November 29, 2019
Stress Urinary Incontinence After Prostatectomy
We’re fortunate enough to live in a day and age where a cancer diagnoses is no longer a death sentence. There are numerous treatment options available in the world, and chances are if you’re reading this blog post, you are part of a population that actually has access to this kind of care. That being said, while we benefit from medical advancements and treatments, said treatments and surgeries are still scary and come with their own set of risks and side-effects, mentally, physically, and emotionally. According to Cancer.org, prostate cancer is the second most common cancer that impacts the male population after skin cancer. Fortunately, there are options, one of them being surgical. After a life-saving procedure is done, the last thing anyone thinks about is the after-effects of the surgery. Especially if those after-effects include urinary incontinence.
To be specific, we’re talking about Stress Urinary Incontinence, or SUI. SUI is the accidental leak of urine that comes out whenever the bladder, abdomen, or urinary tract is put under pressure or “stress”. The leak can be brought on by triggers as common and mundane as a cough or a sneeze. Other triggers could include activities like laughing, lifting, running, jumping, or dancing. SUI occurs due to weak pelvic floor muscles, the muscles may be damaged as well. The pelvic floor muscles are the layer of muscles that support the pelvic organs and span the bottom of the pelvis. The pelvic organs are the bladder and bowel in men, and bladder, bowel and uterus in women, according to the Continence Foundation of Australia. With SUI, these muscles and surrounding tissues and nerves are not strong enough to hold back the flow of urine when put under pressure. There can be several factors into one developing stress incontinence, influenced by medical history and lifestyle choices. One may have a greater chance of developing SUI if they have the following risk factors: Childbirth - Women who have delivered vaginally, or even through c-section but had been through labor leading up to the procedure are likely to develop stress incontinence as the trauma from labor damages and weakens the pelvic floor. In an article in Parents magazine, Dr. Roger Goldberg, M.D., explains how common moms develop light leaks. "Even a seemingly uneventful pregnancy and delivery can change urinary control for up to 50 percent of women," says Goldberg, the director of urogynecology research at the University of Chicago NorthShore University HealthSystem. Age - As we age, it is natural to lose muscle mass, tone, flexibility, and function. Unfortunately, our pelvic floor muscles are also susceptible to the fate of time and may start to fail us in our later years. 
Obesity - Obese or overweight individuals put more weight and inherent stress on the bladder and pelvic floor over time in addition to having weakened muscles. Smoking - Those who smoke are destined to develop some sort of chronic cough, which may damage the pelvic floor over time. Plus, nicotine is a bladder irritant, increasing bathroom break trips. Hormonal Changes - The ups and downs of estrogen in both men and women (but mostly women) can actually have a pretty big impact on urinary health. This may increase the risk of perimenopausal women developing light bladder leaks as estrogen production decreases. High-Impact Activities - Dancers, runners, gymnasts, horseback riders, etc. may find themselves suffering from light bladder leaks even if none of the other risk factors apply to them. Over time, repeated impact on the pelvic floor may weaken and damage it leading to leaks. Of course, another factor that may impact urinary health and the development of SUI is surgical procedures that involve the pelvic floor such as a hysterectomy, small bowel repair, or cancer-removing procedures like a prostatectomy.
So, what is a prostatectomy? Well, actually it is more than one procedure. According to the Mayo Clinic, it “includes a number of surgical procedures to remove part or all of the prostate gland.” The prostate is “a small, squishy gland about the size of a ping-pong ball, located deep inside the groin, between the base of the penis and the rectum. It is important for reproduction because it supplies the seminal fluid, which mixes with sperm from the testes.” There are two types of prostatectomy procedures, and the kind performed depends on the type of condition involved that called for the removal of the prostate and the recommended procedure. Radical prostatectomy - surgery to remove the entire prostate gland and surrounding lymph nodes as treatment for men with localized prostate cancer. A surgeon can perform a radical prostatectomy using several different techniques. Simple prostatectomy - removes an enlarged part of the prostate that has become obstructive. This procedure is generally recommended for men with severe urinary symptoms and very enlarged prostate glands (rather than prostate cancer), and can be performed open or robotically. Post-procedure, the pelvic floor may become weakened and lead to light bladder leaks. If this becomes a problem, reach out to a healthcare professional for advice.
