The Procedure That Got Me Dry Again After Nine Years Of Incontinence
Like many men, Peter Barton had to deal with urinary incontinence after prostate surgery and was among those who dont see the problem improve over time. After years of using pads as the problem got worse, Peter decided to try a surgical treatment the male sling.
PETER: As a fit farmer aged 65 it was a great shock when I was diagnosed with prostate cancer back in 2008. My wife and I examined all the options for treatment and opted for robotic assisted surgery, which was then still in its early development in the UK.
The surgery went well. My excellent urologist had said that wed just got the tumour before it had broken out of the prostate and my family were much relieved as he confirmed the cancer was unlikely to return.
I was out of hospital in two days but had to wear a catheter for two weeks these were pretty miserable weeks. It wasnt painful at all, but it was awkward. It kept getting caught up on things and was constantly leaking. Things improved when the catheter was removed however I was left incontinent.
For the next nine years life was good but, although I followed instructions about pelvic floor exercises, which I know work for some men, my incontinence slowly worsened. For the first year or two I was using a size one pad the lightest. After two years, Id moved on to the number two and by the last few years I was on a number three, which needed changing several times a day. Each of these can hold a considerable amount of urine.
What Is Urinary Incontinence Symptoms Causes Diagnosis Treatment And Prevention
Urinary incontinence , the involuntary loss of urine, is a very common condition that no one wants to talk about. Because of the stigma that surrounds it, many people are too humiliated to seek help. But most conditions that cause UI can be corrected with medical or alternative interventions.
Occurring much more often in women than men, UI happens when the muscles in the bladder that control the flow of urine contract or relax involuntarily, resulting in leaks or uncontrolled urination. UI itself is not a disease, but it can be a symptom of an underlying medical issue.
Can It Be Repeated
Yes, after 3 months at the earliest. About 5% of patients lose their response to Botox® over time because they develop antibodies to the Botox®. This is more likely if injection treatments are given more frequently than every 2-3 months. Currently there is no evidence that repeated injections causes damage to the bladder but this is a new treatment and the long term effects of repeated injections is not fully investigated.
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Is Incontinence Normal After Prostate Surgery
Bladder leakage after prostate removal is not all that uncommon and typically will go away after your body begins to heal and your muscles regain strength. Approximately 6-8 percent of men who have had surgery to remove their prostate will develop urinary incontinence. The good news is that most men will eventually regain bladder control with time.
What Causes Urinary Incontinence
When your baby moves down through your vagina to be born, your pelvic floor stretches and it remains stretched for some time.
The combination of hormones and stretched muscles means the muscles that control your bladder are weakened. This can lead to your accidentally leaking urine.
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Can Urinary Incontinence Be Prevented Or Avoided
You may be able to prevent urinary incontinence by working to keep pelvic muscles strong. But even so, it doesnt guarantee that you will never have urinary incontinence.
There are also lifestyle changes you can make to help prevent urinary incontinence. You may find it helpful to make some changes in your diet. Alcohol, caffeine, foods high in acid , and spicy foods can irritate your bladder. Talk to your doctor if you think your diet may contribute to your incontinence.
Some people find that limiting how much they drink before bedtime helps reduce nighttime incontinence.
Losing weight if you are overweight can also help reduce incontinence.
When Should I See A Doctor About Incontinence
Its important to know that incontinence can be treated. Many people believe that its something that just goes along with aging and is an unavoidable issue. If you find that incontinence is disturbing your daily activities and causing you to miss out on things you typically enjoy, talk to your healthcare provider. There are a wide range of options to treat incontinence.
How Botox For Bladder Control Works
Botox relieves symptoms of urge incontinence by calming the nerves that overstimulate your bladder. It relaxes bladder muscles, allowing the bladder to store larger volumes of urine and reducing overactive bladder episodes. The benefits last from 6-12 months, and the procedure can be repeated if successful. A major study found that men and women given Botox used the bathroom 1 to 2 time less often after treatment.
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How Long Does Incontinence Last
One thing you should know is that most men regain continence following prostate surgery. If youre between the ages of 40 and 60, and generally healthy, the outlook is particularly good. In such cases, most men are no longer experiencing incontinence after about three months.
For others, it takes closer to a year. In such cases, there are effective treatments.
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What The Caregiver Can Do
- Encourage or help the patient with appropriate skin care after using the bathroom. Use warm water and pat the area dry.
- Help the patient keep a diary that records specific foods or drinks that may affect how frequently the patient goes to the bathroom.
- Help the patient maintain a bladder or bowel plan.
