Mr Thyer offers specialist management of prostate cancer.
Mr Thyer has a special interest in robotic and laparoscopic surgery for prostate and kidney cancer but also performs surgery for many other urological conditions.
A normal healthy bladder holds 400-600ml, a healthy bladder will fill and store urine, when your bladder is ‘full’ you are signalled to go to the toilet and you are able to empty your bladder to completion. You should not leak any urine in between voids, this is referred to as being ‘continent’.
Some people have urgency, or urge incontinence meaning that they need to go to the toilet ‘urgently’ and if they do not make it, they may leak urine. Some people have ‘stress incontinence’ meaning they leak urine when they cough, sneeze or jump.
Post prostatectomy when your catheter is removed you will notice that your bladder is more irritable, you are likely to notice altered sensations and signals and may find that you have ‘stress incontinence’ which is leakage of urine when there is pressure such as with coughing, sneezing, lifting and bending.
We expect you to see significant improvement in your bladder control in the weeks following surgery and we expect that with time, your bladder function will return to normal and you will respond to your bladders ‘filling’ sensation, so when your bladder is full, you go to the toilet and empty to completion and your stress incontinence resolves so that you are ‘continent’. If there are concerns that you will have a slower than usual continence recovery, we will discuss this with you.
Whilst trying to improve your bladder control there are certain modifications you can make to your fluid intake to help regain continence and reduce frequency and urgency. Please avoid irritants such as caffeinated, carbonated, citrus fluids and alcohol. This includes tea, coffee, juice and energy drinks. To optimise your continence outcomes, you are best to drink mostly water.
When time permits, try to have a lay down during the day, often you will find as the pelvic floor muscle fatigues later in the day, you will have leakage of urine. If you rest during the day and lay down, taking all the weight off the pelvic floor, this should help reduce the leakage late in the day.
It is imperative you maintain a healthy weight and healthy lifestyle, being overweight is likely to impact negatively on your continence outcomes. We recommend you implement a healthy diet and exercise regime and are able to assist you with this if needed.
It is highly recommended to see a pelvic floor physiotherapist prior to your prostatectomy to have a pelvic floor assessment and an individualised regime implemented. Once your catheter is removed you can recommence pelvic floor exercises. You must not over do the exercises, you should do them only as prescribed by the physiotherapist. If you experience pain in the perineum, you may be overdoing the exercises which is counterproductive as the pelvic floor will fatigue which will exacerbate the leakage.
We recommend men’s disposable or washable continence products; men’s disposable pads are specially designed for men and look like ‘padded cricket boxes’. Continence pads hold different volumes and we recommend you purchase level 2 men’s pads. You can purchase pads from your local pharmacy or supermarket, however, most men prefer to order them online through either independence Australia or surgical house. Tena, Depend and Molimed are common brands. Men’s washable underwear and swimmers are also available, you can purchase these online through Night N Day Comfort.
There are various government funding schemes for continence products, but you must be a health care, pension card or DVA card holder to qualify for pad funding schemes. If you hold a concession card, please let us know so that funding can be arranged by the continence advisor in our office or at the hospital where you have your procedure.
Continence Foundation of Australia
Getting started with Pelvic Floor Exercises:
Disposable continence pads:
Washable continence underwear: