The Link between Incontinence and Prostate Cancer Surgery

Each year, approximately 19,000 Australian men are diagnosed with prostate cancer2, and over 8,000 undergo a radical prostatectomy in Australia.3

 

19,000

annual cases of prostate cancer in Australia2

over

8,000

radical prostatectomies performed each year3

While getting rid of the cancer is a man’s top concern, the fear of being incontinent is often on a man’s mind. In order to remove the cancer, the surgery may cause weakness or damage in the pelvic floor muscles and the urinary sphincter that help control urine flow.

Once the catheter is removed after surgery, the man may experience symptoms ranging from light urine leakage (a few drops when you exercise, cough or sneeze) all the way to a complete inability to control your urination.

The relationship between prostate cancer treatment and stress urinary incontinence

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Cancer Free But Incontinent

Continence tends to improve over time. While every man’s situation is different, studies show that as many as 80% of men reporting bladder leakage immediately following a prostatectomy, or removal of the prostate due to prostate cancer.4 Sometimes, this leakage will resolve on its own within the first few weeks or months after surgery, but between 9-16% of men will continue to have incontinence one year after their surgery.5

Recovery can be impacted by factors such as age, general physical health, and degree of full bladder control before surgery.

Side Effects of Prostate Cancer Treatment

Prostate cancer is not the cause of stress urinary incontinence, but the treatment of prostate cancer may lead to bladder leakage.

A radical prostatectomy and radiation (external beam or brachytherapy), which are common prostate cancer treatments, may damage the urinary sphincter and cause stress urinary incontinence.6 As a result, your symptoms may range from light leakage to a complete inability to control the flow of urine.

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What is a Radical Prostatectomy?

A radical prostatectomy is an operation that removes the prostate and the tissue around it. During the procedure, cuts are made to remove the prostate and then the surgeon rebuilds the urinary tract by pulling the bladder down to fill the space where the prostate once was and to reconnect it to the urethra and sphincter. Sometimes, the nerves and muscles that control the sphincter (the muscle that helps to keep urine in the bladder) may be damaged and cause stress urinary incontinence.6 It is normal to experience urinary incontinence immediately following a radical prostatectomy, and often times, it will be restored during the first year of recovery.4,5

However, for some patients, continence (or bladder control) will not be achieved on its own and it is important to know that there are treatment options for those patients that need further assistance to restore or regain their continence.

 


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References:

  1. Mayo Clinic. Urinary incontinence in men. June 2014. http://www.mayoclinic.org/diseases-conditions/urinary-incontinence/basics/causes/con-20037883. Accessed September 13, 2016.
  2. Prostate Cancer Statistics. (2015, December 17). Retrieved from https://prostate-cancer.canceraustralia.gov.au/statistics
  3. Radical prostatectomy hospital admissions 40 years and over. (2015). Australian Atlas of Healthcare,129-134. Retrieved July 16, 2019.
  4. Hoyland, K., Vasdev, N., Abrof, A., & Boustead, G. (2014). Post-radical prostatectomy incontinence: etiology and prevention. Reviews in urology, 16(4), 181–188.
  5. Ficarra V, Novara G, Rosen RC, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol. 2012 Sep;62(3):405-17.
  6. Prostate Cancer: Urinary Incontinence. WebMD Website. http://www.webmd.com/urinary-incontinence-oab/mens-guide/urinary-incontinence. Accessed September 13, 2016.
  7. Chung, E., Katz, D. J., & Love, C. (2017). Adult male stress and urge urinary incontinence – A review of pathophysiology and treatment strategies for voiding dysfunction in men. Australian Family Physician, 46(9), 661–666.
  8. About Incontinence—Contributing Factors—Prostate Problems in Men. The Simon Foundation for Continence. http://www.simonfoundation.org/about_incontinence_contributing_factors_prostate.html. Accessed September 13, 2016.
  9. Sandhu JS. Treatment options for male stress urinary incontinence. Nat Rev Urol. 2010 Apr;7(4):222-8.3.
  10. Herschorn S, Bruschini H, Comiter C, et al. Surgical treatment of stress incontinence in men. Neurourol Urodyn. 2010;29(1):179-90.
  11. Kotkin L, Koch MO. Impotence and incontinence after immediate realignment of posterior urethral trauma: result of injury or management? J Urol. 1996 May;155(5):1600-3.
  12. Data on file with Boston Scientific. Based on market research by Dymedex

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