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Post Prostatectomy Urinary Incontinence and Pelvic Floor Physiotherapy

Posted by Administrator on Jan 01 2015
What's New >> Shayla Hall

Post Prostatectomy Urinary Incontinence and Pelvic Floor Physiotherapy

The majority of men undergoing radical prostatectomy will have some degree of urinary incontinence following surgery (studies suggest anywhere from 5% to 87%).
Urinary Incontinence Pelvic floor physiotherapy is useful for men undergoing prostate surgery in order to learn how to improve the health of the pelvic floor muscles. Practicing proper pelvic floor muscle contractions will help to improve the strength, endurance, and coordination of the pelvic floor muscles and thereby aid in regaining continence. An incorrect pelvic floor muscle contraction can actually promote incontinence, so if you are doing your pelvic floor muscle exercises, make sure you are doing them correctly!
Pelvic floor physiotherapy will also address questions regarding when it is advisable to return to exercise, the effects of diet on urinary function, and what is the normal progression regarding continence post prostatectomy. Pelvic floor physiotherapy can also help with different aspects of sexual health post prostatectomy.

Why is urinary incontinence so common following a radical prostatectomy?

 

radical prostatectomy

Urinary incontinence is the accidental or involuntary loss of any amount of urine from the bladder. In a radical prostatectomy, the entire prostate is removed, as is the portion of urethra (the tube that carries urine from the bladder to the external world) that the prostate surrounds. Because the prostate itself helped to provide resistance to urine flow through the urethra, removal of the prostate can affect continence.

As well, there are two sphincters (valves) that control urine flow – an external sphincter (the pelvic floor muscles) and an internal sphincter (located between the bladder and the beginning of the urethra). With a radical prostatectomy, the internal sphincter is damaged and therefore the external sphincter becomes the only functioning sphincter to control urine flow.

As with any surgery, there can be damage or trauma to the various nerves that control continence and/or to the bladder itself which may affect continence.

How is urinary incontinence addressed with pelvic floor physiotherapy?

pelvic floor Pelvic floor muscle exercises are the most widely recommended non-invasive treatment and they are used as the first line of treatment when dealing with urinary incontinence.

If you think about your urethra like a garden hose and your pelvic floor muscles like a clamp, in order to stop the flow of urine through the urethra, you will need strong and coordinated pelvic floor muscles. Also remember that you no longer have the internal sphinter functioning correctly so your sole sphincter for clamping down on the urethra is external sphinter (the pelvic floor muscles).

During your pelvic floor physiotherapy treatment, you will check for signs of hyperactivity of the pelvic floor muscles as well as checked for a proper pelvic floor muscle contraction. As with any muscle, the pelvic floor must be able to fully contract as well as fully relax. Sometimes pelvic floor muscles are tight and therefore dysfunctional and may require manual stretching and relaxation techniques. The strength of your contraction will also be determined and different techniques will be applied in order for you to gain full strength of your pelvic floor muscles.

You will be given a home program to work on independently and it is the exercises that you do on a daily basis which will be the most important influence on the health of your pelvic floor.

How can diet effect urinary function?

In terms of diet, it is important to avoid bladder irritants like caffeinated beverages (such as coffee and tea), alcohol, smoking, and spicy foods. It is important to have adequate fibre in your diet as well as proper fluid intake as concentrated urine is actually a bladder irritant.

Where do I get further information?

Please feel free to contact Marnie Tocheniuk at Elaho Medical Clinic if you have any questions or if you would like to make an appointment.
Marnie will also be speaking on ‘Incontinence Following Prostate Surgery’ on September 25th, 2012 for the North Shore Prostate Cancer Support and Awareness Group. The talk is open to newcomers and it will begin at 7pm at Lions Gate Hospital Basement Auditorium.

The North Shore Prostate Cancer Support and Awareness Group meets the
4th Tuesday of the month from 7-9pm (except December) and the group
provides a wealth of information and support.
You can contact Marnie Tocheniuk at Elaho Medical Clinic
E-mail Tom Sayle at NorthShorePSA@gmail.com if you would like further information.
 

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