5 “Truths” About Urinary Incontinence You Need to Know

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By Dr. Michael Gambla, M.D.
By Dr. Michael Gambla

Most men wouldn’t think twice about taking their car into the shop if it was leaking fluids, yet many seem content to ignore their own leakage problems. Urinary incontinence is a fairly common condition that affects more than 61 million men over age 45 worldwide, and up to 17 percent of men over age 651. Many chalk it up to a simple fact of life, a product of growing older2.

But, the fact that it’s a common condition is no reason you have to put up with it. Modern treatment options are making urinary incontinence a thing of the past for thousands of men who no longer have to live in fear of an embarrassing leak and are now free to enjoy life on their own terms.

So, what are you waiting for? If you’re tired of dealing with the cost, odor and annoyance of absorbent pads, here are five things you need know about why you shouldn’t put off seeing a doctor any longer:

  • There is life after prostatectomy. Most men find themselves incontinent as a result of trauma—primarily radical prostatectomy to treat prostate cancer. Feeling as though they’ve already been poked and prodded enough with their cancer treatments, many are not inclined to voluntarily undergo yet another procedure. Others may subconsciously avoid incontinence treatment because it forces them to revisit the fact that they’ve had cancer, when they’d much prefer to just put that episode behind them. But, with today’s prostate cancer treatment technologies, many men go on to live long, full lives for years after treatment. That could mean dealing with incontinence every day for decades! You’ve overcome a very serious illness and have a new lease on life. Why would you want to spend it suffering with an embarrassing—and entirely treatable—condition? You owe it to yourself to make the most of life after prostatectomy. Ask your doctor about incontinence treatments that can help you live a fuller, more active life.
  • Incontinence can cause significant mental and emotional problems. For some, incontinence is a mild annoyance, an inconvenience when they play golf or perform some other activity they don’t do that often. But what happens when the leaking starts to interfere with socializing, exercise and day-to-day life? Many men live in fear of an accident someone will notice and avoid public situations altogether. They might withdraw from friends and family, and feel lonely, depressed and isolated as a result2,3. This not only affects the man suffering from incontinence, but also those who love him, who begin to feel neglected, shunned and distant. Urinary incontinence has a profound effect on the day to day lives of most of those who suffer from it3. So, before you decide that your incontinence is only a problem for you, consider it from the perspective of your family, friends and loved ones. Consider seeing the doctor for their sake, if not only for your own.
  • There are treatment options beyond pads. Most men are familiar with absorbent products because they’re widely advertised and available. However, they’re also costly, annoying and sometimes cause skin rashes and embarrassing odor. In fact, they’re not really treatment options at all—they do nothing to solve the problem, and frankly, very little to make it tolerable. Today, we have a number of non-invasive surgical options that can put an end to incontinence with out-patient procedures and proven technology that can have you dry and back on your feet in a matter of a few days, or a few weeks at most. For example, the artificial urinary sphincter is one option that has been around for more than 35 years and is considered the gold standard for treating moderate to severe stress urinary incontinence (leakage brought on by physical strain or activity)4. Concealed entirely within the body, the sphincter uses a small cuff, fluid pump and reservoir systems to hold the urethra closed and prevent urine from escaping. When you’re ready to urinate, you simply squeeze the internal pump, which relieves pressure on the urethra and allows urine to flow. The system automatically resets itself to hold the urethra closed once again. It’s a simple, quick—and discreet—procedure, much less so than carrying around spare pads and changing them frequently.
  • You must be your own advocate. Since it’s not a critical health issue, like heart disease or diabetes, your family physician may not even ask about incontinence. And, even though it is a common side effect of radical prostatectomy5, some cancer doctors don’t address the issue—they’re focused on beating the cancer and saving your life. I highly recommend you take the initiative to investigation the treatment options on your own, even before seeing a doctor. Certainly the Internet is a place to start, but also consider local prostate cancer survivors’ support groups. These men have probably already been through it and are likely more than willing to share their insight to save others from enduring the same problems. There may be treatment options you’re unaware of that only someone with experience can tell you about. For example, the male sling is ideal for mild to moderate stress incontinence6, but it’s not quite as well known as the artificial sphincter. Made of synthetic surgical mesh (similar to what’s used for hernia repair), the sling is implanted inside the body and works like a hammock to support the muscles around the urethra and control urine flow. Slings can typically be implanted in less than an hour and many walk out of the procedure dry.
  • You shouldn’t wait to inquire about options. Most urologic oncologists won’t even consider incontinence treatments until at least a year post-op to allow for complete healing from the surgery and stabilization of scar tissue. And, while it may be true that the condition could improve over time, it doesn’t mean you shouldn’t inquire about the options and be ready to proceed when the time is right. Consider a consultation with a urologist who specializes in incontinence at about six months post-op. He or she can teach you some techniques to do on your own to improve continence and ensure that you’re performing them properly. If these measures don’t work, then at least you’ll have a good idea of the treatment options available when you hit the one-year mark and will be ready to proceed with a permanent solution, rather than waiting a year to even start investigating. The longer you wait and the worse symptoms become, the more difficult it can be for some men to achieve complete dryness.

Just as using absorbent products to soak up an oil leak from your car won’t solve the problem, absorbent pads won’t deal with the root cause of urinary incontinence. And, avoiding getting either fixed could lead to other problems on the road of life. For a variety of reasons, some men are reluctant to see a doctor about any medical condition—I call them “medical introverts.” However, avoiding incontinence treatment out of fear or embarrassment is simply unnecessary. I guarantee that having an accident in public will be exponentially more embarrassing than talking with your doctor about this issue. With today’s simple evaluation procedures, he or she can work with you to determine which permanent solution is best for your situation. The modern treatment options now available mean there’s no reason to let incontinence keep you from enjoying life to its fullest.

Dr. Michael T. Gambla, M.D. is a practicing urologic surgeon with Central Ohio Urology Group, Inc. He is board certified by the American Board of Urology. He earned his medical degree from Rush Presbyterian University Medical College in 1996 and completed both his residency and internship at The Ohio State University Hospitals. 

1 Data on file at AMS

2 Hunskaar S et al. One hundred and fifty men with urinary incontinence. III. Psychosocial consequences. Scand J Prim Health Care 1993;11:193-196.

3 Brocklehurst JC. Urinary incontinence in the community – anaylsis of a MORI poll. BMJ 1993;306:832-4.

4 Klingler HC, Marberger M. Incontinence after radical prostatectomy: surgical treatment options. Curr Opin Urol. 2006 Mar;16(2):60-4

5 Gozzi C et al. Early results of transobturator sling suspension for male urinary incontinence following radical prostatectomy. Eur Urol (2008),doi:10.1016/j.eururo.2008.04.096

6 Data on file at AMS-claim 300

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