PROSTATE CANCER TREATMENT:THE ANATOMICAL RETROPUBIC APPROACH .WHAT TO DO ABOUT INCONTINENCE

Most men experience temporary urgency and stress incontinence after the catheter is removed—in fact, it would be remarkable if they didn’t. Think about it: The urethra has been stretched and possibly irritated for three weeks by the catheter; it’s probably going to take hours to days for it to recover from this insult.

Urinary control generally returns in three phases . Phase One—you’re dry when lying down at night. Phase Two—you’re dry when walking around. And Phase Three—you’re dry when you stand up after sitting. Persistent stress incontinence (leaking urine when you stand up or exercise) is rare, and total incontinence is even more rare.

There’s also something you can do to control stress incontinence—special exercises, called Kegel exercises, that strengthen the external sphincter. To help speed up your recovery, practice starting and stopping your urinary stream every time you go to the bathroom. The best way to do this is when standing to urinate: Try to shut off your urinary stream by contracting the muscles in your buttocks tightly. (There are other methods of performing these exercises, but by doing them this way you can be sure you’re exercising the right muscles.) Only perform these exercises when you urinate—don’t do them at other times, because you will tire out the sphincter muscle.

Until your urinary control returns completely, wear a pad, such as a Serenity pad, or disposable diaper, such as Depends. You can get these at the pharmacy or grocery store. Some men prefer using a special kind of padded underwear called Confidens Brief; your doctor should have good suggestions and perhaps even some samples for you to try. Whatever you do, do not wear an incontinence device with an attached bag, a condom catheter or clamp! If you use these devices, you won’t develop the muscle control you need to be continent. Also, until your urinary control has returned, avoid drinking excessive amounts of fluids, and limit alcohol and caffeine—both can make the problem worse. Again, remember: You will get through this.

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