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Michael J. Macksood, D.O., F.A.C.S.
AFTER RADICAL PROSTATECTOMY By Michael Macksood, DO, FACS Radical prostatectomy is the best treatment for prostate cancer in a young man with localized disease and a life expectancy of ten years or beyond. Nowadays, the surgery is fairly routine with a high success rate and low complication rate. One of the most bothersome complications a patient may have is urinary incontinence post-operatively. This complication should be present in no more than 3 to 5% of patients by six months after surgery. After radical prostatectomy and removal of the Foley catheter, it is normal for all patients to go through a period of time when they have urinary leakage of various degrees. They will be instructed to wear a diaper or some sort of a pad and perform Kegel exercises. We cannot predict how long post-operative incontinence will be a problem for an individual. There are, however, certain indicators of who may have a problem for a prolonged period of time. If a patient has a slim build, a small prostate, low-stage cancer and he is young, his chance of getting urinary control back more quickly after surgery is quite high. If a patient is heavy set, has a large prostate or a large cancer, it may take him significantly longer to regain urinary control. We usually counsel a man to be patient and wait at least six months before making a decision on further therapy. Most problems with urinary incontinence will resolve in the first six months after surgery. If incontinence is still a problem six months from the radical prostatectomy, the patient may be a candidate for an artificial urinary sphincter (AMS 800) to solve the problem. The surgery takes approximately 20 to 30 minutes to perform and the patients will usually be in the hospital for a 23-hour stay. The success rate of the artificial urinary sphincter is quite high and 70% of patients will have total resolution of their urinary incontinence. The other 30% will have significant improvement in the degree of incontinence. While urinary incontinence after radical prostatectomy is an unlikely complication; in those patients that experience it, incontinence can have a major impact on their quality of life. It is important that the patient understands that it does not have to be a permanent problem. There is a solution to the unwanted incontinence that can occasionally accompany the radical prostatectomy. For more information you can make an appointment with Dr Macksood to discuss your incontinence. Product details about AMS 800™ Urinary Control System
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Urological Services, P.C.
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