- Encourage the patient to go to the bathroom at consistent time frames during the day, like after a meal.
- Encourage regular daily exercise, as permitted by the health care team.
Are There New Techniques That Reduce The Chance Of Becoming Incontinent
When removingthe prostate, surgeons try to save as much of the area around the bladder and the sphincter muscles around the urethra as possible, thus limiting damage to the sphincter. Doctors have also fine-tuned 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.
Still, at this point, any man who is undergoing radiation or surgery to treat prostate cancer should expect to develop some problems with urinary control. With newer techniques, some men will have only temporary problems controlling their urine, and many will regain full control of their bladder in time.
Alternative And Complementary Therapies
The treatment of urinary incontinence varies depending on the cause of the bladder control problem. In most cases, a physician will try the simplest treatment approach before resorting to medication or surgery.
Bladder habit training This is the first approach for treating most incontinence issues. The goal is to establish a regular urination schedule with set intervals between urination. A doctor will usually recommend urinating at one-hour intervals and gradually increasing the intervals between urination over time.
Pelvic muscle exercises Also called Kegel exercises , this exercise routine helps strengthen weak pelvic muscles and improve bladder control.
The person contracts the muscles used to keep in urine, holds the contraction for 4 to 10 seconds, then relaxes the muscles for the same amount of time.
It may take weeks or months of regular pelvic exercise to show improvement.
Another way to perform Kegel exercises is to interrupt the flow of urine for several seconds while urinating.
Will I Have Incontinence For My Entire Life
Sometimes incontinence is a short-term issue that will go away once the cause ends. This is often the case when you have a condition like a urinary tract infection . Once treated, frequent urination and leakage problems caused by a UTI typically end. This is also true for some women who experience bladder control issues during pregnancy. For many, the issues end in the weeks after delivery. However, other causes of incontinence are long-term and related to conditions that are managed throughout your life. If you have a chronic condition like diabetes or multiple sclerosis, you may have incontinence for a long period of time. In those cases, its important to talk to your provider about the best ways to manage your incontinence so that it doesnt interfere with your life.
A note from Cleveland Clinic
It can be embarrassing to talk about bathroom habits with your healthcare provider. This embarrassment shouldnt stop you from treating incontinence, though. Often, your healthcare provider can help figure out the cause of your bladder control issue and help make it better. You dont need to deal with it alone. Talk to your healthcare provider about the best ways to treat incontinence so that you can lead a full and active life without worrying about leakage.
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How Does The Urinary System Work
The urinary system consists of the kidneys, ureters, the bladder and urethra. The kidneys filter the blood to remove waste products and produce urine. The urine flows from the kidneys down through the ureters to the bladder. A ring of muscle squeezes shut to keep urine in the bladder and relaxes when we need to wee. The urine passes through another tube called the urethra to the outside when urinating .
Living With Bowel Incontinence
You can help manage bowel incontinence by following a bowel care plan and using the toilet before you leave home. You can also make sure you carry your medications, supplies, fecal deodorants, and a change of clothes with you.
Anal discomfort, itching, and irritation can be common. Here are some ways to help manage these symptoms:
- Wash the anal area after a bowel movement or use baby wipes.
- Use a moisture-barrier cream in the anal area.
- Use wick pads or disposable underwear.
- Change soiled underwear frequently to keep the anal area clean and dry.
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When You Should See A Health Care Professional
You shouldnt have to wear a pad to soak up urine every day. Also ask yourself these questions:
Is the urge to urinate interfering with your work because of leaking or frequent bathroom breaks?
Do you map out where bathrooms are when you run errands?
Is incontinence interfering with your sex life or intimacy with your partner?
These are all signs of a problem, and that it may be time for you to talk with a gynecologist.
Surgery For Prostate Cancer
Surgery is a common choice to try to cure prostate cancer if it is not thought to have spread outside the prostate gland.
The main type of surgery for prostate cancer is a radical prostatectomy. In this operation, the surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles.
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What Causes Postpartum Incontinence
You can blame this common postpartum symptom on the pregnancy- and delivery-weakened muscles around the bladder and pelvis, which may have a harder time controlling your flow after childbirth.
Plus, as your uterus shrinks in the weeks following delivery, it sits directly on the bladder, compressing it and making it more difficult to stem the tide. Hormonal changes during and after pregnancy can batter your bladder too.
