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Q. What are the possible causes for urinary incontinence?

Answered by
Dr. Shahil Khant
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 19, 2016 and last reviewed on: Jan 28, 2021

Hello doctor,

I am 76 years old. I had an open radical prostatectomy about four months back. Today, I am completely incontinent. I do not smoke or drink. I do hiking and exercise daily. I also do the Kegel exercises faithfully. I have read several ways to do them and I can locate the sphincter muscle. After the surgery, besides the catheter, I had a drain tube from my chest. For the two days in the hospital, it drained at least a cup a day. On the second day, as I was leaving, the nurse took out the drain. I traveled six hours to my home. Upon arriving, I noticed that the scrotum had swollen and my penis had shrunk. By the end of the next day, it had swollen so much that I could hardly walk and if I scratched, it would bleed. I called the surgeon, and he was not concerned. The next day, I was in very much pain and could not reach the surgeon. That evening, I called my regular doctor who told me to go to ER. The next day, they did a CAT scan and found a lake at the bottom of my abdomen, but told not to worry as my scrotum would not explode. Four days later I saw the surgeon, who told me to increase the diuretic that I was using to reduce blood pressure (Hydrochlorothiazide). I increased the dose from 50 mg once a day to 150 mg. After a week, I suffered from severe cramps. My surgeon told me to eat bananas. I did and there was no change. So, he lowered the dose to 100 mg. After three weeks, the scrotum returned to normal, but my penis was shrunken from about 4 to 5 inches to less than an inch. Today, I can stop the urination with mental concentration, but the sphincter does not seem to get the signal from the bladder. My penis is now about one inch. I am socially isolated because of the smell. I cannot continue my professional speaking to promote books. My surgeon says sorry. In a year, I can be put in with an artificial sphincter. Do you think the lake in my abdomen caused the problem? Do you have any suggestions? Currently, I am taking Atenolol 50 mg, Amlodipine or Olmesartan 5 to 40 mg and Simvastatin 20 mg. The blood examination revealed all parameters within the normal limits.

#

Hi,

  • Welcome to icliniq.com.

Relax and do not worry.

Urinary incontinence is a major complication of radical prostatectomy. It happens in 90 percent of the patients.

Your urinary incontinence is not related to the lake in the abdomen. Usually, urinary incontinence will be present till one year in almost every patient who undergoes prostate surgery.

The best solution is to do the Kegels exercises properly. Your sphincter might recover by one year.

Regarding the penis size also, you do not have to worry as it will recover with time. I can give you some temporary solutions so, that your quality of life becomes better and you can do your daily work.

I suggest you use a penile clamp. It is an external clamp like device, which you can apply daily to prevent incontinence. It will stop the urine so that at least you get time to go to the bathroom.

You can also use a condom catheter. It is also a good option as you can wear it every time and go outside so that the urine drain continues through a condom catheter into urine bag, which will be attached to your leg.

For further information consult a urologist online --> https://www.icliniq.com/ask-a-doctor-online/urologist


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