Incontinence

Prostate cancer treatment can cause temporary or long-term incontinence. The prostate gland plays a role in controlling the flow of urine. When the prostate is removed or damaged by surgery or radiation, problems with urinating often occur.

Incontinence is the inability to control urine flow when coughing, laughing, sneezing, or exercising. When urine is emptied into the bladder from the kidneys, it is kept inside the body by a couple of valves that stay closed until "told" to open during urination. The prostate surrounds the tube that allows urine flow to outside the body.

Removing the prostate through surgery or destroying it through radiation can disrupt the way the bladder holds urine by damaging the muscles that form the valves.

• Stress incontinence is the most common form of this side effect after prostate cancer surgery.
• Men can also experience overflow incontinence when it takes a long time to urinate and have a weak force or dribbling stream. This side effect is often caused by blockage or narrowing of the bladder outlet by cancer or scar tissue.
• Men also experience urge incontinence when one has the sudden urge to go to the bathroom to pass urine. This problem occurs when the bladder becomes overly-sensitive.

When removing the prostate, surgeons do their best to leave the bladder valves intact. Additionally, doctors have been able to fine tune the process of placing radioactive seed implants, using sophisticated computer projections that allow the seeds to destroy the prostate while limiting damage to the bladder valves.

Treatment of incontinence depends on a number of factors: severity, type and cause. It is an extremely common medical problem but depending on your situation, there are many ways to improve the condition including exercise, medicine, and surgery.

If you're experiencing some form of incontinence, the first remedy attempt is almost always exercise. Pelvic floor exercise, such as "Kegel exercises," bio-feedback and electrical stimulation have been very effective in strengthening the muscles that stop urine leakage.

For more information, see the American Urological Society's web pages:

• Causes and Natural History of Bladder Control Problems
• Minimally Invasive Management of Urinary Incontinence
• Surgical Management of Urinary Incontinence

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