Urine Incontinence after Radical Prostatectomy: A Simple Solution to Minimize Urine Leakage
- 1. Department of Neurology, University of South Florida, USA
Abstract
This is a case study report of a single patient’s experience using a perinea compressive support during working hours to reduce urinary leakage.
Setting: A significant percentage of patients have urinary incontinence after radical prostatectomy. This incontinence is worse during working hours due to being upright and urine flows with gravity. Currently, there are two procedures that have provided improvement in urine leakage, male sling procedures and artificial sphincters. Both have moderate failure rate as well as complications including erosion, infection, urethrocutaneous fistula and mechanical complications artificial sphincter. An alternative to these procedures one can the use of a perinea compressive support which is worn during working hours and removed at night. The perinea compressive support has shown good results with minimizing urine leakage during working hours. When the bladder is full the person voids.
Method: A tight fitting elastic belt with anterior and posterior supports and a compressive sponge over the urethra has produced significant improvement of incontinence.
Conclusion: Post prostatectomy urinary leakage can be significantly reduced by wearing a perineal compressive support.
Keywords
Pca; Ppi
Citation
Mohapatra RN (2016) Urine Incontinence after Radical Prostatectomy: A Simple Solution to Minimize Urine Leakage. J Urol Res 3(3): 1053.
INTRODUCTION
A large number of post prostatectomy patients have significant urinary leakage. Some of them use a pad in their underwear, which requires frequent changes to stay dry. I have developed a tight fitting elastic belt with anterior and posterior support and compressive sponge over the urethra for use during working hours to minimize urine leakage. This outer wear can be worn over the underwear with a pad during working hours to minimize urine leakage. At night time this can be taken off as most patients experience little leakage while lying flat in bed.
CASE REPORT
A 70 year old male had a radical prostatectomy due to prostate cancer. In spite of post op Kegel exercises; he continued to have urinary leakage which required him to wear a pad during working hours. After 7 years, he underwent radiation treatment to the bladder neck for recurrence of prostate carcinoma and his urine leakage became much worse. For the past 3 years, he has worn the perinea compressive support over the brief under wear with a pad during working hours, and this has minimized the need for frequent pad changes.
RESULT
The patient experienced significant improvement in urine leakage with the use of the perinea compressive support. Prior to using this device, he was changing the pad 5-6 times a day; he now changes the pad only 1-2 times per day which has significantly improved his quality of life.
Figure 1 Tight fitting elastic belt with anterior and posterior support and compressive sponge over the urethra.
Figure 2 Tight fitting elastic belt with anterior and posterior supports and a compressive sponge over the urethra as worn by the patient
DISCUSSION
After radical prostatectomy and radiation treatment, there are significant complications associated with both the male sling procedure and artificial sphincter. Perineal compressive support reduces urine leakage significantly during working hours. Patients that are significantly overweight can also use a suspender to prevent sagging of the device. Device is removed at night as it is not needed. Penile clamps are uncomfortable and it damages the skin.