Required treatment of urinary incontinence after removal of prostate adenoma

• September 9, 2018
• Prostate
• Ekaterina Komisarova

A malignant neoplasm in the prostate is a very serious disease that is fraught with very dangerous consequences for human health and life, including death. It is not amenable to drug therapy, and the only way out is surgery to remove the internal organ. The operation is very complex, so it requires long-term complex rehabilitation. Many people experience urinary incontinence after prostatectomy. When will this syndrome go away? Every man asks this question, since it not only brings a lot of inconvenience to everyday life, but also creates strong psychological pressure. Let's look at this in more detail and find out the main causes of incontinence, and also find out what treatment can be for involuntary discharge of waste products.

Causes

Let's look at this in more detail. Urinary incontinence after removal of the prostate gland in men is one of the most common pathologies in the field of urology. It makes life in the usual rhythm impossible, since waste products can be released at any time and with varying intensity. There is only one reason for the syndrome - the consequences of an operation during which mechanical damage occurs to the bladder and its muscle layer, as a result of which the rhabdosphincter ceases to perform its functions normally.

This problem will not go away on its own; it requires long-term treatment. As a rule, therapy is carried out comprehensively.

The duration of the rehabilitation period depends on a large number of factors, among which the most important are the patient’s age, the degree of damage to the prostate gland, the individual characteristics of the body and the characteristics of the course of the oncological disease.

Answering the question about when urinary incontinence will go away after prostatectomy, it should be noted that a lot depends on the patient himself.

One of the most effective methods of treatment is physiotherapy, based on a set of special exercises aimed at strengthening and increasing the tone of the muscle tissue of the pelvic area.

Some representatives of the stronger sex do not fully understand their importance, so after working out for a while and not noticing much improvement, they simply give up and give up. Therefore, if you want to get rid of incontinence, then you need to make every effort to do this.

Preparing the patient for surgery

So what do you need to know about this? Urinary incontinence after radical prostatectomy is just one of the possible complications. In fact, there are many more of them. As mentioned earlier, this type of operation is very complex, so in most cases it does not take place without any consequences for the patient’s health. At the same time, doctors try by any possible means to prevent any risks and minimize the likelihood of developing negative manifestations.

Before undergoing prostatectomy, the patient is prescribed a comprehensive examination, which allows one to obtain detailed information about the state of his health and the characteristics of the course of the disease. Based on the clinical picture, a decision is made on the advisability of the operation and the methods of its implementation.

Attention is paid to the following factors:

• age;
• weight;
• are there any problems with the functioning of the genitourinary system;
• the amount of carcinoembryonic antigens in the blood;
• size of the malignant tumor;
• state of blood clotting.

If no serious abnormalities or problems with the patient’s health are identified that may pose a great risk to the successful outcome of the operation, then after preliminary preparation the prostate gland is removed.

When will urinary incontinence go away after prostatectomy? It is very difficult to say even approximate dates, since everything here depends on many nuances.

The main ones among them are the following:

• level of blood loss;
• the degree of damage to the nerve trunks and prostate gland;
• integrity of the urethra and bladder;
• surgeon experience;
• the technique used to perform the prostatectomy;
• regenerative abilities of the body;
• patient's age.

According to medical statistics, complete restoration of urination after removal of the prostate gland takes on average 3 to 5 weeks, provided that the patient adheres to all the doctor’s instructions and undergoes a course of intensive therapy. However, in some cases, rehabilitation may take 3-6 months. Most often, this occurs in the elderly and people with any concomitant diseases of the genitourinary system.

Types of prostatectomy

Rehabilitation of a patient if he has urinary incontinence after prostatectomy (it is very difficult to say exactly when it will go away) largely depends on the method used to remove the malignant tumor. These days there are several types of surgery. The choice of a specific type depends on the level of qualification of the specialized specialist, the clinical picture of the patient and the severity of damage to the internal organ. In this case, the surgeon must consult with an anesthesiologist, since the operation must be performed under anesthesia. In addition, after the patient is operated on, he is placed in a ward equipped with specialized equipment.

As for the main techniques, in modern urology the following prostatectomy techniques are distinguished:

• retropubic;
• perineal;
• radical laparoscopy;
• laparoscopy using the Da Vinci robot;
• transurethral resection;
• laser removal.

