Dear Dr. Roach: I am a 78-year-old male. I have no prostate. It has been removed. I suffer from incontinence. I do not want surgery, so could you recommend any over-the-counter medications? — J.S.
Answer: Incontinence after prostate removal is common, especially after surgery for prostate cancer. Most men will have some degree of incontinence, although it often gets better one to two years after surgery. Stress incontinence is the most common type. (Stress incontinence is when a person loses urine involuntarily under “stress,” such as a cough or sneeze. Urge incontinence, the other major type, is when you have the urge to go to the bathroom right away, or you will have an accident.)
Over-the-counter medicines are not likely to help stress incontinence after prostate surgery. One effective non-drug therapy is pelvic physical therapy. This strengthens the pelvic floor and needs to be performed by a therapist who has expertise in male incontinence.
Other treatments include an artificial urinary sphincter and pelvic sling surgery, although I can understand why you are anxious about having another surgery. Your regular doctor or urologist can discuss prescription drug treatments, if appropriate.
