Bladder Surgery May Be Needed As a Follow Up To Prostate Cancer Surgery

July 3, 2012 by  
Filed under Prostate Cancer News

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One major side effects of prostate cancer surgery is urinary incontinence. This is a condition whereby a man is not able to control the flow of his urine after surgery.

As a matter of fact, he could be dripping and may need to wear pad for some time. This sure is an embarrassing situation to even imagine.

The cause of incontinence after radical prostatectomy is that the nerves or tissues connecting the bladder are damaged in the course of the surgery.

However, a new study conducted in Canada has suggested there is a need for a bladder surgery as a follow up surgery to control severe incontinence. This helps men to stay dry. More details are provided below:

One in 20 men who have their prostate gland removed may need a second surgery for severe loss of bladder control, new research from Canada suggests.

Based on more than 25,000 men who had prostate surgery, the study also found that rates of subsequent surgery for urinary incontinence doubled between five and 15 years after the first operation.

“The risk of incontinence will continue and (will) increase from a cancer survivor’s perspective,” said lead author Dr. Robert Nam, from the University of Toronto.

The study, published in the Journal of Urology, is the first to suggest that urinary incontinence may be a long-term problem for men many years after their prostate surgery, according to the researchers.

“Doctors should discuss with patients the risk of needing incontinence surgery after radical prostatectomy,” said Nam, adding that physicians themselves need to be more aware that bladder issues can persist even 15 years after prostate surgery.

An estimated 241,000 new cases of prostate cancer will be diagnosed in the United States in 2012 and the disease will kill about 28,000 men, according to the American Cancer Society.

One of the main side effects of prostatectomy – surgery to remove the prostate gland – is incontinence. Urinary problems usually result from damage to certain nerves and muscles during the procedure.

According to the Prostate Cancer Foundation, about a quarter of men report frequent leakage or no bladder control and the need to use absorbent pads at six months after prostatectomy. But by three years, fewer than 10 percent report using pads at all.

However, the new study’s finding that the long-term likelihood of having a surgical procedure to treat incontinence went up with the passage of time suggests that bladder issues persist.

Nam and his colleagues tracked hospital and cancer registry data for 25,346 men who underwent radical prostatectomy between 1993 and 2006.

Overall, nearly five percent of these men had follow-up operations for bladder issues.

And the number of men getting incontinence surgery almost doubled over time, from 2.6 percent at five years post- prostate surgery to 4.8 percent after 15 years.

If the prostatectomy was done after age 60, a man’s risk of needing a subsequent surgery for incontinence doubled, Nam’s team found.

Among the 15 percent of study subjects who needed radiation treatment after prostate removal, chances of needing incontinence surgery were 50 percent greater than those who didn’t get radiation.

The experience level of the surgeon who performed the original prostatectomy also influenced a man’s chances of needing bladder surgery.

Men whose surgeons did more than 48 prostatectomies a year were half as likely to need incontinence surgery than men whose surgeons did a lower volume of prostate removals.

The more surgeries a doctor does, “the better the outcome in terms of patients staying dry,” said Nam.

The finding further confirms the need for patients to choose surgeons and medical centers with deep experience in treating prostate cancer, said Dr. Peter Scardino, a prostate cancer surgeon at Memorial Sloan-Kettering Cancer Center in New York, who was not involved in the study.

“It suggests the risks of having surgery are higher perhaps than is commonly thought or understood,” Scardino told Reuters Health. Source.

Urinary incontinence is an embarrassing situation for any man that has to face it if nerve-sparing procedure was not recorded in treating his prostate cancer. However, the new study highlighted above is proffering a solution to control this side effect.

This solution is by undergoing another surgery. This time, it would be for the correction damages done to the nerves associated with controlling urine.

You should discuss this possibility with your surgeon if you are about to undergo radical prostatectomy. Bladder surgery may provide you with better comfort.

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