Each technique has its own advantages and disadvantages. In addition, after prostatectomy, urinary incontinence (reviews of people who have undergone it will be given at the end of the article) requires complex treatment. Here everything also depends on the type of surgical intervention and the accompanying complications that it entailed.

Retropubic prostatectomy

What is she? This technique is used more often than others. With it, a small incision is made in the lower peritoneum, after which the blood vessels are stopped and the affected part of the prostate gland is cut out.

In this case, the doctor strives to cause as little harm as possible to the nerve bundles. They are the ones responsible for the functioning of the genitourinary system. If you can keep the roots intact, then urinary incontinence after prostatectomy is minimized.

After the tumor is removed, the urethra is sutured to the bladder and a catheter is installed, through which waste products will initially be removed from the body. Statistics show that after about a week and a half, the bladder is completely restored and begins to function normally.

Perineal prostatectomy

This technique is prescribed in the early stages of cancer for patients who have problems with excess weight. The thing is that subcutaneous fat deposits significantly complicate surgeons’ access to internal organs, so skin incision is made in the perineal area. A prerequisite for this is the size of the prostate. It should not be more than 50 cubic centimeters. In addition, the lymph nodes should not be affected by cancer.

After removal of the prostate gland, a scan of the rectum is performed to check for metastases and identify any problems with the functioning of the genitourinary system. To eliminate the possibility of blood clots forming in the blood vessels, the patient is given a drip using the drug Heparin.

Radical laparoscopy

What is its peculiarity? This technique is considered one of the best, since it very rarely causes urinary problems. After a radical prostatectomy, intensive care is not required, since modern equipment makes it possible to remove formations with high precision, while keeping healthy tissue intact.

This technique is based on the use of a medical endoscope equipped with a video camera and surgical instruments that are inserted into the body through an incision in the lower part of the peritoneum.

The main advantages of radical laparoscopy are minimal trauma to soft tissues and nerve columns, as well as a short rehabilitation period.

As medical statistics show, urinary incontinence after radical prostatectomy, reviews of the technique fully confirm this, occurs in isolated cases. At the same time, if complications do appear, they can be eliminated very quickly. In just a week, the person recovers completely and is discharged home.

Laparoscopy using the Da Vinci robot

Scientific progress and the development of robotics have brought surgery to a completely new level of development. One of the innovative methods of prostatectomy is laparoscopy using the Da Vinci technique.

The operation is carried out using specialized drones equipped with a video camera and microscopic surgical equipment. Thus, doctors do not need to perform any actions themselves, since robots do it for them.

Qualified specialists only observe everything that happens on the monitor screen and control the entire process. The equipment is inserted into the body through an incision on the anterior wall of the peritoneum.

No treatment for urinary incontinence after prostatectomy is practically required, since the precision of tumor removal allows the nerve nodes to be left intact, so the risk of complications is relatively low.

Compared to other types of surgical intervention, this technique has the following advantages:

• low blood loss;
• absence of pathological processes;
• fast rehabilitation;
• preservation of erectile function;
• excellent tolerability of the operation by patients of any age category.

According to medical experts themselves, today this type of laparoscopy is one of the best methods for removing the prostate. Urinary incontinence after robot-assisted prostatectomy almost never makes itself felt, since the nerve bundles and muscle fibers remain intact. As for the disadvantages, there is only one, namely, the high cost.

Transurethral resection

The methods for removing prostatitis described above require transabdominal access. However, for adenoma, surgery can be performed directly through the urethra.

This technique is called TUR. It is performed according to the following algorithm:

1. The patient is given anesthesia.
2. A flexible tube is inserted through the urethra, inside of which there is a video camera with a light source and an electric loop responsible for cauterizing damaged areas of soft tissue.

Urinary incontinence after robot-assisted prostatectomy and transurethral resection is minimized, since all manipulations are carried out under the strict supervision of a physician. Obtaining visual information allows you to remove the tumor with high precision without damaging soft tissues and nerve nodes. No stitches or specialized treatment is required.

Removal of the prostate using a laser

Why do many patients choose this method? This is another type of surgical operation that is performed using specialized equipment that emits laser beams with a transmission length of 532 nm.

