Prostate Cancer: A Man’s Perspective

1. Prostate Cancer: A Man’s Perspective Myra Siminovitch, MBA, Physiotherapist February 23, 2010

2. Prostate • Walnut-sized gland • Lies just underneath the bladder • Produces the liquid(semen) which transports sperm • Weighs approximately 20 grams • Surrounds the urethra, like a doughnut, just below bladder

3. Male Anatomy

4. Male Anatomy

5. Conditions That Affect The Prostate • Benign Prostatic Hyperplasia (BPH) • Enlarged Prostate • Prostatitis • Infection, Inflammation, non bacterial conditions • Non malignant enlargement of prostate gland • Prostate Cancer

6. Normal and enlarged Prostate

7. Prostate Symptoms • Obstructive Symptoms • Hesitant urination • Weak or interrupted urinary stream • Feeling of incomplete emptying • Irritative Symptoms • Urinary frequency • Nocturia (waking at night to urinate) • Urgency • Urge Incontinence • Dysuria (painful urination)

8. What is Urinary Incontinence? • Urinary Incontinence is the involuntary loss of urine. • This often results in social or hygienic problems • It is a common condition that can be embarrassing and distressing and may severely affect your quality of life.

9. Chronic Urinary Incontinence • Stress Urinary Incontinence • Cough, laugh, lift • Urge Urinary Incontinence • Key in the door • Mixed Incontinence • Stress and urge • Overflow Incontinence • Obstruction, medications, neurological conditions • Functional Incontinence • Impairment physical &/or mental abilities

10. Contributing Factors • Diet • Constipation • Medication • Prostate Problems • Obesity / Overweight • Smoking • Limited mobility

11. Contributing Factors: Diet Foods and drinks that make the bladder contract more often • Alcohol • Carbonated beverages (with or without caffeine) • Coffee or tea • Medicines with caffeine • Citrus juice and fruits • Tomatoes • Tomato-based products • Highly spiced foods • Sugar • Honey • Chocolate • Corn syrup • Artificial sweetner

12. Contributing Factor -Prostate Surgery • The urinary sphincter may have been stretched or damaged • Injury to the blood vessels or nerves may have happened

13. What To Do To Decrease Leaking • Exercise Program for Pelvic Floor Muscles • Bladder Retraining • Individuals with urge incontinence • Timed Toileting • Individuals with Decreased sensory awareness of bladder filling • Diet • Eliminate bladder irritants • Increase fiber to prevent constipation • Increase Fluid intake

14. How The Bladder Works • The bladder is a muscle which is shaped like a balloon • The bladder has 2 functions: • The storage of urine produced by the kidneys • The elimination of urine • The bladder contracts when it is full to empty

15. How The Bladder Works • The sphincter muscle acts like a faucet. When closed it helps prevent urine from leaking. When open the urine can pass out. • The brain and nervous system receive a message when the bladder is full to signal you to empty your bladder.

16. Bladder Dysfunction • Normally Not Life Threatening • Can Seriously Affect The Quality of One’s Life • Either the Bladder is: • Unable to store urine • Unable to completely empty

17. Function of Pelvic Floor Muscles • Support, hold in pelvic contents • bladder, urethra, bowel, • Closing Force • When tightened, muscles around urethra and anus, place a closing force to stop leakage

18. Pelvic Floor Muscles

19. Function of Pelvic Floor Muscles • Weak muscles give you less control of your bladder and bowels • With weak muscles you may leak urine when you cough, sneeze, laugh or walk/exercise • Pelvic Floor Muscles can become weak and sag after bladder or prostate surgery

20. Muscle Exercise Program • Improve strength so that muscles are strong enough to prevent urine loss • Hold the contraction • Gain control over the muscles so that you can use them quickly to prevent urine loss • Quick squeezes

21. Urge Suppression Techniques • Contract your pelvic floor muscles as if you wanted to hold gas or as if you wanted to stop the urine flow • Squeeze then let go quickly • Repeat 5 times in 5 seconds • Repeat 10 times in 10 seconds This technique will temporarily stop the urge It will give you enough time to reach the bathroom

22. KEGEL Exercises • Contract your pelvic floor muscles as if you wanted to hold gas or as if you wanted to stop the urine flow • Hold for 5-10 sec and relax 10 sec, repeat 10 times in a row • Have to do them throughout your day, total of 6-7 sets/day • Be careful not to strain while doing these exercises • To remember to do your Kegel’s or pelvic muscle exercises each day do them during the commercial's of your favourite 30 minute program. They can be done lying down, sitting or standing

23. Prostate Surgery • Regularly do your Kegel exercises • Do urge suppression for urgency and frequency • For dribbling, push up behind the scrotum; • massage the base of the penis with your thumb to empty all the urine in the urethra • See a continence specialist for more help

24. Incontinence ProductsFeatures To Look For: • Affordable • Accessible • Gathers at the waist and legs to fit closely • Discreet and not too bulky • Quiet • Easy to apply/User friendly

25. Absorbent Products • Absorb and Contain Urine • Include • Pads • Garments • undergarments • protective underwear • briefs • Disposable • Reusable