The Prostate Protocol By Scott Davis The Prostate Protocol is designed for all those who want a natural solution for BPH. The online program can help users to treat BPH. Also, it will address the root cause and prevent a recurrence. You might not expect this benefit from conventional treatments. The program is the outcome of extensive research.
How can one manage urinary incontinence after prostate surgery?
Urinary incontinence control after prostate surgery, such as prostatectomy (removal of prostate), is very common. However, the majority of men are able to gain bladder control with the right approach and therapy. The following is a comprehensive guide about urinary incontinence control after surgery:
✅ 1. Pelvic Floor Exercises (Kegel Exercises)
Pelvic exercises, or Kegel exercises, are perhaps the best ways to regain control over the bladder. They will make the muscles that govern the flow of urine stronger.
How to perform Kegels: In order to perform Kegels, you need to find the muscles responsible for stopping urination. After finding them (you can find them by stopping the flow of urine while in the bathroom), squeeze and hold them for 5-10 seconds, and then release for 5-10 seconds. Repeat this 10-15 times, 3 times a day.
Consistency: Regular practice of the exercises is essential, and weeks or even months might pass before noticeable improvement can be seen.
✅ 2. Bladder Training
Bladder training is a process of slowly lengthening the time between bathroom trips to restore bladder control over the need to urinate.
Start with a schedule: Start with a schedule of going to the bathroom at regular time intervals (e.g., every hour). Slowly attempt to increase intervals of bathroom trips.
Timed voiding: Begin by urinating on a regular schedule (every 2-3 hours) whether or not you feel like it. Gradually decrease bathroom visits as your bladder control improves.
✅ 3. Incontinence Pads or Adult Diapers
Along with developing bladder control, using incontinence pads or adult diapers will help you contain leaks. There are plenty of products designed specifically for men that are comfortable and discreet.
Choose absorbent products suitable to your activities and needs. Daytime and night-time products can give protection and dryness.
✅ 4. Medications
Various medications are available that can treat urinary incontinence by improving bladder function or controlling muscle contractions:
Alpha-blockers (such as tamsulosin): These medications are able to relax muscles near the bladder neck and improve urine flow.
Anticholinergic medication (such as oxybutynin, tolterodine): These can reduce frequency and urgency by relaxing overactive bladder muscles.
Topical estrogen (for men with specific incontinence types): This may be possible to improve the tone of the bladder sphincter.
It’s always best to consult your doctor first before starting any medication, as he or she is able to recommend the most suitable one based on your condition.
✅ 5. Electrical Stimulation (Neuromodulation)
For other guys, electrical stimulation therapy, or neuromodulation, can assist. It stimulates the nerves that control the bladder to improve bladder control.
Sacral nerve stimulation (SNS): A tiny device is implanted near the sacral nerve, which helps with bladder function and controlling involuntary bladder contractions.
Transcutaneous electrical nerve stimulation (TENS): This is an outpatient procedure in which electrodes are applied to the skin to stimulate nerves and constrict pelvic floor muscles.
✅ 6. Biofeedback
Biofeedback is a technique that allows you to observe and control the operation of body functions, like pelvic muscle tightening, with the help of equipment that provides real-time feedback.
Your biofeedback therapist can instruct you on how to use a device to monitor the efficacy of Kegel exercises and other activities of pelvic floor muscles.
This can be very useful for men who have difficulty exercising correctly on their own.
✅ 7. Weight Management
Excess weight can put additional stress on the pelvic muscles and bladder, worsening incontinence. Maintaining healthy weight through proper diet and regular exercise can relieve this stress and help improve bladder control.
✅ 8. Severe Incontinence Surgery
In some cases, urinary incontinence may not be improved even with non-surgical treatments. Surgical options are:
Artificial Urinary Sphincter (AUS): It is implanted around the urethra and regulates urine flow by acting as an imitation for the original urinary sphincter.
Male Sling Surgery: A sling is placed below the urethra to provide support and avert leakage when physical activity or exercise is applied.
These interventions are usually entertained once other methods of treatment fail.
✅ 9. Lifestyle Changes
Restrict caffeine and alcohol: Both irritate the bladder and worsen urinary urgency and frequency.
Stay hydrated: Drink sufficient fluids to ensure healthy bladder function, but do not overhydrate, which may result in more frequent urination.
Avoid constipation: Straining during bowel movements can exacerbate incontinence. A diet high in fiber and regular exercise can prevent constipation.
✅ 10. Psychological Support
Urinary incontinence can be emotionally stressful to manage. Think about seeing a therapist or support group to deal with the emotional aspects of the condition.
Support groups: Connecting with others experiencing the same situation can provide emotional support, coping strategies, and encouragement.
Management of urinary incontinence after prostate surgery involves the combination of pelvic floor exercises, bladder training, medications, and lifestyle modification. For long-term cases, medical devices or surgery may be required. Chronic cases require open communication with your doctor in order to decide on the most appropriate management plan for you.
Would you like additional information regarding a specific management decision or advice on how to incorporate these strategies into your everyday practice?