As with transurethral resection, an endoscope that emits thermal energy is inserted through the patient's urethra. Thanks to vaporization, not only the affected areas of the internal organ quickly die, but also the liquid contained in it evaporates.

No treatment for urinary incontinence is required after radical prostatectomy performed using this technique. The patient can go home the next day.

Rehabilitation period

What is he? Problems with urination after removal of the prostate gland occur quite often, but not every patient faces such a problem. Here everything mainly depends on the method of operation. As you have already seen, today in urology there are modern methods of surgical therapy that are highly effective and almost completely eliminate any complications.

If the removal of the prostate gland went well, then long-term drug therapy is not required for complete recovery. The treatment program is selected based on the patient’s health condition and how he underwent the operation.

In most cases, medication is not required, but to speed up the recovery process, you must adhere to the following recommendations:

• perform physical exercises using the Kegel technique;
• complete cessation of bad habits;
• transition to a healthy diet;
• attending electromyostimulation procedures;
• wearing special pads.

It is worth noting that for the first time after removal of an internal organ, a man may experience burning and pain in the urethra during urination, frequent urge to go to the toilet, as well as incontinence.

Such symptoms are considered normal, but if they do not disappear or you notice a deterioration in your health, you should immediately go to the hospital, since such clinical manifestations may indicate the presence of any problems.

In this case, complex treatment of urinary incontinence after prostatectomy is required.

Basic therapy methods

Many people are interested in the question of how to treat urinary incontinence after prostatectomy. Self-medication is not recommended, since an integrated approach to solving the problem is important here. However, complete recovery may take from 6 to 12 months.

The therapy program is based on the following activities:

• physiotherapy;
• myostimulation;
• taking medications;
• radio wave therapy;
• traditional medicine.

It is important to understand that only those patients whose urethral sphincter has not been destroyed can count on a full recovery. Otherwise, the patient will have a catheter installed, which he will have to live with for the rest of his life. As for traditional methods of treatment, they act as an additional measure necessary to increase the effectiveness of the main therapy.

If after several months no improvement is observed and the person continues to have an involuntary urge to urinate, then in this case specialized protective equipment is recommended for use.

These include:

• diapers for adults;
• specialized gaskets;
• urinals;
• pencil clips.

It is worth noting that when wearing urological products, there is a high probability of developing inflammation of the epidermis and its erosion, as well as various infectious diseases, so it is necessary to regularly monitor your health and, if any problems arise, immediately go to the hospital.

What do patients say about surgical treatment methods?

Reviews about urinary incontinence after radical prostatectomy are quite contradictory. Some people complain of incontinence, which cannot be cured for several months, while others completely recover and return to a normal lifestyle. According to medical statistics, conservative therapy in most cases gives the expected result, but in very difficult situations, especially in the later stages of cancer, it may simply be useless. In this situation, a repeat operation is required.

Prostatitis itself is a very serious pathological process that can lead to various negative consequences. However, in the early stages it responds well to treatment.

Therefore, if you have the first suspicion of this disease, you must immediately go to the hospital in order to begin therapy as soon as possible.

In this case, no surgical intervention may be required at all.

Source: https://cureprostate.ru/418070a-nederjanie-mochi-posle-prostatektomii-kogda-proydet-i-kak-lechit

Urinary incontinence after surgery to remove prostate adenoma

Urinary incontinence after surgery to remove prostate adenoma is the most common consequence of such surgery. It occurs in 95% of patients, and doctors always warn about this. There are many reasons for postoperative incontinence. There are also many methods of dealing with unpleasant manifestations. In the initial stages of recovery, it is necessary to come to terms with this unpleasant manifestation as something inevitable. It is advisable to take care of your own comfort in advance. Special urinals can make everyday life much easier after surgery.

Problems with controlled urination often arise even before the intervention. This is one of the symptoms of a late stage of the disease. In men, the excretory system functions inextricably with the reproductive system. Problems with the prostate gland lead to urinary problems.

The main task of each patient is to prevent serious complications. If you see a doctor in time, you can even avoid surgery.

Prostatitis develops in 80% of men over 45-50 years old, and at the age of 60-70 years this diagnosis is generally inevitable. Inflammatory processes in the prostate gland develop due to hormonal imbalance.

Everyone knows about the female menopause, but it is not customary to talk about the fact that similar problems overtake men.

