SeniorJournal.com - Daily News for Senior Citizens

  FRONT PAGE Aging • Health • Alzheimer's - Mental • Nutrition • Medicare & Medicaid Politics  • Fitness  • Social Security • Alerts • Sex Health • Features • Retirement  Elder Care  >Search  >Senior Links

[NavBar.htm]

Senior Journal: Today's News and Information for Senior Citizens & Baby Boomers

More Senior Citizen News and Information Than Any Other Source - SeniorJournal.com

• Go to more on Health & Medicine or More Senior News from SeniorJournal.com on the Front Page

   

E-mail this page to a friend!

Health & Medicine for Senior Citizens

Incontinence Following Radical Prostatectomy Reduced by Behavioral Therapy Program

Editorial writers ask if limited benefits are worth the patient and clinician time and effort; researchers say 'yes' do to significant, durable improvement in incontinence and quality of life,

Illustration of the urinary tract - More at MedlinePlusJan. 12, 2011 - Men who suffered with incontinence – lack of bowel control - for at least one year following radical prostatectomy, achieved a significant reduction in the number of incontinence episodes after participating in a behavioral training program that included pelvic floor muscle training, bladder control strategies and fluid management.

The researchers also found that the addition of biofeedback and pelvic floor electrical stimulation provided no additional benefit, according to the report in the January 12 issue of the Journal of the American Medical Association (JAMA).

 

Related Archive Stories

 
 

Substantial Improvement in Prostate Cancer PSA Testing Discovered by Genetics Firm

Better results will prevent unnecessary biopsies, catch more cancers, says deCODE

Dec. 16, 2010


Popular Prostate Cancer Staging Does Not Predict Recurrence, Study Finds

Clinical stage was assigned incorrectly in 35.4% of 3,875 men in a multi-institutional national disease registry - Nov. 22, 2010


Aspirin Cuts Death Risk in Half for Prostate Cancer Victims Using Radiation or Surgery

Prior studies have shown anticoagulants like aspirin hinder cancer growth,spread

Oct. 25, 2010


Cholesterol-Lowering Drug Shrinks Enlarged Prostates in Hamsters: Hope for Older Men

Even more effective when combined with drugs approved for treating BPH - watch videos

Oct. 22, 2010 –  Read more, watch videos...


Even Senior Citizens Can Reduce Cancer Risk with Plant-Based Diet, Exercise Says New Study

‘It’s Never Too Late to Lower Your Risk’ is new campaign by American Institute for Cancer Research (see video)

Oct. 21, 2010


More Links Below Story


 
 

Read the latest news
> Health & Medicine
>
Today's Headlines

 

Men in the United States have a 1 in 6 chance of having prostate cancer. Although survival is excellent, urinary incontinence (involuntary leakage of urine) is a significant problem following radical prostatectomy, which is often the treatment of choice for localized prostate cancer.

“Patient surveys indicate that as many as 65 percent of men continue to experience incontinence up to 5 years after surgery. Loss of bladder control can be a physical, emotional, psychosocial, and economic burden for men who experience it," according the background information in the article.

"Although behavioral therapy has been shown to improve postoperative recovery of continence, there have been no controlled trials of behavioral therapy for post-prostatectomy incontinence persisting more than 1 year."

"What Is Prostate Cancer?"
[1 min 41 sec]

Click to watch this video
Transcript, Video help

Also, biofeedback, which assists patients to properly contract pelvic floor muscles, and pelvic floor electrical stimulation, which produces a maximal pelvic floor contraction and improves urethral closure pressure, are often used together in practice and are thought to enhance the effectiveness of behavioral therapy, but empirical evidence of a benefit has been lacking.

A study to evaluate the effectiveness of behavioral therapy for reducing persistent post-prostatectomy incontinence and to determine whether the technologies of biofeedback and electrical stimulation enhance its effectiveness was conducted by Patricia S. Goode, M.S.N., M.D., of the University of Alabama at Birmingham, and colleagues conducted

The randomized controlled trial, which involved 208 community-dwelling men ages 51 through 84 years with incontinence persisting 1 to 17 years after radical prostatectomy, was conducted from 2003 - 2008 and included a 1-year follow-up after active treatment.

Twenty-four percent of the men were African American; 75 percent, white.

After stratification by type and frequency of incontinence, participants were randomized to 1 of 3 groups:
   1. eight (8) weeks of behavioral therapy (pelvic floor muscle training and bladder control strategies);
   2. behavioral therapy plus in-office, dual-channel electromyograph biofeedback and daily home pelvic floor electrical stimulation (behavior plus); or
   3. delayed treatment, which served as the control group.

Participants completed 7-day bladder diaries.

