Incontinence After Prostate Surgery: No Big Deal, Men Say

By Frederik Joelving

NEW YORK (Reuters Health) Jun 03 – Many men have some degree of incontinence after prostate surgery, but few are significantly bothered by it, according to a poll at one U.S. hospital.

Of 315 patients surveyed a year or more after radical prostatectomy, only a quarter said they never experienced any leakage.

Still, more than three-quarters said they didn’t use pads in their underwear and only about 5% said they were significantly bothered by incontinence, the research team reported online May 14th in the Journal of Urology.

"The bottom line is that many men, after having their prostate removed, will have some impact on the way they urinate," said Dr. Erik Castle of the Mayo Clinic in Phoenix, who led the new work. "But the degree of the impact is minimal."

Men considering the various treatments for prostate cancer also face possible side effects such as incontinence and impotence, and getting useful information about how common these problems are is difficult, Dr. Castle said, because there are so many different ways of defining them.

"There is a lot of miscommunication," he told Reuters Health. "The goal of the study was to come up with a more detailed analysis of what men should expect after their prostate is removed."

The researchers sent out questionnaires to 600 men, from 42 to 82 years old, who’d had robot-assisted prostate surgery at their hospital.

The surveys focused on incontinence, asking how the patient’s sex life, physical activity and social life were affected by it.

Just over two-thirds of the men responded. At least one year after their surgery, 78% said they didn’t use pads in their underwear, while only 26% said they never leaked.

"The outcomes are actually pretty darn good," said Dr. Castle, adding that some of the older men might already have been leaking before they underwent surgery.

Men who used more than one pad a day – 17% — most often leaked during exercise or when coughing and sneezing, and said their incontinence was most bothersome in relation to their sex life.

Less than 1% reported leaking all the time.

"We just wanted to get the message across that, ‘Look, the vast majority of patients had some kinds of changes in their lifestyle but are still very happy,’" Dr. Castle said.

SOURCE: http://bit.ly/koe8mc

J Urol 2011.