What to Know About Prostate Cancer Treatment: Urinary Dysfunction
This article is not intended to replace professional medical care or advice. If you have any questions or need additional information, please talk with your doctor.
When facing prostate cancer, each man reacts to treatment differently. Some can quickly regain health and strength after treatment, while others endure more lasting side effects which can hinder their quality of life. Urinary dysfunction is a common issue after prostate cancer treatment and for many men, it can be difficult to talk about and manage.
To understand possible urinary problems, it is important to understand how the prostate and bladder are anatomically connected. The prostate gland is surrounded by extremely vital and sensitive organs; below the bladder, in front of the rectum, around the urethra and within the reproductive system. The bladder itself is a balloon-shaped organ that stores urine after it is emptied from the kidneys. As the urethra carries the urine out of the body, it starts at the bladder and runs through the prostate.
Urine function is normally controlled by two sphincters, or muscles. The internal sphincter is located where the bladder and urethra join, and the external sphincter is located below the prostate. These muscles act together, along with the pelvic floor muscles and guided by messages from the brain, to control urine and the bladder. An enlarged prostate can obstruct or place pressure on the urethra, and prostate cancer treatments may damage the surrounding nerves and muscles, affecting bladder function.
Urinary symptoms resulting from prostate cancer treatment can vary; from urinary incontinence and urgency to passing urine too frequently or difficulty emptying the bladder fully. These symptoms are categorized into a few main types of incontinence; stress urinary incontinence, urge incontinence, overflow incontinence, and mixed incontinence. When choosing between prostate cancer treatment options, men should be aware of how each therapy could affect their bladder.
Different prostate cancer treatments create different urinary side effects. Surgery can physically change your urinary system, which presents the possibility of damaging the nerves that help control bladder function. Radiation therapy can decrease the capacity of the bladder and cause spasms that force urine out, often at unpredictable times. Radiation therapy might also inflame both the bladder and urethra and cause swelling, occasionally narrowing the urethra and making the stream weak and less likely to fully empty.Learn How SpaceOAR Hydrogel Can Minimize Side Effects and Protect Quality of Life
While symptoms like urinary incontinence may improve over the weeks or months following treatment, in some men they can be long-term. Up to 20-40 percent of men with normal baseline urinary function will continue to experience some symptoms over time. Urinary problems after treatment are unwanted and unpleasant, often accompanied by embarrassment and anxiety. The fear of leakage can stop men from living their daily lives.
Patients must weigh certain quality of life factors and longevity, but there is good news. Treatments for prostate cancer are constantly improving, and complications like urinary dysfunction are becoming more manageable and in some cases preventable, meaning a better quality of life for patients. Many injuries to the bladder and surrounding tissues are simply a result of how close these organs sit to the prostate, exposing them to treatment effects like radiation. Generating a pressure force that pushes the organs further away from each other means fewer side effects to the bowel, urinary and sexual organs. Emerging new technologies, such as hydrogel spacers, which focus on reducing side effects of localized prostate cancer therapy are becoming more common as quality-of-life concerns are addressed. In a recently published multicenter randomized, controlled clinical trial of a novel hydrogel spacer used during prostate cancer radiation treatment, results showed a 75% reduced risk of mild urinary incontinence among patients treated with the hydrogel spacer compared to patients that did not receive it. At three years following treatment, the average hydrogel treated patient bowel and urinary Quality of Life measures were the same as before radiotherapy, while the non-hydrogel patients Quality of Life measures had significantly declined.