The researchers found that at 8 weeks, those in the behavioral therapy group had an average reduction of incontinence episodes of 55 percent (from 28 to 13 episodes per week), which was a significantly greater percent reduction than that reported by the control group (average reduction of 24 percent; from 25 to 21 episodes per week).

Those in the behavior-plus group experienced an average reduction of 51 percent (from 26 to 12 episodes per week), indicating that the addition of biofeedback and electrical stimulation did not improve 8-week results compared with behavioral therapy alone.

"Improvements were durable to 12 months in the active treatment groups: 50 percent reduction (13.5 episodes per week) in the behavioral group and 59 percent reduction (9.1 episodes per week) in the behavior plus group," the authors write.

At the end of the 8-week treatment period, 15.7 percent of men in the behavior therapy group, 17.1 percent in the behavior-plus group, and 5.9 percent in the control group achieved complete continence, reporting no incontinence episodes in their 7-day bladder diaries.

Behavioral therapy also improved the effects of incontinence on daily activities and condition-specific quality of life.

"Based on the significant decrease in incontinence frequency and the small number needed to treat (10) to achieve complete continence with behavioral therapy, these findings have important implications for urologists, primary care providers, and their patients," the researchers write.

"Behavioral therapy should be offered to men with persistent post-prostatectomy incontinence because it can yield significant, durable improvement in incontinence and quality of life, even years after radical prostatectomy."

Editorial: Treatment for Post-prostatectomy Incontinence - Is This as Good as It Gets?

Questions remain regarding the optimal way to address post-prostatectomy urinary incontinence, according to an editorial by David F. Penson, M.D., M.P.H., of Vanderbilt University and VA Tennessee Valley Geriatric Research, Education, and Clinical Center (GRECC), Nashville, Tenn.

They write, "Is it behavioral therapy, which likely requires considerable patient and clinician time and effort to implement and is associated with limited benefit?

“Is it surgical implantation of an artificial urinary sphincter [a structure, or a circular muscle, that relaxes or tightens to open or close a passage or opening in the body] that works, but requires another surgical procedure?

“Or is it application of new technologies at the time of prostatectomy that purport to result in better patient-reported outcomes but still appear to be associated with a significant incidence of post-prostatectomy urinary incontinence?

“Perhaps none of these is ideal. A better strategy would be primary prevention: increased utilization of active surveillance among patients with lower-risk disease and selective application of aggressive interventions in patients with worse prognostic variables."


About Urinary Incontinence (Also called, ‘Overactive bladder’)

Age Page by National Institute on Aging

While it may happen to anyone, urinary incontinence is more common in older people. Women are more likely than men to have incontinence. If this problem is happening to you, there is help. Incontinence can often be cured or controlled. Talk to your doctor about what you can do.

Causes of Incontinence

Incontinence is often seen as part of aging. But it can occur for many other reasons. For example, urinary tract infections, vaginal infection or irritation, constipation, and some medicines can cause bladder control problems that last a short time. When incontinence lasts longer, it may be due to:
   ● weak bladder muscles
   ● overactive bladder muscles
   ● damage to nerves that control the bladder from diseases such as multiple sclerosis or Parkinson’s disease
   ● diseases such as arthritis that may make it difficult to get to the bathroom in time
   ● blockage from an enlarged prostate in men

Bladder Control

The body stores urine in the bladder. During urination, muscles in the bladder tighten to move urine into a tube called the urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. Incontinence occurs if the muscles tighten or relax without warning.

Diagnosis

The first step in treating incontinence is to see a doctor. He or she will give you a physical exam and take your medical history. The doctor will ask about your symptoms and the medicines you use. He or she will want to know if you have been sick recently or had surgery. Your doctor also may do a number of tests. These might include:
   ● urine and blood tests
   ● tests that measure how well you empty your bladder

In addition, your doctor may ask you to keep a daily diary of when you urinate and when you leak urine.

Types of Incontinence

There are different types of urinary incontinence:

   ● Stress incontinence happens when urine leaks as pressure is put on the bladder, for example, during exercise, coughing, sneezing, laughing, or lifting heavy objects. It’s the most common type of bladder control problem in younger and middle-age women. It may also begin around the time of menopause.

   ● Urge incontinence happens when people have a sudden need to urinate and aren’t able to hold their urine long enough to get to the toilet in time. It is often, but not only, a problem for people who have diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or stroke.

   ● Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injury can also cause this type of incontinence.

   ● Functional incontinence happens in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.

Treatment

Today, there are more treatments for urinary incontinence than ever before. The choice of treatment depends on the type of bladder control problem you have, how serious it is, and what best fits your lifestyle. As a general rule, the simplest and safest treatments should be tried first.

