procedure would see a probe inserted into the anus before a current, below the pain threshold, is passed through to cause contraction. You’ll then be instructed to squeeze your muscles when the current is on.
- Surgery – alongside injections and devices, several different techniques can be implemented to help with male incontinence. One type of surgery that’s proved successful in some men includes placing rubber rings around the tip of the bladder to help hold urine in.
- Artificial sphincter – this is a device you would control. Made of three-parts, you’ll find a pump, pressure-regulating balloon and a cuff that encircles the urethra and prevents urine from leaking. This has been found to cure or improve incontinence in around 70% – 80% of patients.
- Bulbourethral sling – one of these can be used for certain types of leakage and is used to suspend and compress the urethra. Made from synthetic material or your own tissue, this will provide the required compression needed for bladder control.
Lifestyle changes to reduce male incontinence
Following prostate cancer surgery, several lifestyle changes can be made in an attempt to prevent the issue of incontinence, which can be done alongside the above. These include:
- Avoiding fizzy drinks
- Avoiding drinks containing caffeine (tea, coffee, cola)
- Avoiding alcohol
- Drinking three to four pints of water a day
- Drinking cranberry juice – some men have found this helpful
If you have any questions about living with male incontinence following prostate cancer surgery and you want some advice regarding the products we can provide, please get in touch, or if you want to find out more about incontinence and suitable products in general contact us.
You can do this by calling us on 01204 895410 between 9 am and 5 pm Monday – Friday and one of our members of staff will be more than happy to help. Alternatively, you can use the enquiry form here, and someone will get back to you within 24-hours.