which is not being able to control the urination, is very very common after prostate cancer
surgery. Fortunately, in a vast majority of patients, over time that symptom gets better.
So the treatment really depends on where the spectrum you fall. Immediately after the surgery, most people
cannot control their urination and the best way to manage that for the short-term is to
simply wear some kind of absorbent pads that you can get from any drug store.
After a matter
of weeks or months if it is not getting better, then we need to have a better understanding
of what the causes are. Overwhelmingly, the most common cause of incontinence
after prostate cancer surgery is what we call sphincteric incontinence. Sphincteric incontinence means that the muscles
that were in the wall of the prostate that ordinarily kept the urethra closed, have either
been completely or partially removed or damaged. Okay, so if my fist is like the bladder and
my thumb was like the urethra and this would be the tip of the penis where the urine comes
out, my knuckle is approximately where the prostate would be.
When your doctor did the
surgery, he cut out the prostate, so he cut out from here to here, and then he sewed it
back together. When he made this incision here, he does so
based on the prostate where the prostate in the cancer ends. He does not have much control
over where he can cut. He must cut out all the prostate or the cancer.
This sphincter muscle is in the wall. This
sphincter muscle is supposed to keep the urethra closed so no urine can leak out and sometimes
usually when they cut out the prostate, they cut out part of sphincter with it. The remaining
part of the sphincter is what would ordinarily keep you continent, keep you from leakage. If too much was cut out then you may never
regain continence.
If part of it was cut out then you probably will regain continence over
time and fortunately, the vast majority of patients do regain continence over time..
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