What are the key considerations for nurses and other allied health professionals when managing men who present with urinary incontinence after prostate surgery or radiation?
Prior to surgery, it is important not only to discuss incontinence as a side effect of surgery or radiation, but to discuss opportunities for prevention such as weight loss, decreasing caffeine, discontinuing smoking and other poor lifestyle habits, as well as managing diabetes and other medical problems, all of which can contribute to decreasing incontinence and improving overall good health.
Also important is instruction in preoperative (Kegel) pelvic floor exercises. Kegel exercises can strengthen pelvic floor muscles prior to surgery; after surgery they help patients improve and regain their bladder control.
What are the primary treatments for post-prostatectomy incontinence in these men?
Depending on the degree and bother of the incontinence to the patient, management can be conservative, as discussed previously: limiting caffeine, alcohol, and other bladder irritants; preventing constipation; and performing Kegel exercises. Continence pads are also an option for management. For men with urge incontinence, medical therapy with an anticholinergic or beta-3 agonist is an option. For those with severe stress incontinence, treatment options include surgical implant of an artificial urinary sphincter or a urethral sling procedure.
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