After prostate surgery, urinary incontinence is common. Most patients who undergo radical prostatectomy experience urinary incontinence (UI) and erectile dysfunction (ED) as a consequence.
As the weeks go by, the UI usually improves, but a significant percentage of these patients improve very slowly or not at all. In these cases, early pelvic floor physiotherapy treatment, specifically for men, can speed up the recovery process and decrease the percentage of incontinent men.
Who is most at risk of developing incontinence after prostate surgery?
It is a problem that depends on many factors, from the type of surgery and the surgeon’s skill, the characteristics of the tumor and the patient himself, the immediate postoperative period and the performance or not of specific early treatments, etc. can influence the development or not of the problem.
More aggressive tumors usually require more aggressive surgeries, the older the patient the greater the risk, patients catheterized several times after surgery, systemic diseases such as diabetes or neurological diseases, obesity or poor control of the pelvic floor muscles can negatively affect recovery.
Why does urinary incontinence arise after this surgery?
The surgery itself is the problem, in order to remove the tumor it is necessary to cut, tear and remove tissues that are basic in the function of continence. A part of the sphincter system is eliminated and the rest is structurally and functionally damaged.
How can it be treated?
It is essential to understand that these patients cannot be treated with therapies for women, or by giving a paper with exercises from more than 50 years ago. These patients need a specific assessment by transperineal functional ultrasound. After this test, a clinical history and a physical examination adapted to this type of problem, we will have the necessary information to structure a personalized treatment for UI and ED.
Electromyographic and ultrasound systems to improve motor control, neuromuscular electrostimulation in cases where it is possible and functional therapeutic exercise adapted to this problem and to each patient are the basis of recovery. Allowing time to pass for months in patients who do not evolve rapidly reduces the chances of regaining continence. A patient who is not continent after a maximum of 6 weeks should be evaluated.