If you care about your health, you need to visit a urologist regularly. If you cannot do without surgery, then you should familiarize yourself with the main methods of recovery in advance.

Indications for surgery

Adenoma is a benign tumor that gradually develops against the background of chronic inflammation of the organ. If you start treatment in a timely manner, you can get rid of the disease with the help of medications. But sometimes the disease develops rapidly, various aggravating factors influence, then surgery cannot be avoided.

Prostate adenoma often develops into a malignant formation. To prevent the development of cancer , doctors suggest removing a benign tumor immediately. Other indications for surgery are:

• severe pain;
• complete absence of urination;
• absolute urinary incontinence;
• significant tumor growth.

Before the operation, the patient must be hospitalized for preliminary preparation. In many cases, antibacterial therapy is carried out to minimize the negative consequences and complications after the intervention. A complete examination of the patient is necessary.

Based on its results, the tactics of radical treatment, type of operation, and type of anesthesia are determined. Epidural anesthesia is increasingly used in surgical practice.

Unlike general anesthesia, it does not have such a negative effect on the functioning of the cardiovascular system of elderly patients.

The choice of doctor and hospital where the operation is performed is of no small importance. Specialists with extensive experience know how to minimize the negative consequences of surgery, including urinary incontinence.

Features of the operation

Radical removal of an adenoma is carried out by modern surgeons in several ways. With complete excision of a benign tumor, an incision is made in the scrotum and the surgeon removes all damaged tissue, sometimes including nearby healthy tissue. This is done in order to prevent further development of cancer.

Transurethral resection of the prostate (TUR) is becoming increasingly common in our country . This is a minimally invasive intervention.

The likelihood of complications after TUR is minimal, but in the later stages of the disease such interventions are not performed.

The duration of the operation, regardless of how it is performed, is 30-60 minutes. The patient remains in the hospital for two weeks after the intervention, but full recovery takes several months.

During a full-fledged operation with an incision, stitches are required. Today, self-absorbable surgical suture material is used in medical practice. There is no need to remove such sutures, but the doctor must constantly monitor the healing process.

The very next day after the operation, the patient is raised to his feet and must walk. This contributes to the speedy restoration of the excretory system.

Moderate physical activity is the main method of combating uncontrolled urine output after removal of an adenoma. The patient receives full treatment aimed at a speedy recovery.

Causes and conditions of incontinence

Incontinence occurs in 95% of patients after excision of an adenoma or other surgery on the genitourinary system.

Some people do not feel the urge to go to the toilet at all, while other patients involuntarily release only a few drops of urine. Doctors traditionally monitor the situation, but take a wait-and-see approach.

The causes of incontinence are of no small importance. There may be several of them:

1. consequences of forced catheterization;
2. consequences of anesthesia;
3. excision during surgery of the muscle layer surrounding the urethra.

The patient must have a reusable catheter installed immediately after surgery. It lasts for several days. Urine is released into a special urine collector without the slightest urge to go to the toilet.

In this way, inflammatory processes in the bladder are prevented. This tactic is applicable for all types of surgical interventions. Due to prolonged catheterization, the urethra expands and loses its elasticity.

After removing the catheter, urine continues to be released without the urge to go to the toilet.

Sometimes anesthesia has this relaxing property. It does not work this way for all patients, but urinary incontinence is one of the common consequences of using some anesthetics. After the substances are completely removed from the body, its functions return to normal.

Another common cause of urinary incontinence is due to muscle excision during surgery. It is impossible to remove a tumor without affecting nearby tissue.

It is the muscles surrounding the urethra that act as a sphincter, restraining the urge to go to the toilet. When the integrity of the muscle layer is compromised, urinary incontinence is an expected and inevitable complication. You can deal with such consequences if you stock up on patience and support from professionals in advance.

Restoring normal urination

Doctors always insist and emphasize that incontinence is an expected phenomenon when such a benign tumor is removed. Such manifestations can last up to several months, but it is within your power to quickly restore all functions of the excretory system.

training the perineal muscles gives a positive result. The doctor will tell you about the technique of the training process. The point is to periodically tense and relax the muscles in this area. Over time, the muscle layer will build up and you will be able to control the urge to go to the toilet.

