Issue Date: July 20, 2008
Prostate cancer surgery doesn't mean incontinence.
Good news for men
New surgical techniques can help protect the bladder's functioning.
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For those with prostate cancer, the surgical treatment of choice, a radical prostatectomy, can lead to urinary incontinence. Studies have suggested that about 20% of men who underwent prostate surgery developed urinary incontinence postoperatively, with some of them continuing to have problems more than a year later. The good news is that the surgeons who perform this operation are working to come up with better techniques to cure the cancer while preserving the bladder's integrity.
The primary problem with incontinence after prostate surgery is dysfunction of the sphincter muscles. There are two sphincter muscles at the outlet of the bladder, one up close (proximal) and the other a little more downstream (pardon the pun).
During prostate surgery, the proximal sphincter is sometimes removed, so urinary continence depends on the integrity of the downstream (distal) sphincter. New surgical techniques allow surgeons to remove the prostate while leaving the distal sphincter muscle unscathed. Alternative, non-surgical techniques also can help men avoid incontinence.
Men with prostate cancer should discuss the options with their doctor. The future looks brighter for men who need this therapy.
Tedd Mitchell, M.D., president of the Cooper Clinic, writes HealthSmart weekly.
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