Exercise may prevent incontinence from prostate surgery

NEW YORK (Reuters Health) - A healthy weight and regular exercise may help protect men from one of the most common side effects of prostate cancer surgery, a new study suggests.

Researchers found that among 165 men who had their prostate glands removed due to cancer, those who were not obese and were getting regular exercise before surgery had the lowest prevalence of long-term urinary incontinence.

What’s more, even among obese men, those who had been physically active before surgery were less likely to be incontinent one year after surgery.

All of the men in the study had undergone radical prostatectomy, where a surgeon removes the prostate gland and some of the surrounding tissue. Urinary incontinence and sexual dysfunction are common side effects, though both often improve over time.

So far, most efforts to prevent lasting side effects have focused on improving surgical techniques -- limiting damage to the nerves, muscles and blood vessels around the prostate gland.

But these latest findings suggest that there are also lifestyle measures men can take to cut their risk of lingering urinary incontinence, said lead researcher Dr. Kathleen Y. Wolin, an assistant professor of surgery at Washington University School of Medicine in St. Louis.

“This is another reason for men to get up and get active,” she told Reuters Health in an interview.

In general, men with prostate cancer, like all other men, are encouraged to follow a healthy lifestyle, which includes regular exercise. A study published last month found that among men with prostate cancer, those who got as little as 15 minutes of exercise per day had lower death rates than inactive men during the two-decade study period.

“We strongly recommend that men with prostate cancer talk with their physicians about how to fit physical activity into their lives if they are currently sedentary,” Wolin said.

For their study, published in the Journal of Urology, Wolin and her colleagues looked at urinary incontinence rates among 165 men roughly one year after radical prostatectomy. Before surgery, all of the men had reported on their exercise habits; those who said they exercised for at least one hour per week were considered active.

Overall, the researchers found that obese, sedentary men had the highest rate of long-term incontinence, at 41 percent. Active, non-obese men had the lowest rate, at 16 percent.

Among obese men who were physically active, one-quarter were incontinent, which was identical to the rate among non-obese, inactive men -- suggesting, the researchers say, that exercise can offset the negative effects of obesity.

Exactly why exercise might prevent incontinence is unclear. One possibility, Wolin said, is that exercisers have better overall muscle tone, which may help with bladder control.

Another potential reason is that long-time exercisers are more likely to follow their doctors’ advice on performing post-surgery Kegel exercises, which strengthen the pelvic-floor muscles and may improve incontinence and sexual function.

According to Wolin, more studies are needed to see whether certain types and intensities of exercise are more effective than others -- and how exercise habits after prostate surgery may affect long-term incontinence risk.

SOURCE: Journal of Urology, February 2010.