High-volume surgeons no better at reducing postoperative incontinence (After radical prostatectomy)

Medical Xpress / University of Gothenburg / Scandinavian Journal of Urology ^ | Sept. 9, 2022 | Rebecka Arnsrud Godtman et al

[ConservativeMind]

In men who have had prostate cancer surgery, urinary incontinence is a common side effect. Its frequency varies from one surgeon to the next. In a major study, the number of surgeries performed by the urology surgeon made no difference to the patients' incontinence risk. This surprised researchers.

Prostate cancer is the most common form of cancer in men, with some 10,000 new cases detected annually in Sweden. If the tumor has not spread, the prostate gland is often operated on, usually with a robot-assisted, laparoscopic technique. Immediately after the procedure, almost all men are incontinent, because of disturbed activity in the sphincter (surrounding the upper part of the urethra) caused by the operation. This circular muscle is located just below the prostate. This urinary incontinence usually disappears after a few months, but there is a risk of it persisting.

"For other surgeries, patients of surgeons who perform the operations frequently are known to have fewer complications. It's a plausible association, since 'practice makes perfect.' But to our surprise, we couldn't see that link. In the men operated on by high-volume surgeons, the risk of postoperative urinary incontinence was no lower than in those whose surgeons were less experienced. This underlines the importance of feed-back to surgeons by use patient-reported outcome measures (PROM) in order to improve surgical technique to obtain better results," Godtman says.

One year after surgery, 14% of the men had urinary incontinence. The operations in the study were performed by 83 surgeons. For 15 of them, the patients had a lower incidence of incontinence than expected, while for six of the surgeons, the incidence among their patients was higher, regardless of how many procedures the surgeons performed during the study period.

[Arlis]

I wouldn’t say that. He chose radical prostatectomy - as many do. Most say that is the #1 most successful way to address prostate cancer.

He’s in the 1/3rd in whom the cancer returns - regardless of the procedure.

He is a dear man of God who is suffering greatly. Pray for him. Rob is his name.

[fwdude]

I had a good surgeon. Very little problem regaining continence after a few months.

My problem now is easy emptying.

[ConservativeMind]

I am finding boron at 20 mg a day (Upper Tolerable Limit) and DIM 300 seem to do as well or better than my prior nettle root extract and pygeum extract. I would say all of that together does a fine job, but I wanted to try a mineral and veggie approach over the other two items.

See if those could help with your symptom.

[ConservativeMind]

This is a long shot, but may not have terrible side effects if taken for just eight weeks:

Boron supplementation inhibits the growth and local expression of IGF-1 in human prostate adenocarcinoma (LNCaP) tumors in nude mice

https://pubmed.ncbi.nlm.nih.gov/14713551/

The amount used was 1.7 mg per kilogram of weight, per day.

He would want to talk with his doctor, as the Upper Tolerable Limit is 20 mg/day.

A lady on FR takes over a 100 mg a day, multiple days a week, and sees no issue with it.

[babyfreep]

I have sent you a FReepmail. :-)