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Posted by Nick on May 25, 1999 at 15:30:48 I am completely incontinent resulting from a radical
Prostatectomy. I have used leg bags and penis clamps.
The clamps are not as messy to use as the leg bags. Are there
any long term effects from using the penis clamp? Until I
get the clamps adjusted properly I do experience discomfort.
Does the urethra get damaged because of the constant squeezing?
I am trying to avoid the decision of having an artifical
sphincter installed because from what I have read it is not
the magic cure either. How long can an individual carry on
with the clamp? Any replies will be sincerely appreciated.
Thank you.
Posted by HFHS M.D.-KR on June 02, 1999 at 08:41:45-------------------------------------------------------------------------------------------- Dear Nick, Incontinence after radical prostatectomy occurs in 10 to 20 % of patients.
There are two types of incontinence stress and urge. Stress incontinence can be described as the loss of urine with straining , coughing, lifting etc. Urge incontinence occurs when patients cannot delay urination. Often they can’t reach the bathroom in time. After radical prostatectomy both can occur. Incontinence improves somewhat over time after surgery. By one year, the level of incontinence you experience is most likely the final result. This means that up to one year things are changing and improving.
If you have persistent incontinence, there are several options. The Cunningham clamp for the penis is one option. This allows control of urine and is relatively neat. This can cause problems with the bladder because if the urine is not emptied frequently enough pressure is transmitted to the kidneys and can cause kidney failure. Also, with prolonged use, the skin of the penis can be damaged .
A condom catheter is a better option than the clamp because the bladder is drained and there is no backpressure on the kidneys. The downside is the need to wear a leg bag.
It may be advisable to try several types of condom catheters. There is a system called the McGuire catheter that fastens around the waist. Medical supply stores carry various types.
The artificial urinary sphincter is the surgical option to treat persistent incontinence. It has the benefit of allowing the patient to control urination. A sphincter is placed around the urethra and connected to a pump which is then inflated and deflated by the patient. The risks of the sphincter include, infection (as with any prosthetic material), malfunction of the device, erosion of the sphincter into the urethra, and failure of the device to achieve total continence. If you are hesitant to undergo surgery at this time I would suggest a condom catheter drainage system is a better option for you. In experienced hands however many patients are very satisfied with the artificial urinary sphincter. Dr. Riad Farah at our institution has a wealth of experience in this area. This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568). HFHS MD-KR
*keyword: post-prostatectomy incontinence
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