 Good afternoon. My name is Dr. Kevin Bazraelian. I'm a urologist and we're here Embarrassing questions about your prostate exam So we're going to start off with the first question and see what we have Well, it says what can be done to manage incontinence? Incontinence means not continent that means loss of urine or involuntary loss of urine so incontinence in urology can be Happening in when males or females it could be from Long-term medical problems physical problems in women and it can be from surgical problems in both males and females There's urge incontinence which has the urge to get to the bathroom and you can't make it Then there's stress incontinence, which means you have a cough of sneeze you sit down That can cause a squirt of urine which is incontinence And then there's total incontinence or a mixture of the both So the way as we treat it depends on the cause So after an evaluation to determine the exact cause as best we can then we can do a lot of different things You can treat it with a surgical procedure You can treat it to elevate the floor of the bladder at the junction of the floor and the urethra Urethra is a short tube in a woman that exits the urine in the male. It's much longer despite the fact that of penis It's still in Urethra, so you can treat it surgically you can treat with medicines and we have an algorithm In other words, we have a plan so someone comes in they say well I have urgency and I have to run to the bathroom Well, you can treat it one with behavioral modification. You can learn how to best control your bladder You can stop your fluids you can make sure before you go on a long trip You don't drink two cups of water and a glass of oranges and get in the car and drive to the casinos No, you don't do that you wait to your halfway there to start drinking your coffee So you can control by behavioral modification Then you have sacral stimulation which is the way we stimulate the sacral nerves Believe it or not They're in the ankle area and that can control the bladder to help you control your pelvic floor muscles Or we have surgical techniques So they're all different variations depending on the degree The cause and if it's male or female That was a good question by the way Next one how common is urine incontinence after prostate cancer treat? The short answer is three to eight percent of men three to eight not thirty three to eight percent of men have some form of leakage of urine after a Radical prostatectomy whether it's robotic or with incision and that means they could least lose someone they cough or sneeze Or they can drip a little bit For the non-cancerous treatments of prostate cancer the levels are much lower and of course It depends on the skill of the practitioner or the type of surgery that's done if you're doing a Focal therapy for prostate cancer. It's a very low rate less than 1% 2% if you're doing a scraping of the prostate or other larger Procedures to open the channel Then you can go anywhere from you know 2 to 5% so there's different degrees of it and going back to the question How common is it? Somewhere between 3 to 8 percent overall Okay So it shouldn't stop you from having surgery if you need surgery for one of the absolute reason to have surgery for prostate Including cancer. Is it normal to get an erection? During a prostate exam. I presume you're less than that of the person getting the exam. So no, it's not normal It happens very uncommon. I've been practicing for many decades and I can think of one time it happened. So There are Nerves in the area of the rectum the self not the prostate that can intensify ejaculation and erections But not during exam Shouldn't be doing that shouldn't happen. Could it? Yeah, of course it could