Post Prostatectomy Incontinence

What is Post-Prostatectomy Incontinence?

Incontinence is a condition involving the inability to retain or hold urine, resulting in loss of bladder control. Post-prostatectomy incontinence is incontinence experienced after prostate surgery and affects as many as 95% of men who undergo prostatectomy. 95% of men with post-prostatectomy incontinence will regain complete bladder control within 3-12 months post-surgery. However, in rare cases, symptoms of post-prostatectomy incontinence will persist past 12 months, and require additional medical management.

Causes and Risk Factors of Post-Prostatectomy Incontinence

The surgical removal of the prostate significantly disrupts the continence mechanism. This impact alters the length of the urethra, reduced urethral pressure, reduced capacity for the bladder to store urine, and can impact the nerves and muscles that control bladder function. Due to the impact on the continence mechanism, the majority of men will experience some degree of post-prostatectomy incontinence. There are a number of risk factors that will increase the likelihood of the incontinence being severe or prolonged. These include;  

• Obesity (BMI >30)
• Pre-existing bladder symptoms
• Previous radiation or surgeries
• Lack of physical activity
• Surgical complications
• Increasing age.

Attending pre-op physiotherapy to address known pre-existing conditions is an efficient way to at least reduce these risks. Pre-operative physiotherapy and correct pelvic floor muscle exercises have been demonstrated to reduce the severity and length of time one will suffer with post-prostatectomy incontinence.

Symptoms of Post-Prostatectomy Incontinence

Urine leakages or poor bladder control that occur immediately following a prostate surgery. This may include;–

• Leakage when coughing/straining/lifting
• A sudden and strong urge to urinate
• Extended use of continence aids, like pads (past 12 months)
• Leakage after emptying the bladder (post-micturition dribble)
• Increased urinary frequency (particularly at night).

Post-Prostatectomy Incontinence Treatment

Post-prostatectomy incontinence is diagnosed through the collection of an extensive history of bladder, bowel, and sexual health, as well as physical examinations using transperineal ultrasound to assess pelvic floor muscle function. Once the diagnosis is complete, a physiotherapist will work to develop at-home pelvic floor muscle exercises, alongside in-clinic focuses that will typically include – 

• Education surrounding the efficient use of the best containment products
• Pelvic floor muscle training
• Emsella treatments are proven to strengthen the pelvic floor muscles 
• Shockwave Therapy to decrease bladder overactivity
• Advice regarding a planned, assisted return to physical activity.

On rare occasions, persistent cases may also require further surgical intervention, including the implementation of a urethral sling or artificial urinary sphincter, but these routes should be a last resort, considered only if physical therapy doesn’t facilitate improvements.

Put Post-Prostatectomy Incontinence Behind You with Sydney Pelvic Clinic

Facing incontinence after an already invasive surgery can be incredibly distressing, and requires a gentle, measured approach that takes your specific needs into account at every stage of recovery. That’s precisely what you can enjoy when you contact our team or book an appointment online with our professional physiotherapists today, and it can make all the difference for a recovery that sees you enjoying a new lease of life in no time.