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Strategy for Incontinence From Prostate Cancer Surgery

Study Shows Benefits of Behavioral Therapy in Reducing Incontinence Episodes

Decrease in Incontinence Episodes continued...

By the end of the eight-week study, almost 16% of men in the behavioral therapy group were completely dry, as were 17.1% in the group that also added biofeedback and electrical stimulation along with behavioral therapy and 5.9% of men in the comparison group.

Ninety percent of men in the behavior therapy group and 91% of men in the behavior therapy with biofeedback and electrical stimulation group said their leakage was “better” or “much better” when compared with 10% of men in the comparison group, the study shows.

Overall, 47% of men in the treatment groups said they were satisfied with the level of improvement.

Second Opinion

David F. Pearson, MD, MPH, the director of the Center for Surgical Quality & Outcomes Research, and a professor of urologic surgery at Vanderbilt University Medical Center in Nashville, Tenn, says that behavioral therapy is as good as it gets when it comes to a nonsurgical way of treating incontinence after prostate cancer surgery, but he is not sure it is good enough for many men. Pearson wrote an editorial that accompanied the new study.

When it comes to the behavioral intervention outlined in the study, “there is no downside,” he says. “No harm, no foul.”

In terms of improvement, “the surgical options such as placement of sphincter or a male sling are better than this, but for a noninvasive treatment probably is at good as it gets,” he says.

“In the end, patients have to realize there is a chance of bothersome symptoms that will require another aggressive intervention down the road,” he says.

When a man is diagnosed with prostate cancer and considering surgery, it can be hard to appreciate how side effects such as incontinence can affect their quality of life, Pearson says.

“There is no denying the fact that this study shows it has an effect, but people just have to realize that if you want to be totally dry, this isn't going to do that,” he says.

“Are you OK going from four leaks a day to two? Most of my patients will say ‘No. When I walked in I didn’t wear diapers, and I don’t want to wear them now,’” he says.

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