Therapy May Help Cut Incontinence After Prostate Surgery
(HealthDay): "HealthDay - TUESDAY, Jan. 11 (HealthDay News) -- Nearly two-thirds of men who
have prostate cancer surgery experience urinary incontinence afterward,
but new research suggests that behavioral therapy can help lessen bladder
control problems for a significant number of them."
After eight weeks of behavioral therapy -- including fluid management, pelvic exercises and bladder control techniques -- the researchers found a 55 percent reduction in incontinence episodes.
It's not a perfect treatment, and it does require work, but it also provides a significant improvement in quality of life.
Behavioral therapy involved instruction in pelvic floor exercises, pelvic muscle contraction and daily exercises, such as deliberately stopping the flow of urine and urge control which meant delaying a visit to the toilet and using pelvic floor contractions to avoid an accident. Men were instructed to drink eight ounces of beverages six to eight times a day, spaced throughout the day. They were advised to avoid caffeine.
After eight weeks, the researchers found that the average number of incontinence episodes dropped from 28 to 13 a week, a 55 percent decline and he reductions in incontinence lasted at least 12 months.
Not everyone is convinced, however, that behavioral therapy is the best option.
"For patients with incontinence, especially bad incontinence, behavioral therapy might not be worth the time," said Dr. David Penson, professor of urological surgery and director of surgical quality and outcomes at Vanderbilt University in Nashville, Tenn. "I don't think the bang is worth the buck."
For many men, he added, an even better option might be to wait to have surgery and monitor this often slow-growing cancer through PSA, or prostate-specific antigen, test surveillance. PSA testing measures the level in the blood of this protein, which is considered a biological marker of prostate cancer.
"Can't we consider the idea of watching these patients for a bit?" Penson asked. "An ounce of prevention is worth a pound of cure."