Physiotherapy also gives good results. The patient is prescribed sessions of magnetic therapy, ultrasound therapy, and exposure to infrared radiation. Sometimes medications are also offered, the action of which is aimed at restoring the functions of the urinary system.

Improved quality of life after surgery

Many patients become deeply depressed after being discharged home because they cannot return to a full life. They can wet themselves at any moment. Men complain that they can’t even go out to the store without being embarrassed. The odors are also unpleasant for those around you, there is a need for constant washing, and clothes get damaged.

It is in your power and interests to get rid of such inconvenience and improve your quality of life.

To do this, you must constantly use disposable urine bags. They are securely attached to the skin with Velcro, hold the contents, and do not leave any unpleasant odors. In this way, you can quickly return to a full life, and those around you will not even be aware of the existing problem.

Urinary incontinence after a complex operation is a normal phenomenon, but you have the power to quickly restore your own health and usefulness. To do this, you need to follow the doctor’s advice, work with a rehabilitation specialist, and use disposable urine collection bags.

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Source: https://MedProstatit.ru/nederzhanie-mochi-posle-udaleniya-adenomy-prostaty.html

Treatment of urinary incontinence after surgery to remove prostate adenoma

Prostate adenoma is a pressing problem of not only medical but also social significance. If earlier it bothered mature and elderly men, today it is easy to identify in young people.

The most effective way to combat male pathology is surgery. The use of modern minimally invasive techniques allows you to consolidate the achieved result and minimize the development of complications, which is not always possible.

Urinary incontinence after BPH surgery is the most common condition.

The concept of prostatectomy and types of possible complications

Prostate adenoma is a benign formation, the development of which is caused by hyperplasia of prostate tissue. If conservative therapy turns out to be ineffective, and the symptoms increase, the doctor chooses a radical method of treatment - surgery. Modern medicine offers several options for performing operations.

1. Laparoscopic method. A type of surgical intervention used when a tumor grows to a significant size or to remove a diseased organ affected by cancer cells. It is carried out using the Da Vinci Robot surgical device. Modern equipment provides the patient with minimal trauma, and the doctor with a three-dimensional image on the operating display with the ability to enlarge it.
2. Laser removal. It is performed using a transurethral method, in which a special device is inserted and the affected tissue is evaporated using a laser. Healthy cells remain intact.
3. Transurethral resection - TUR. An endoscopic method in which a resectoscope is inserted through the urethra. The surgeon performs coagulation and acts on damaged tissue with high-frequency current. The removed samples are sent for histological examination.
4. Adenomectomy. The open method of removing a large tumor involves dissection of tissue in the peritoneal area between the navel and pubic area and resection of the adenoma. The indication for this operation is oncology. If the pathology is malignant, the doctor performs a radical prostatectomy - RP. Along with the tumor formation, nearby lymph nodes and parts of healthy prostate tissue are removed.

A correctly performed operation rarely causes complications; a small percentage of the risk is still present. They can occur both during the procedure and several months later.

In the first case, these are the following negative manifestations:

• allergic reaction to anesthesia;
• bleeding due to vessel damage or poor blood clotting;
• mechanical injury to the urethra.

Long-term consequences include the following pathologies:

• infectious process due to poor antiseptics;
• urinary incontinence as a result of damage to the bladder sphincter;
• urethral stricture;
• disorders of the gastrointestinal tract (constipation, diarrhea);
• bladder neck stenosis;
• residual cavity at the site of the removed tumor;
• thrombosis of blood vessels;

Older people may develop pneumonia.

The appearance of enuresis symptoms after removal of prostate adenoma

After complete or partial resection of the prostate gland, the urinary process is disrupted in most patients.

The likelihood of developing uncontrolled bladder emptying is determined by many factors. According to various data, its frequency ranges from 3% to 80%.

Since this pathology is a problem of social maladaptation, its correction is an important task of modern medicine.

Characteristic manifestations

Urinary incontinence in men can occur after removal of the prostate by any surgical method. Experts identify several types of this disorder, each of which appears as a result of a specific exposure factor.

1. Stressful. Characterized by droplets or small amounts of urine, it occurs due to sudden tension in the abdominal muscles during sneezing, coughing, laughing, and other types of physical activity.
2. Orthostatic. Episodic incontinence that occurs regardless of the time of day, body position and intensity of physical activity. Develops due to frequent imperative urge to urinate.
3. Total. Periodic or constant leakage of urine in large volumes. Develops against the background of spinal cord and urinary tract injuries during surgery.

