In a nutshell
This study reviewed the research on bladder problems in patients who had radical prostatectomy (RP – complete removal of their prostate). The review found that retention (holding too much urine) and incontinence (unable to hold urine) were common problems in men after RP but can be treated in a number of ways.
Some background
Radical prostatectomy is a procedure used in many prostate cancer patients to help with the best survival rates. However, it may have several side effects such as incontinence and retention. It is important to assess these problems and explore the best ways to manage them.
Methods & findings
The first methods used to control incontinence are behavioral/lifestyle modifications, such as restricting fluid or limiting caffeine or alcohol. However, the effectiveness of these changes are still unclear. Pelvic floor muscle training (PFMT) has been shown to lead to short term improvments. This involves exercising the muscles that help to hold in urine. In one study, PFMT combined with biofeedback (a treatment that uses electric sensors to train body responses) improved continence in 96% of patients by one year after surgery.
Medications may be tried if PFMT is not effective. These include phosphodiesterase inhibitors (such as Viagra) and serotonin/norepinephrine reuptake inhibitors (such as Cymbalta). These treatments have shown significant improvements in incontinence compared to placebo (treatment with no active effect).
Surgical treatment may be tried following medication. One option is an artificial urinary sphincter, a way to compress the urethra (tube that urine travels through). Roughly 80% of patients achieve continence with this device. However, an average of 26% of patients will need further treatment, and 5.5% experience infection. A male urethral sling is another surgical option. This sling provides support for the urethra that improves continence.
The bottom line
The study concluded that it is important to inform patients of available options of treatment for urinary incontinence and retention after radical prostatectomy.
The fine print
Treatment options should be studied and compared with each other.
What’s next?
Talk to your doctor about the several treatment options available for urinary incontinence and retention after radical prostatectomy.
Published By :
Urology
Date :
Oct 11, 2017