There Are Treatment Options
If your postpartum urinary incontinence is causing a problem, or not resolving in a timely manner, there are treatment options available. The first line of defence is to do Kegel exercises. Dr. Pourzand can help you learn how to do Kegels properly, if youre not sure. She will also give you guidance on how many you should do each day to build up strength and flexibility in the muscles of your pelvic floor. There are other treatments that may be appropriate, depending on numerous factors. One of the reasons so many of her patients prefer Dr. Pourzand is the highly personalized treatment she provides. Before suggesting treatment for your postpartum urinary incontinence, Dr. Pourzand will take your medical history, current medical needs, and your lifes circumstances into consideration. If you have questions or concerns regarding postpartum urinary stress incontinence, book your appointment with Dr. Pourzand today. We have two locations for your convenience, and you can use our online scheduling tool or call to make an appointment at the location that works best for you.
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Bladder And Bowel Incontinence
Incontinence is a loss of control of a person’s bowels or bladder which can cause accidental leakage of body fluids and waste. Incontinence can be more than a physical problem. It can disrupt your quality of life if its not managed well.
Fear, anxiety, and anger are common feelings for people dealing with incontinence. You may avoid being intimate or having sex because you are afraid of urine, gas, or stool leakage. Fear of having an accident may keep you from being physically active, enjoying hobbies, or spending extended time outside your home.
Anyone can have incontinence during and after surgery or some other treatments for cancer. Incontinence can also occur because of other non-cancer medical conditions. Be sure to talk to your health care team if you have difficulty controlling urination or bowels. Talking about incontinence can be embarrassing, but being open and honest with your health care team can help manage it.
Is Incontinence More Common In Women
Incontinence is much more commonly seen in women than in men. A large part of this is because of pregnancy, childbirth and menopause. Each of these events in a womans life can lead to bladder control issues. Pregnancy can be a short-term cause of incontinence and the bladder control issues typically get better after the baby is born. Some women experience incontinence after delivery because of the strain childbirth takes on the pelvic floor muscles. When these muscles are weakened, youre more likely to experience leakage issues. Menopause causes your body to go through a lot of change. Your hormones change during menopause and this can alter your bladder control.
Men can also experience incontinence, but it isnt as common as it is in women.
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How Is Incontinence Diagnosed
Often, the diagnosis process for incontinence will start with a conversation with your healthcare provider about your medical history and bladder control issues. Your provider might ask you questions like:
- How often do you urinate?
- Do you leak urine between trips to the toilet, how often does this happen and how much urine do you leak each time?
- How long have you been experiencing incontinence?
These questions can help your provider figure out a pattern with your leakage, which often points to a specific type of incontinence. When your provider is asking about your medical history, its important to list all of your medications because some medications can cause incontinence. Your provider will also ask about any past pregnancies and the details around each delivery.
There are also several specific tests that your provider might do to diagnose incontinence, including:
While at home, your provider might recommend you keep track of any leakage in a journal for a few days. By writing down how often you experience incontinence issues over the span of a few days, your provider might be able to identify a pattern. This can really help in the diagnosis process. Make sure to write down how often you need to urinate, how much you are able to go each time, if you leak between trips to the bathroom and any activities you might be doing when you leak urine. Youll then bring this journal with you to your appointment and talk about it with your provider.
Will Kegel Exercises Help With My Urinary Control
Kegel exercises are recommended and contribute to regaining urinary control. Dr. David Samadi even encourages patients to start them before surgery as a type of pre-conditioning. Kegels are a simple exercise of clenching and releasing the muscles that control your urine flow.
Kegels must be done every day to strenghten the pelvic floor muscles. Check this Mayo Clinic article on how to perform these exercises.
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How Can I Help Myself
Urinary problems can affect your self-esteem and independence, and affect your work, social and sex life.
Making some changes to your lifestyle may help, and there are some practical steps that can make things easier.
- Try to drink plenty of fluids, but cut down on fizzy drinks, alcohol, tea and coffee as these may irritate the bladder
- Do regular pelvic floor muscle exercises to help strengthen the muscles that control when you urinate.
- Try to stay a healthy weight. Being overweight can put pressure on your bladder and pelvic floor muscles.
- If you smoke, try to stop. Smoking can cause coughing which puts pressure on your pelvic floor muscles. NHS Choices has more information about stopping smoking
- Plan ahead when you go out. For example, find out where there are public toilets before leaving home.
- Pack a bag with extra pads, underwear and wet wipes. Some men also find it useful to carry a screw-top container in case they cant find a toilet.
- Get our Urgent toilet card to help make it easier to ask for urgent access to a toilet.
- Disability Rights UK runs a National Key Scheme for anyone who needs access to locked public toilets across the UK because of a disability or health condition.
- If you often need to use the toilet at night, leave a light on in case youre in a hurry, or keep a container near your bed.
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