A mixed type of incontinence is often observed, combining several varieties with the same severity of characteristic signs or with a predominance of one of them.

Pathogenesis

Urinary incontinence after a TUR of prostate adenoma is considered a common occurrence. In this case, the mechanism of occurrence of pathology can be determined by a wide variety of factors.

1. Postoperative catheterization. Removing the tube provokes the involuntary release of urine.
2. Secondary infections. They develop against a background of weakened immunity.
3. Detrusor hyperactivity.
4. Loss of urinary control due to spinal nerve injury.
5. Removal of the bladder sphincter during surgery.
6. Damage to the pelvic organs.
7. General intoxication of the body.

In some cases, uncontrolled urination occurs due to shock.

List of disposing factors

Since incontinence in medicine is considered a symptomatic complex, experts divide all factors into two groups: intraoperative, discussed above, and preoperative. The latter includes:

• patient's age;
• prostate size;
• presence of urinary disorders;
• PSA level in the blood;
• body mass.

Considering the nature and intensity of uncontrolled urination, it is the last indicator (extra pounds) that doctors pay great attention to. They believe that with adequate physical training, the patient’s weight decreases and pelvic muscle tone is observed, which reduces the likelihood of developing incontinence or shortens the recovery process.

Examination to determine the cause

Next, laboratory tests are prescribed, among which the main ones are:

• general urine analysis;
• Nechiporenko test to exclude the inflammatory process;
• culture for the pathogen if infection is suspected;
• blood test to determine glucose levels.

The latter is performed in order to exclude diabetes mellitus, which is characterized by the production of large amounts of urine, which increases the frequency of the urge to defecate.

Instrumental diagnostics includes a list of the following procedures.

1. Ultrasound. The condition of the pelvic organs is assessed, as well as the amount of residual urine is determined after the act of urination.
2. Cystoscopy. Allows you to identify damage to the bladder mucosa and its etiology.
3. Uroflowmetry. The evacuation function of the bladder during the natural act of emptying is assessed.
4. Cystometry. Helps determine intravesical pressure and assess detrusor overactivity.

The patient performs a cough test to visually assess the degree of urinary incontinence. In addition, he is asked to keep a diary, the readings of which will help control the quality and volume of urine excreted, as well as the frequency of urination.

Restoring normal urination in men

Treatment of urinary incontinence after radical prostatectomy is selected for each patient individually, taking into account the form of the pathology, its severity, and the presence of concomitant diseases. Traditionally, the general principles of therapy are applied, but in the absence of the desired result, the doctor resorts to other methods of treatment.

Inpatient therapy

With an integrated approach, it is possible to achieve early results in the first three months. Conservative therapy takes the leading place in the treatment of pathology. On the second or third day, the patient has the catheter removed and transferred to the general ward.

During this period, he is prescribed a course of antibacterial drugs and uroseptics. The patient is advised to drink plenty of fluids from 1.5 liters on the first day after surgery to 2 liters in the following days. It is recommended to empty your bladder every 2 hours.

Further treatment is aimed at restoring the functions of the pelvic organs and strengthening the pelvic floor muscles. To do this, it is recommended to perform a set of exercises according to A. Kegel’s method.

Home treatments

At home, the patient can continue to perform gymnastics started in the hospital. The most common methods of treatment are also considered to be from the arsenal of traditional medicine.

1. Medicinal herbs. It is recommended to use infusions and decoctions that have antiseptic, antitumor and restorative effects.
2. Bee products. Honey and propolis contribute to the overall strengthening of the body's defenses and activate the immune system.
3. Drinking soda. In some cases, daily use of this remedy is indicated. At the same time, it is recommended to adjust your diet and create a proper daily routine. The course and duration of therapy is selected individually for each patient.

If incontinence develops after surgery, doctors advise not to despair and not give up. You should not self-medicate, because only a specialist knows how to quickly and effectively get rid of the unpleasant consequences.

Repeated surgeries

Surgical treatment of urinary incontinence after removal of prostate adenoma is used only after completing a six-month course of complex therapy. In medical practice, there are several options for surgical correction of pathology.

