by SARAH WOODWARD
COMMUNICATIONS COORDINATOR • BIODERM, INC.
When your doctor was preparing you for surgery or radiation treatment, did he mention incontinence? How about erectile dysfunction? Did you expect to have embarrassing accidents or spend your golden years in a glorified pair of pampers? “After many complications with prostate surgery, I was left with complete incontinence. Every day was miserable and I didn’t want to go anywhere.” That was life for Phil, after he had a radical prostatectomy. And unfortunately, it probably sounds pretty familiar to many of you. It certainly did to me. Phil is one of thousands of our customers that have reached out in the last year to share their story. The reality is that almost all men will experience at least some urinary incontinence after surgery. Most heal within a few months, but an estimated 5-8% will be incontinent permanently according to physician surveys1. Self-reporting patients, however, regularly disclose a much higher level of permanent urinary incontinence, sometimes as high as 31%.2 A 2013 survey conducted by American Medical Systems, found that 43% of prostate cancer survivors experienced urinary incontinence, with 23% of survivors needing to wear adult diapers3. Of those polled, a staggering 27% reported their side-effects were worse than expected. And if those numbers don’t knock your socks off – try this one on for size: a 1999 Survey of US Too Prostate Cancer survivors indicated that as many as 20% of men were not warned about the possibility of incontinence prior to prostate cancer surgery!4
All of this leads to two serious questions – is incontinence after treatment for prostate cancer being under-reported by doctors? And are patients like you truly prepared for the potential post-operative side effects? To answer these questions – we talked to doctors and patients who clued us in to a few of their observations!
1. Doctors and patients often define incontinence differently. This difference dramatically affects their perceptions of incontinence and the successfulness of their treatments.
So, what’s the difference exactly? It varies by study but in general urologists often define post-operative incontinence as leaking that requires you to use more than one pad per day5. Men who experience only stress incontinence will also frequently be deemed ‘fully continent’ by their doctors. On the other hand, men like Phil often use a broader definition, identifying incontinence as any lack of urinary control including leaks, sudden urges to void (potentially resulting in accidents) or stress incontinence when physically active (bending, lifting, sneezing, etc.). This difference may seem small, but its impact on your quality of life definitely isn’t! Men that used 2 or more pads a day identified a significant negative impact on their quality of life6, including their emotional and physical well-being.
2. There is no amount of technology that can replace a skilled surgeon.
In the last several decades, medical science has seen a significant improvement in the tools available to surgeons and their patients. The introduction of nerve-sparing radical prostatectomy in particular, reduced complications including urinary incontinence and sexual dysfunction. However, technology comes with caveats. The introduction of new robotic systems is only as good as the surgeon operating it. “Robotic systems are simply tools and do not have the capability to perform the operation without the surgeon. The surgeon uses the robotic instrument much as he/she would with a scalpel.”7 In general, more experience leads to better outcomes and improperly trained physicians can increase complications. A recent CNBC News report on lawsuits fi led against Intuitive Surgical, makers of the da Vinci 3D surgical robot, expressed concerns about training – certification can require as little as seven hours of training8 – less training than you would get if you wanted to work at your local Best Buy Geek Squad. In an era of ever growing healthcare costs, how many surgeons get more than the minimum required training? Prior to your surgery – do you know what kind of training your surgeon had completed, how often he had done that particular procedure or anything about the tools he’d be using? Most don’t and it is no doubt to their detriment.
3. Patients lack awareness of newer product options to manage incontinence and 3 in 10 are too embarrassed to discuss the issue with their doctor.