>> Continued at Age Page

>> More information at MedlinePlus


More Links to Reports on Prostate Cancer in SeniorJournal.com Archives

Prostate Cancer Victims Should Be Especially Watchful for Precancerous Colon Polyps

Study is first to show that men with prostate cancer are at increased risk of colon cancer – two most common cancers for older men

Oct. 20, 2010


Popular ADT Prostate Cancer Treatment Associated with Bone Decay

'Virtual bone biopsies' may help identify men at risk for fractures after androgen deprivation therapy

Oct. 8, 2010


Older Men with Low Baseline PSA Do Not Benefit from Early Prostate Cancer Detection

Prostate cancer is the most commonly diagnosed malignancy and the third leading cause of death from cancer in men in Western countries

Sept. 13, 2010


Most Men With Just Low-Risk Prostate Cancer Receive Aggressive Treatment

Over 90% of prostate cancers diagnosed before they spread and the 5-year survival rate for these is almost 100%

July 27, 2010

New Study Finds Gene Fusions May be ‘Smoking Gun’ in Prostate Cancer Development

Gene fusion – not the androgen receptor – is the more specific “bad actor” in prostate cancer  - May 21, 2010


Provenge Approved as Vaccine for Advanced Prostate Cancer; Activates Immune System

Survival for Provenge patients was 25.8 months, compared to 21.7 months for those receiving placebo

By SeniorJournal.com staff - April 30, 2010


Prostate Cancer Treatment Choices Vary Based on Type of Specialist Men Choose to See

About half of all men seen just by a urologist; last week the attention was on the type of prostate cancer screening men should pursue - March 9, 2010


Study of Senior Men Finds Similar Results With Open or Laparoscopic Prostate Surgery

Researchers studied almost 6,000 senior citizens, suggest patients be informed about the differences and similarities in expected outcomes, make treatment decisions with an experienced surgeon - Feb. 22, 2010


ADT Therapy for Prostate Cancer Can Increase Heart Risk Factors

Androgen-deprivation therapy (ADT) may increase cardiovascular risk, but unclear whether it’s linked to increased death from heart disease - Feb. 3, 2010


Favorite Drink of Senior Citizens Coffee Appears to Fight Advanced Prostate Cancer

More good news for senior men is FDA consideration of prostate cancer vaccine, Provenge

Dec. 8, 2009


Study Uncovers Key to How ‘Triggering Event’ in Prostate Cancer Occurs

Researchers link hormone androgen to creation of gene fusion in prostate cancer, a major killer of older men; may help learn how other cancers begin

Oct. 29, 2009


Cancer Society Stands Firm: Older Women Need Mammograms, Men Need Advice on Prostate Tests

‘Mammography is effective – mammograms work and women should continue to get them,’ ACS

Oct. 23, 2009


Minimally Invasive Radical Prostatectomy Has Advantages, But Higher Rate of Complications

MIRP, especially with robotic assistance, increased from 1% to 40% of radical prostatectomies from 2001 to 2006,despite limited data on outcomes and costs

Oct. 14, 2009


Study Says Men are Not Adequately Involved in Prostate Cancer Screening Discussions

Another new study finds screened men up to four times more likely to be diagnosed with prostate cancer than unscreened men

Sept. 28, 2009


Keep up with the latest news for senior citizens, baby boomers

Study Shows Seed Implants a Suitable Prostate Cancer Treatment Option for Older Men

Prostate cancer treatment ‘outcomes are impacted by disease-related risk factors but not by age

Aug. 4, 2009


Men Who Delay Radical Treatment of Prostate Cancer Don’t Seem to Worry About It

Men with neurotic personalities and those in poor physical health exhibited more anxiety and distress than others

July 27, 2009


Heavy Alcohol Drinking Spurs High-Grade Prostate Cancer, Stops Prevention by Finasteride

Four or more drinks on 5 or more days per week doubles risk of high-grade prostate cancer

July 13, 2009


Predicting the Return of Prostate Cancer Improved by Results from John Hopkins Study

May also help resolve the debate on when, and in what form, secondary treatments should occur

July 2, 2009


PARP Drugs May Be Miracle Cure for Cancer Suggests Success with Breast, Ovarian, Prostate Cancer

NEJM editorial says PARP inhibitors may point to a new direction for anticancer drugs - watch video

June 25, 2009


Veterans Badly Mistreated for Prostate Cancer at VA Hospital, Reports NY Times

92 of 116 cancer treatments were botched during a six year period at Philadelphia unit

June 22, 2009


Prostate Cancer Test Proven to Offer Early Prediction of Bone Metastasis, Mortality

UCSF Cancer of the Prostate Risk Assessment gives patients and doctors a better way of gauging long-term risks and pinpointing high risk cases.

