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63 yrs old with incontinence from prostatectomy any procedures available to relieve ?

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In brief: Time since Surgery

Stress urinary incontinence (sui) occurs after prostatectomy as a result of three main factors: loss of passive resistance (prostate out), a weak or attenuated sphincter or nerve injury.
About 98-99% of men will regain sufficient control by one year; if not, a male sling or artificial sphincter may be considered. If you are not yet 1 year out, be sure to be performing kegel exercises, they help.

In brief: Time since Surgery

Stress urinary incontinence (sui) occurs after prostatectomy as a result of three main factors: loss of passive resistance (prostate out), a weak or attenuated sphincter or nerve injury.
About 98-99% of men will regain sufficient control by one year; if not, a male sling or artificial sphincter may be considered. If you are not yet 1 year out, be sure to be performing kegel exercises, they help.
Dr. Robert Donato
Dr. Robert Donato
Thank
2 comments
Dr. George Klauber
Agree with most of above except that incidence of permanent urinary incontinence after radical prostatectomy across the country is > than 1 - 2%. That may be incidence at the best centers where maybe hundreds of these operations are performed every year. Kegel + modified Kegel exercises with a ball between the knees is worth doing until U decide to have an artificial urinary sphincter inplanted
Dr. Robert Donato
Thanks for the clarification. It's hard to get it all in with 400 characters. Kegels are critical in speeding the recovery of urinary continence after prostatectomy. I teach patients pre-op how to perform them, by practicing starting-stopping their urinary stream. Once they are able to isolate the sphincter without the feedback of urination, I then encourage them to being slowly with an emphasis on building slow twitch fiber (long holds, increasing reps). This they begin pre-operatively. I also have patients take anti-spasmodics early post-op to help with stregthening in the setting of significant bladder overactivity. This coupled with rapid sphincter contraction at the sensation of urge can inhibit bladder instability that commonly occurs. Additionally, with the bladder pressures minimized, it builds patient confidence in being able to stop their stream. For those who are refractory to the above after 6-12 months, I recommend medical intervention. If by 12-18 months they are having bothersome incontinence I will then provide the above recommendations.
Dr. Darren Mack
Urology

In brief: Yes.

There are a variety of procedures to alleviate incontinence after a prostatectomy.
A thorough evaluation from a urologist is recommended. Kegel exercises, urethral slings, and artificial urinary sphincters can be utilized to eliminate or improve stress urinary incontinence. Prior to surgery, your urologist might recommend some routine tests such as cystoscopy or urodynamics.

In brief: Yes.

There are a variety of procedures to alleviate incontinence after a prostatectomy.
A thorough evaluation from a urologist is recommended. Kegel exercises, urethral slings, and artificial urinary sphincters can be utilized to eliminate or improve stress urinary incontinence. Prior to surgery, your urologist might recommend some routine tests such as cystoscopy or urodynamics.
Dr. Darren Mack
Dr. Darren Mack
Thank
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