1. Implantation of the artificial sphincter of the bladder. Indicated for insufficiency of the internal element of the organ, as well as pelvic injuries.
2. Injection therapy. Periurethral injection of collagen can temporarily reduce the symptoms of the disorder. The short-term effect is due to the migration and resorption of the component.
3. Sling operations. Creation of a mechanism for urinary continence by compressing the bulbous urethra using a special loop.

The use of the last method on the list for correcting involuntary urination shows good results and is considered the most reliable, which is confirmed by the experience of the urology clinic of the First Moscow State Medical University. Sechenov.

Prevention of incontinence after surgery in men

When a patient is discharged from a medical facility, the doctor recommends adhering to certain rules of behavior for a long time after the operation and changing some aspects of their usual life.

1. Physical exercise. Walking with acceleration is shown, as well as walks in the park, square, and forest. It is unacceptable to play sports, run, or lift weights.
2. Diet and nutrition. Fiber-rich foods should predominate to make stool easier. Constipation and straining during bowel movements can lead to suture dehiscence after RP or TURP.
3. Sex. Sexual activity remains prohibited for 4-8 weeks. Excitement can cause internal bleeding and increase the risk of wound infection.
4. Hygiene procedures. Only daily warm showers are allowed. Visits to saunas, baths, and hot baths are strictly contraindicated.

The recovery period after any operation involves maintaining a healthy lifestyle, giving up bad habits - smoking, drinking alcohol and, especially, drugs.

Conclusion

The problem of urinary incontinence after surgery for prostate adenoma does not lose its relevance and is considered quite difficult to treat. Only an integrated approach to its elimination can make it possible to successfully combat pathology.

The lack of therapy often leads to a number of physical and psycho-emotional changes in a man’s body. Modern methods make it possible to successfully combat this disorder and, if complete cure is not possible, to significantly reduce the degree of incontinence.

Source: https://UroMir.ru/urologija/inkontinencija/nederzhanie-mochi-posle-operacii-po-udaleniju-adenomy-prostaty.html

Urinary incontinence in men after prostate removal - what to do?

The most effective and frequently used method of combating benign and malignant prostate tumors is surgery.

Causes of postoperative urinary incontinence

There are several options for removing prostate tumors:

• laparoscopy is a gentle method in which large incisions are not made on the body;
• prostatectomy – complete excision of the affected organ;
• perineal resection is a complex, traumatic method used in extreme cases, in which the entire gland is excised, including adjacent tissues.

More than half of patients are sent for prostatectomy. During the procedure, soft tissue and nerve fibers of the gland are cut out.

Postoperative enuresis can be temporary or permanent. Temporary urinary incontinence is observed in all patients without exception, lasting about 2 weeks after surgery. There is no need to worry: this is a normal phenomenon caused by catheterization of the bladder, a slow return to consciousness after anesthesia, and a sudden release of the urinary canal.

• Immediately after surgery, slight blood streaks may be observed in the urine.
• Persistent enuresis requires treatment and occurs due to:

• malfunction of the urinary sphincter;
• weakening of the muscles of the bladder and pelvic floor;
• rupture of nerve fibers and the inability to transmit impulses, as a result of which the urge to urinate becomes uncontrollable.

If 3 weeks after the surgical procedure the enuresis still does not go away, then it is permanent. This means treatment is necessary.

Incontinence varies in severity for each patient. In one patient, only a few drops of urine flow out when coughing, laughing, or sudden body movements; in another, the bladder is completely emptied.

Predisposing factors

Enuresis after prostatectomy is always observed, but persistent incontinence occurs in patients who have predisposing factors to this.

Urologists identify intraoperative and preoperative factors. The first are described in the previous section, the second include:

The most provoking factor of the above is excess weight. Medical experts say that in patients with a healthy body weight and good physical fitness, the pelvic muscles are toned, so rehabilitation after surgery is quick, and complications are almost not observed.

Methods for normalizing urination after surgery

After prostatectomy there is a long rehabilitation period. In the first few days after the surgical procedure, the use of a catheter is mandatory. When the catheter is removed, the patient may experience unpleasant symptoms:

• urine mixed with blood;
• burning when urinating;
• urinary incontinence;
• frequent urge to empty the bladder.

