Surgical Procedures for Bladder Control After Complete Prostrate Removal

Bladder control after a prostatectomy is a serious concern. Most men will face some bladder control problems in the weeks after a prostate removal, but some men face the problem long after their recovery. Medications may help with bladder problems and exercises will increase the strength of the pelvic muscles. When bladder problems persist despite these treatments, surgery may correct the problem.

Incontinence

• The type of incontinence you have will determine the type of surgery that will work best for you. Many men experience stress incontinence when the sphincter, which keeps urine from leaving the bladder and entering the urethra, becomes weak because of damage in surgery.
  Before surgery, urine is blocked because of an enlarged prostate. This causes the bladder to attempt to force urine out. After your prostate surgery removes the block, the bladder may continue to forcefully empty urine into the urethra. This causes urge incontinence and an overactive bladder.
  Many men experience a mix of these types of incontinence, and surgery may be the best answer. Your doctor will suggest treatments such as exercises and medications to treat the condition, but when these efforts fail to control urinary incontinence, bladder surgery provides a permanent cure for the problem. Keep a journal of your incontinent episodes so that you can give your doctor as much information as possible.

Artificial Sphincter

• An artificial sphincter procedure is common for men who have incontinence due to a weak or damaged sphincter. The device is filled with fluid and fits around the neck of the bladder. The inflated device keeps the opening closed until it is time to urinate. A pump is installed under the skin that is activated when the artificial sphincter must be deflated. The pump is placed in the scrotum and will re-inflate on its own in about a minute and a half.
  Your doctor will determine whether the artificial sphincter procedure is the proper treatment for urinary incontinence.

Sling Procedure and Bladder Suspension

• Your doctor may recommend a sling procedure to prevent stress incontinence when exercise and medications do not stop the involuntary leaking of urine. A sling will hold your bladder up and keep the urethra closed.
  Bladder suspension surgery will provide support for the bladder and urethra so that the muscles are strengthened and the urethra is kept closed. This type of procedure is also helpful for stress incontinence.
  Discuss all of your options with your doctor to determine which procedure will work best for your bladder problem.