At age 57, I had a radical prostatectomy slightly more than one year ago as an apparently successful cancer treatment. Incontinence is still a significant problem and I am considering further treatment to control this problem. The incontinence condition is very slowly improving but also quite limiting. What is a reasonable amount of time to wait to see if full bladder control will be recovered without additional treatment? I have heard that the artificial sphincter implant is the most effective treatment and that collagen injections are usually not very effective. I understand there is also a "modified Stamey procedure" but have little information about it. In your opinion, what incontinence treatment is most likely to provide full bladder control and are there any particular medical centers specializing in that procedure?
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Dear Bill,
I am glad to hear that you are otherwise doing well. Incontinence is a problem that can certainly affect your quality of life. By six to nine months your continence is fairly stable and I would not expect significant improvement beyond that time.
You need to have a formal evaluation for this with cystoscopy (looking into your bladder) and a cystometrogram (evaluation of bladder function). A significant number of patients who do not spontaneously regain their continence following a radical prostatectomy are found to have changes in their bladder function which influence their management. Some may only require management with medication.
Collagen often does not work for patients such as yourself. With cystoscopy your urologist can determine if you would be a reasonable candidate to try this. The most reliable treatment is the insertion of an artificial urinary sphincter (assuming normal bladder function).
This procedure is widely perfomed in the U.S. and certainly at most (if not all) academic centers.
This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. We at The Henry Ford Hospital Department of Urology have experience in the evaluation and treatment of problems such as you describe. We would be most interested in helping you. You can reach us through our toll-free number (1-800-653-6568). We can also arrange local accommodations through this number if this is your need. Please bring any x-rays [and pathology slides] (not just the reports) as well as any physicians’ notes and lab test results that you may be able to obtain. These will help us greatly. Hope to see you soon! HFHS M.D.-SAL
*Keyword: Incontinence
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