Most men who undergo surgery gradually get rid of the above symptoms over a period of time from 3 weeks to a year. The rehabilitation period is difficult, and you need to be prepared for it.

To prevent postoperative complications, the following methods are used:

• Kegel gymnastics (alternate compression and relaxation of the pelvic floor muscles, which delay the exit of the urinary stream);
• following a therapeutic diet that excludes the consumption of foods that have a diuretic effect;
• electrical stimulation of nerve fibers to accelerate the recovery of prostate tissue;
• use of male urological pads;
• taking medications prescribed by a doctor.

Drug therapy

Drugs are prescribed that stimulate the urethral sphincter, relax the muscles of the bladder, and inhibit the urge to urinate.

The basis of therapy is anticholinergic medications that affect the activity of the neuromuscular system and have a relaxing effect on muscle tissue. The drugs have many side effects, sometimes even causing hallucinations, so they are taken under the strict supervision of a medical specialist.

Among the additional drugs used in complex therapy are:

• antidepressants (effective if enuresis is accompanied by stress);
• alpha-adrenergic receptor blockers (stimulate metabolic processes in prostate tissues);
• beta-adrenergic blockers (help relax the smooth muscles of the bladder);
• antihypertensive drugs (optimal for minor stress exposure);
• urological botulinum toxin (injections into the bladder are prescribed if incontinence occurs due to spinal cord injury or multiple sclerosis).

The doctor may prescribe other medications based on the patient’s condition. The dosage and therapeutic course are selected individually for each patient.

Therapeutic diet

Dietary nutrition cannot be the main method of treatment; it only enhances the effectiveness of drug therapy and speeds up recovery. Products that have a diuretic effect, take a long time to digest, and stimulate gas formation in the intestines are excluded from the diet.

During treatment, a man should forget about cigarettes, alcoholic and carbonated drinks, fast food, heavy and fatty foods. Wrong food provokes constipation and excessive gas formation, and because of this, the restoration of the gland and the tightening of sutures slow down.

After surgery, medical specialists recommend that men take vitamin complexes based on group B compounds. These substances accelerate the regeneration of the myelin sheath of nerve fibers.

Folk remedies

After returning home from the hospital, a man can continue doing Kegel exercises. Also, the remedies offered by traditional medicine cope well with enuresis:

1. Medicinal plants. Infusions and decoctions based on herbs that have antiseptic, strengthening and antitumor effects are recommended. Sage, dill, rose hips, yarrow, and corn silk are effective.
2. Honey and propolis. Strengthen the immune system, retain moisture in the body, normalize the state of the nervous system, which is important for a quick recovery.
3. Carrot. To get rid of enuresis, you should drink a glass of freshly squeezed carrot juice every day before breakfast.

Before using any folk remedy, it is advisable to consult a medical specialist to avoid side effects.

Radical fix for the problem

In most cases, implantation of an artificial urethral sphincter is practiced. The operation of the device that prevents the flow of urine is regulated by the patient. After installation of the sphincter, urinary function is normalized in 80% of patients.

In modern surgery, sling operations are increasingly used. A special device called a sling creates pressure in the urethra, thereby restoring bladder control.

After prostatectomy, patients are often asked to install a rubber ring at the outlet of the bladder, which prevents urine from spontaneously flowing out.

Prevention of urinary incontinence

After discharge from the hospital, a man should still adhere to rules for some time that reduce the likelihood of developing permanent enuresis.

1. Physical activity. Fast walking and walks in the fresh air are recommended. You cannot run or engage in strength sports.
2. Diet. To normalize intestinal function, you should include dishes rich in fiber in your menu. Constipation can lead to surgical sutures coming apart.
3. Intimate life. You should not have sexual intercourse for 1 – 2 months after surgery. An erection can cause internal bleeding.
4. Hygienic measures. You need to take a warm shower every day. During rehabilitation, it is contraindicated to visit baths and saunas, or take a hot bath.

During the rehabilitation period, your lifestyle should be extremely healthy. It is necessary to throw away cigarettes, give up alcohol and other drugs.

Source: https://gormons.ru/zhelezy/predstatelnaya-zheleza/nederzhanie-mochi-u-muzhchin-posle-udaleniya-prostaty-chto-delat/