New device can improve incontinence caused by prostate treatment

By Glenna Picton

Incontinence is a common side effect following prostate cancer surgery and one that causes significant quality of life issues. But a new device can help men manage bladder control, said Baylor College of Medicine urologist.

Prostate cancer affects one in six men in the United States. Surgery is the most common treatment and may be followed by radiation or hormone therapy.

"After getting through surgery, some prostate cancer patients may become distressed and embarrassed when dealing with incontinence or the loss of their bladder control," said Dr. Mohit Khera, an assistant professor in the Scott Department of Urology at BCM.

Why it happens

Incontinence occurs when the muscles that support the bladder or control the release of urine are weakened. Muscles at the end of the urethra (the pathway from which urine exits the body) undergo pressure that they cannot sustain, causing early release.

In prostate cancer surgery patients, the urethral muscles are weakened by the removal of the prostate gland and subsequent injury to the surrounding urethral muscle.

Sling procedure

To fit patients with the sling, doctors make a small incision under the scrotum. The sling has four "arms" that go through the patient's tissue, heal and "scar" into place.

The sling lifts and compresses the urethra, said Khera. It brings the urethra and bladder back into their natural position and helps with bladder control.

"The sling serves as a hammock for the urethra," said Khera. "It is made of polypropylene mesh and does not require any additional hardware or artificial materials. It's very natural."

Patients go home the day of surgery. They will have a catheter for one to two days and should be back to full activity in four weeks, Khera said.

Significant improvements

Alternate treatments are more invasive and may be less tolerable to some patients, Khera said. They include silicone rubber-made sphincters which require hospitalizations and abdominal surgeries. An inflatable device fits the urethra and controls bladder function and pressure.

"We are making significant advances in improvement of quality of life following prostate cancer surgery," said Khera.

Erectile dysfunction is also a common condition caused by removal of the prostate gland. Khera leads an erectile preservation program at BCM that rehabilitates and treats men before and after surgery.