June 15, 2009


New Blood Test Significantly Increases Accuracy of PSA Screening for Prostate Cancer

Greatly reduces false-positives in prostate cancer screening that often require a biopsy of the gland to check for tumors

May 28, 2009


Men Should Not Give Up on PSA Prostate Cancer Screening, Just Yet

Urologists argue that men should not be swayed from getting the test - it still saves lives

May 13, 2009

 

Statins Protect Against Prostate Cancer, Erectile Dysfunction and Prostate Enlargement, Mayo Study Finds

Study followed older men 40 to 79 from 1990 to assess urologic outcomes among aging men

April 27, 2009


Elderly Men with Short Life Expectancy Do Not Need Prostate Cancer Screening, Study Shows

U.S. trial shows no early mortality benefit from current annual screening for prostate cancer - watch video, link in story

March 19, 2009


Enough is Enough of Prostate-Specific-Antigen Testing Once Men Reach Age 75

PSA test has decreased prostate cancer deaths but other problems more likely to kill elderly

Feb. 23, 2009


Simple Urine Test May Reveal the Aggressiveness of Your Prostate Cancer

Sarcosine is better indicator of advancing disease than traditional prostate specific antigen test (PSA); it is detected in urine, researchers hopeful simple urine test can be used

Feb. 12, 2009


Artificial Light at Night Contributes to Prostate Cancer and Breast Cancer Say Researchers

Theories for cause: suppression of melatonin production, suppression of immune system, body's biological clock confused between night and day

Feb. 3, 2009


GPS for the Body Sometimes Needed for a Moving Prostate During Radiation Therapy

Prostate can move during a treatment session and can make delivering radiation safely to the tumor a challenge

By Constantine A. Mantz, MD

Jan. 21, 2009


Selenium or Vitamin E to Stop Prostate Cancer May Do More Harm Than Good

National Cancer Institute stops clinical trial from going forward

Oct. 27, 2008


Benign Prostatic Hyperplasia Strikes Up to 90 Percent of Oldest Men, Can Be Life-Threatening

It’s Prostate Health Month and urologist say cancer is not the only thing senior citizens should watch for

Sept. 29, 2008


High Cholesterol Bad for Heart but May Also Increases Prostate Cancer Risk

September both National Prostate Health and National Cholesterol Education Months

Sept. 18, 2008


Common Painkillers Like Aspirin Seem to Lower PSA Level that Predicts Prostate Cancer

Not enough data to say that men who took the medications were less likely to get prostate cancer

Sept. 8, 2008


Height Linked to Prostate Cancer Development, Growth in Review of 58 Studies

‘We speculate that factors that influence height may also influence cancer and height is therefore acting as a marker for the causal factors’

Sept. 3, 2008


Brachytherapy May Be Best Prostate Cancer Treatment Choice for Obese Men

Follows finding that surgery is technically more challenging in overweight men

Aug. 19, 2008


Prostate Screening Bias Against Obese Men Leads to Late Detection, Less Surgical Success

Aggressiveness of obese men's late-detected tumors and that they may be more difficult to remove, is a double whammy for fat guys

Aug. 8, 2008


Task Force Says Men Age 75 and Older Should Not Be Screened for Prostate Cancer

Chances are they will die of something else before the cancer gets them

Aug. 5, 2008


Androgen Deprivation Does Not Improve Survival for Seniors with Prostate Cancer

Conservative management of the disease does a better job, says study

July 8, 2008


Radiation for Cancer Recurrence after Radical Prostatectomy Shows Increased Survival

Provocative evidence that even men with adverse prognostic features may benefit from salvage radiotherapy

June 17, 2008


Older Men With Prostate Cancer at Much Greater Risk of Bone Fractures

Patients should be checked for osteoporosis, particularly if treated with ADT

May 14, 2008

 

> Medical Malpractice,

> Nursing Home Abuse,

> Personal Injury

Our Experienced Lawyers Can Help

Beth Janicek, Board Certified Personal Injury Attorney"We win because we care, we prepare and we have no fear," Beth Janicek, board certified personal injury attorney

 

Free Consultation on your case.

Call Now Toll Free

1-877-795-3425

or Send Email

More at our Website

 

 

Search for more about this topic on SeniorJournal.com

Google Web SeniorJournal.com

Keep up with the latest news for senior citizens, baby boomers

 

Click to More Senior News on the Front Page

Copyright: SeniorJournal.com

    

 

Published by New Tech Media - www.NewTechMedia.com

Other New Tech Media sites include CaroleSutherland.com, BethJanicek.com, SASeniors.com, DrugDanger.com, etc.