UPDATE - Issue 26 - Summer 2006
Tom Stuttaford on Incontinence
Tom Stuttaford, medical correspondent for The Times, recently mentioned a reader asking about treatments for incontinence that may follow a radical prostatectomy.
He wrote, 'Incontinence is the most common problem post surgery. Immediately after the operation most men are slightly incontinent for a week or two but it soon clears up. Some men have severe incontinence for a few months after surgery, but the worst of the incontinence disappears. About 3 per cent of patients are left with incontinence that is a problem. A slightly larger proportion, up to 15 per cent, are left with incontinence that is a nuisance, but no more. When compared to the alternative, a possible recurrence of the cancer, most men would consider this an acceptable nuisance. The overwhelming majority of the small proportion who are left incontinent control their condition with a small pad worn within their pants. The incontinence tends to be worse after standing, when tired, after alcohol or if there is any sexual interest.
What can you do about it? Patients are recommended to learn pelvic floor exercises before surgery, and to have pre and post-surgery physiotherapy. Some doctors believe that traditional physiotherapy to strengthen the pelvic floor is less important than constant practice at controlling urination. Others that recovery is in the lap of the gods coupled with the amount of neurological damage to the intricate network of nerves around the bladder. At some time or another I have experienced all of the complications, and three are still a nuisance. However, I never regret having had a radical, for nine years later I am still alive'.