A recent parentgiving.com survey reached out to more than 5,000 people dealing with incontinence to help evaluate the stigma associated with incontinence and product options for men and women. They came back with some fairly astonishing responses – 3 in 10 people with incontinence never mention it to their doctor (regardless of the cause) and nearly 7 in 10 people with incontinence live in fear of having an accident. The stress and worry alone can have a huge impact on your quality of life.9 And sadly, many men assume that their only options are absorbent products like diapers and pads. It’s simply not true. In the same parentgiving.com survey, only 4 in 10 individuals were “very satisfied” with their absorbent
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That’s understandable, since the price of most absorbents is about $0.86 per pad11. Pads should be changed 4-6 times a day12, meaning the annual expenditure for wearing absorbents could be as high as $4,402. Absorbents aren’t generally covered by insurance, so the costs are coming right out of your pocket. Fortunately for men, there is a different option, Men’s Liberty. It’s a popular choice because the skin friendly seal moves with you throughout the day, eliminating embarrassing accidents and catching all those unexpected leaks. And as an added bonus, you can go to the urinal anytime you want and empty the bag or even pee right through it. Working on kegel exercises, you can do that too – all with the Men’s Liberty in place.
So what should patients like me do?
As the patient, it’s your job to be proactive. Don’t shy away from doing your own research and asking your Doctor about what you find. Most people with incontinence never mention it to their doctor. And when a patient comes in wearing a diaper, the Doctor may not even bring it up! If you want a better option or have questions about your incontinence, ASK!! We strongly encourage men to talk to their doctor, exercise and do everything they can to regain continence. Simply ‘living with it’ isn’t really an option. Phil tried coping as best he could. “I had to limit my intake of liquids which was unhealthy in itself.” Fortunately for Phil, his doctor offered him a better option that gave him back a sense of normalcy and restored the self confidence that was being ripped away after every accident. “After my doctor offered the Liberty external device, life has been much better. I can now drink what I want and lead a more normal life. I am very thankful there was a product like the Men’s Liberty that has given me some normalcy in my life and allowed me to be active again.” If you’re interested in hearing more stories from men dealing with incontinence, visit us online at www.MensLiberty.com/blog.
*This article is intended for educational use only and does not constitute medical advice. Always consult your doctor before beginning a new exercise regime or other major lifestyle change.
Author: Sarah Woodward is the Communications Coordinator at BioDerm, Inc. a medical device manufacturer in Largo, FL. At BioDerm, she is responsible for marketing content, social media, writing and graphic design. She also authors the Men’s Liberty blog which focuses on incontinence issues among men. For more information on Men’s Liberty, visit us online at www.MensLiberty.com or call our Customer Care Team at (800) 814-3174.
1 McGlynn, B., et al. “Management of Urinary Incontinence Following Radical Prostatectomy,” Urol urs. 2004;24(6), http://www.medscape.com/viewarticle/496416_2
3 Survey Conducted by Angus Reid, on behalf of American Medical Systems. Accessed online: http://www.torontosun.com/2013/05/06/mostprosate-cancer-survivors-say-side-eff ects-hurt-sex-life-survey
4 Palmer, Mary, et al, “Incontinence Aft er Prostatectomy: Coping With Incontinence Aft er Prostate Cancer Surgery” Oncology Nursing Forum, http://ons.metapress.com/content/634nl63w98273180/
5 Moore KN, Truong V, Estey E, Voaklander DC., “Urinary incontinence after radical prostatectomy: can men at risk be identified preoperatively?” J Wound Ostomy Continence Nurs. 2007 May-Jun;34(3):270-9; quiz 280-1. Accessed online: http://www.ncbi.nlm.nih.gov/pubmed/17505246
6 SACCO, E., PRAYER-GALETTI, T., PINTO, F., FRACALANZA, S., BETTO, G., PAGANO, F. and ARTIBANI, W. (2006), Urinary incontinence aft er radical prostatectomy: incidence by definition, risk factors and temporal trend in a large series with a long-term follow-up. BJU International, 97: 1234–1241. doi: 10.1111/j.1464-410X.2006.06185.x
11 Brazzelli et al. “Absorbent Products for Containing Urinary and/or Fecal Incontinence in Adults,” Journal of Wound, Ostomy and Continence Nursing, Jan. 2002: pp. 45-54.