Post-Prostatectomy Incontinence

Post-Prostatectomy Incontinence

Affiliated: Find a Doctor | Overview

What is Post-Prostatectomy Incontinence?

Post-prostatectomy incontinence is one of the feared complications after removal of the prostate gland and may have a significant negative impact on one’s quality of life.

What can I expect during the evaluation?

A detailed history will be obtained and focused genitourinary examination will be performed.  A urinalysis will also be obtained.  Urodynamics will be performed to evaluate bladder storage function and a cystoscopy performed to evaluate the urinary tract.

What treatments are available for post-prostatectomy incontinence?

There are nonsurgical and surgical treatment options available depending on the severity of symptomatic bother to the patient.  Together with your UCLA urologist, you will choose a treatment that is best for you.

Nonsurgical Treatment Options:

• Conservative measures of treatment include biofeedback and pelvic floor physical therapy.  Patients will focus on strengthening their pelvic floor through Kegel exercises.  Pelvic floor physical therapy can help patients target these muscles in order to achieve maximal results.  Patients who have very mild incontinence may benefit from this therapy.
• For patients with very mild incontinence and for whom Kegel exercises did not improve symptoms or the patient would like to achieve further improvement, urethral bulking agents and male slings are available.  Urethral bulking agents are injected through the urethra through a scope placed into the urethra.  The substance is called Coaptite and is a naturally occurring substance that is made of calcium hydroxylapatite, which is present in bone.

Surgical Treatment Options:

Male slings are a surgical procedure for patients with mild to moderate incontinence (usage of 2 to 3 pads or less).  The advantage of this procedure is that it can be placed with small incisions and the recovery period is relatively short.  A surgical mesh is placed in the groin region to provide compression to the urethra.  A catheter is left in place and removed the next day. 

An artificial urinary sphincter is a device that has multiple components and is surgically placed.  The device is composed of a cuff, pump and pressure-regulating balloon.  The cuff is placed around the urethra to provide circumferential compression.  The pump is placed into the scrotum and the patient is able to squeeze the device in order to activate it and urinate.  The pressure-regulating balloon transfers fluid when the pump is activated.  The artificial urinary sphincter has been present for over 20 years and has proven clinical success.