What is Stress Urinary Incontinence?
To be specific, we’re talking about Stress Urinary Incontinence, or SUI. SUI is the accidental leak of urine that comes out whenever the bladder, abdomen, or urinary tract is put under pressure or “stress”. The leak can be brought on by triggers as common and mundane as a cough or a sneeze. Other triggers could include activities like laughing, lifting, running, jumping, or dancing. SUI occurs due to weak pelvic floor muscles, the muscles may be damaged as well. The pelvic floor muscles are the layer of muscles that support the pelvic organs and span the bottom of the pelvis. The pelvic organs are the bladder and bowel in men, and bladder, bowel and uterus in women, according to the Continence Foundation of Australia. With SUI, these muscles and surrounding tissues and nerves are not strong enough to hold back the flow of urine when put under pressure. There can be several factors into one developing stress incontinence, influenced by medical history and lifestyle choices. One may have a greater chance of developing SUI if they have the following risk factors: Childbirth - Women who have delivered vaginally, or even through c-section but had been through labor leading up to the procedure are likely to develop stress incontinence as the trauma from labor damages and weakens the pelvic floor. In an article in Parents magazine, Dr. Roger Goldberg, M.D., explains how common moms develop light leaks. "Even a seemingly uneventful pregnancy and delivery can change urinary control for up to 50 percent of women," says Goldberg, the director of urogynecology research at the University of Chicago NorthShore University HealthSystem. Age - As we age, it is natural to lose muscle mass, tone, flexibility, and function. Unfortunately, our pelvic floor muscles are also susceptible to the fate of time and may start to fail us in our later years. Obesity - Obese or overweight individuals put more weight and inherent stress on the bladder and pelvic floor over time in addition to having weakened muscles. Smoking - Those who smoke are destined to develop some sort of chronic cough, which may damage the pelvic floor over time. Plus, nicotine is a bladder irritant, increasing bathroom break trips. Hormonal Changes - The ups and downs of estrogen in both men and women (but mostly women) can actually have a pretty big impact on urinary health. This may increase the risk of perimenopausal women developing light bladder leaks as estrogen production decreases. High-Impact Activities - Dancers, runners, gymnasts, horseback riders, etc. may find themselves suffering from light bladder leaks even if none of the other risk factors apply to them. Over time, repeated impact on the pelvic floor may weaken and damage it leading to leaks. Of course, another factor that may impact urinary health and the development of SUI is surgical procedures that involve the pelvic floor such as a hysterectomy, small bowel repair, or cancer-removing procedures like a prostatectomy.
What is Prostatectomy?
So, what is a prostatectomy? Well, actually it is more than one procedure. According to the Mayo Clinic, it “includes a number of surgical procedures to remove part or all of the prostate gland.” The prostate is “a small, squishy gland about the size of a ping-pong ball, located deep inside the groin, between the base of the penis and the rectum. It is important for reproduction because it supplies the seminal fluid, which mixes with sperm from the testes.” There are two types of prostatectomy procedures, and the kind performed depends on the type of condition involved that called for the removal of the prostate and the recommended procedure. Radical prostatectomy - surgery to remove the entire prostate gland and surrounding lymph nodes as treatment for men with localized prostate cancer. A surgeon can perform a radical prostatectomy using several different techniques. Simple prostatectomy - removes an enlarged part of the prostate that has become obstructive. This procedure is generally recommended for men with severe urinary symptoms and very enlarged prostate glands (rather than prostate cancer), and can be performed open or robotically. Post-procedure, the pelvic floor may become weakened and lead to light bladder leaks. If this becomes a problem, reach out to a healthcare professional for advice.
Revive®
Men are certainly able to develop light bladder leaks, and their chances of SUI developing only increases with age and medical history and procedures like prostatectomy and bladder cancer. While it is important to take into consideration that men also face incontinence challenges, women are twice as likely to develop SUI and are less likely to speak up about it. Revive® is a new reusable bladder support device for women that helps to reduce leaks for up to 12 hours a day and may be a better option than pads, liners, or surgical procedures.