Immunotherapy is a new prostate cancer treatment, particularly in advanced cancer. It’s designed to enhance the body’s immune system such that it detects and kills cancer cells more efficiently. While traditionally not as often used in prostate cancer as it is in other cancers like melanoma or lung cancer, immunotherapy is effective, particularly in metastatic or treatment-resistant prostate cancer. That is a general overview of how immunotherapy has been used to treat prostate cancer.
1. Immune Checkpoint Inhibitors
Checkpoint inhibitors are immunotherapy drugs that act against specific proteins on immune cells (e.g., PD-1, PD-L1, or CTLA-4). These proteins generally help the cancer cells evade the immune system by binding to the checkpoint, and the tumor has a free run. By blocking such proteins, checkpoint inhibitors can revive the immune system’s ability to identify and kill cancer cells.
Key checkpoint inhibitors in prostate cancer:
Pembrolizumab (Keytruda): PD-1 inhibitor that has shown to be effective in prostate cancer, particularly in patients with highly microsatellite instability-expressing tumors (MSI) or mismatch repair deficiency (MMRd) tumors.
Ipilimumab (Yervoy): CTLA-4 inhibitor, sometimes used with other medications like nivolumab (a PD-1 inhibitor) to increase immune system function.
Clinical Application: It is especially utilized in metastatic castration-resistant prostate cancer (mCRPC), particularly those with MMRd or high tumor mutational burden (TMB), thus making their cancer susceptible to immune checkpoint blockade.
2. Cancer Vaccines
Sipuleucel-T (Provenge): An autologous dendritic cell vaccine that has been approved for use in metastatic castration-resistant prostate cancer. It works to stimulate the patient’s own immune cells to combat prostate cancer cells. In this therapy, a patient’s immune cells are taken out, engineered in the lab to have them attack prostate cancer, and then returned to the patient. Though its impact on survival is minor, it has proven to be beneficial when overall survival is considered in certain patients.
How it works: Sipuleucel-T targets prostate-specific antigen (PSA), which marks most prostate cancer cells. This vaccine instructs the immune system to attack cancer cells expressing PSA.
3. T-cell Redirecting Therapies
This is a newer generation of immunotherapy involving biologics that are designed T-cells (a type of immune cell) to kill prostate cancer cells. These types of therapies typically involve two components: one that targets a specific protein produced by cancer cells and one that binds to the T-cells, telling them to kill cancer.
Bispecific T-cell engagers (BiTEs) are also under investigation for prostate cancer. BiTEs target both prostate cancer cells and T-cells and allow the immune system to strike more effectively.
Early clinical trials have been evaluating T-cell redirectors in prostate cancer with positive results, albeit still largely experimental.
4. Adoptive Cell Therapy
CAR-T (Chimeric Antigen Receptor T-cell) Therapy: This is an approach of harvesting the patient’s T-cells, genetically modifying them so that they more directly target prostate cancer cells, and giving them back to the patient. While CAR-T therapy has revolutionized the treatment of blood cancers, its application to solid tumors like prostate cancer is in its infancy.
In this regard, PSMA-targeted CAR-T therapy (targeting prostate-specific membrane antigen, a protein expressed on prostate cancer cells) is an area of active investigation for future therapies for prostate cancer.
5. Combination Immunotherapy
Combining different immunotherapies or combining immunotherapy with other therapeutic modalities (e.g., chemotherapy, radiation, or androgen deprivation therapy) has proved to be an attractive strategy to enhance efficacy and avoid resistance mechanisms. For example:
The combination of checkpoint inhibitors like pembrolizumab with enzalutamide (an androgen receptor blocker) has been encouraging in clinical trials, providing a multi-modal strategy to overcome resistance in castration-resistant prostate cancer.
6. Immunotherapy for Advanced Prostate Cancer
While immunotherapy is now also being tested in early-stage prostate cancer, it is increasingly used for advanced, metastatic, or hormone-refractory prostate cancer. In some trials, it has been shown that immunotherapy has a striking potential to extend survival among men with metastatic castration-resistant prostate cancer (mCRPC), especially those with certain genetic signatures like MMRd or high TMB.
Limitations and Challenges
Patient Selection: Not all patients with prostate cancer are ideal candidates for immunotherapy. The best candidates have certain genetic mutations (e.g., MMRd or high TMB), which make their tumors susceptible to immune therapies.
Immune Resistance: Prostate cancer can occasionally become resistant to immunotherapies, lowering their effectiveness. This is an important area of ongoing research.
Side Effects: While generally less toxic than chemotherapy, immunotherapy is not without side effects, such as fatigue, rash, diarrhea, and more serious immune-related adverse events (e.g., inflammation in other organs).
Conclusion
Immunotherapy is increasingly playing a more central role in prostate cancer treatment, especially for men with advanced or castration-resistant prostate cancer. While there are numerous challenges yet to be addressed, checkpoint inhibitors, vaccines, and T-cell redirecting drugs promise better prospects, especially when given concomitantly with other treatments. As research goes on, immunotherapy promises to be an even more pivotal force against prostate cancer.
Do you want more specifics about a particular immunotherapy for prostate cancer?
The Prostate Protocol By Scott Davis The Prostate Protocol is designed for all those who want a natural solution for BPH. The online program can help users to treat BPH. Also, it will address the root cause and prevent a recurrence. You might not expect this benefit from conventional treatments. The program is the outcome of extensive research.