After the prostate is removed the male depends almost exclusively on the external sphincter for the control of urine. The male’s body has to “relearn” how to control continence. How much one will leak, how long one will leak, and to what degree one leaks, cannot be predicted. The fear of incontinence along with the fear of impotence are primary factors in the “Decision.” These two factors often are more important to the male than concerns about the “best thing to do to cure the cancer.” Prostate cancer is unique in this way.
Dirty little secret: I don’t think doing Kegels have anything to do with the return of continence. Don’t get me wrong… they don’t hurt anything. I think continence starts with the prostatectomy being performed well, and then…luck. Why it is that I can remove a prostate the exact same way in one patient (and he is dry day one after removing the catheter) and then a another patient takes weeks to regain continence?
From “The Decision.”
A discussion of post-prostatectomy incontinence from Walsh’s book. This is very good.
“The well wear a crown that only the sick can see.”