Male Urinary Incontinence Associated with Prostate Cancer Surgery

An Overview of Male Urinary Incontinence
and Prostate Cancer Surgery

Approximately 5 million men in the United States will suffer from male urinary incontinence each year. According to Dr. Mark Allen, a Plano, Frisco and Dallas, Texas area urologist with North Dallas Urology Associates, a vast majority of these men do not discuss the symptoms associated with their incontinence condition with their family doctors and in many cases, the condition is left untreated.

Urinary incontinence is the loss of urine control. It can lead to episodes of a slight dribble of urine to the inability to hold urine all together. It can also be temporary or permanent depending on the underlying cause. While urinary incontinence is more prevalent in women, it affects more men than what is actually reported. In many cases, a damaged sphincter, the circular muscle that controls the flow of urine out of the bladder, is often the cause of male urinary incontinence. When damaged, which is commonly the unavoidable result of prostate cancer surgery, the muscle cannot squeeze and close off the urethra. This causes urine to leak.

According to Frank, a resident of Plano, Texas and a patient of Dr. Mark Allen, male urinary incontinence and bladder problems were not only creating emotional stress, but it was limiting his normal activities. “Several years ago I was diagnosed with benign prostate hyperplasia (BPH). I have had surgery to correct this, but the result of the condition has left me dealing with incontinence.  For me personally, incontinence has been really stressful. It has limited my activities and sometimes actually leaves me home-bound.  It is costly, messy and very frustrating.”

Causes of Male Urinary Incontinence

Prostate conditions (as in Frank’s case) such as an enlarged prostate and benign prostate hyperplasia, as well as infections such as acute bacterial prostatitis, are common causes of male urinary incontinence.  In addition, incontinence from prostate cancer surgery is also a concern. Incontinence can become a major setback for men who experience the side effects stemming from prostate cancer surgery, and aside from impotence, it can be a major concern for prostate cancer patients undergoing a total prostatectomy (the surgical removal of the prostate). Other causes of male urinary incontinence and bladder problems include:

• Medications and/or prescription drugs that are given in high doses and that have a sedating effect.
• Spinal cord and/or head injury, which ultimately interrupts messages passing from the brain to the bladder.
• Infections such as urinary tract infections or bladder infections.
• Diseases such as cancer, Parkinson’s disease and Multiple Sclerosis (incontinence from prostate cancer surgery is an example).
• The aging process naturally leads to wear and tear on body parts and organs and can lead to forms of incontinence.
• Alcohol/drugs/smoking can cause incontinence because any toxin that effect human functioning can affect the ability to pass urine; Smoking is also a leading cause of bladder cancer and urinary diseases, which ultimately lead to incontinence.
• Mental state such as emotional stress, depression and illness.

“Unfortunately, many of my patients—like Frank—who suffer from male urinary incontinence and bladder problems stop doing things they enjoy, like going to the gym,” says Dr. Allen. “The primary problem is that incontinence and inconsistency go hand in hand. The urine leakage is unpredictable and varied in terms of quantity. The emotional stress comes from the unknown factor. What many men might not be aware of is that there are advanced treatment options now available for male incontinence.”

There are now real solutions for male urinary incontinence and bladder problems that have been proven to change men’s lives and bring them a sense of normalcy.  From minimally invasive surgical procedures like the male sling for mild to moderate incontinence, to the gold standard artificial urinary sphincter implant that can resolve even severe incontinence, treatment is available. American Medical Systems, a company out of Minnetonka, Minnesota and creator of such devices and procedures, has spent the last 35 years working to create medical solutions for both men and women’s pelvic conditions.

Surgical Options Available for Male Urinary Incontinence

• Mild to moderate incontinence:  AdVance® Male Sling System

This is a small sling that is made of synthetic mesh placed inside the body through small incisions. This sling supports the urethra, restoring normal bladder control in most patients. In many cases, the patient becomes continent immediately following the procedure and can resume normal, non-strenuous activities shortly thereafter

• Mild to moderate incontinence:  InVance® Male Sling System

This procedure also involves placing a mesh sling completely inside the body, but it places pressure on the urethra to reduce the possibility of urine leakage. Most patients are continent immediately following the procedure and can resume normal, non-strenuous activities shortly thereafter

• Moderate to severe incontinence: AMS 800® Urinary Control System

For men who suffer from incontinence from prostate cancer surgery (where a total prostatectomy was preformed), the AMS 800® Urinary Control System can offer a solution. This highly advanced, artificial urinary sphincter is placed completely inside the body.  It provides simple, discreet urinary control and mimics a healthy sphincter, keeping the urethra closed until you want to urinate.  The connected system consists of: a pump implanted in the scrotum, an inflatable cuff around the urethra, and a balloon reservoir implanted in the abdomen.  One can control urination by squeezing and releasing the pump.  The pump moves fluid out of the cuff and back into the reservoir. Urine can then flow out of the bladder. Fluid returns from the reservoir to cuff, squeezing the urethra closed again.

As with any surgical procedure, inherent risks are present with these devices and techniques.  Although rare, some of the most severe risks may include infection and erosion, surgical, physical, psychological or mechanical complication.  If these occur, they may necessitate revision or removal of the device.  For the majority of men who have taken the steps to get their incontinence under control, it was a step in the right direction.

“I really had no idea that a small device could help keep my incontinence at bay. For all men who are experiencing this, there is definitely help out there. Just find a reputable urologist and one that has experience with the AMS incontinence devices. My life has returned to normal and I’m able to run, play with my kids and do the activities that incontinence kept me from doing,” says Frank.

If you suffer from male urinary incontinence, don’t wait another day. Make an appointment with your urologist to talk about your options for a permanent solution that can help you restore your quality of life…and live life dry!

For more information on male urinary incontinence associated with prostate cancer surgery, please contact the Plano, Frisco and Dallas, Texas urology office of Dr. Mark Allen.