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Ask The Doc: Is It Normal To Leak After Prostate Surgery?

Question: I just had my prostate removed a few weeks ago, and wasn’t prepared for the bladder leaks I’ve been experiencing. My doctor never told me this could happen. Is it normal? And how long can I expect it to last?


You have to be careful when you talk about what’s “normal,” especially when it comes to health issues. Think about it this way: Is it normal to have a heart attack as you get older? No, it’s not normal, but it’s not uncommon, either. The same goes for leakage after prostate surgery. Is it normal? No, but it’s not surprising, and it’s quite common. 

To understand why, it helps to picture what happens during a prostatectomy. Your prostate is a gland that sits at the bottom of your bladder, and when the gland is removed, the bladder is pulled downwards, filling the space where the prostate used to be. From there, it gets connected to the urethra.  

As part of the process, one of the valves that controls urine flow is also removed. Lose this valve – and add in the nerve or muscle damage that sometimes accompany the procedure – and you may find it harder to control leaks. 

Now, the leakage you experience can vary, but the most common form people experience after prostate surgery is stress incontinence. This is when you leak urine when you cough, sneeze, lift something heavy or otherwise place excess stress on the bladder. That doesn’t mean your condemned to a lifetime of leaking, though. There’s a whole range of options to address your symptoms, so talk with your doctor – or seek one out – to get treatment that can make a real difference for you. 


How Long Can I Expect To Experience Bladder Leaks After Having My Prostate Removed?

The good news is that for most men, bladder control is only a temporary issue following the removal of the prostate, typically lasting between six and 12 months. In fact, many men can go without having to use any type of pad or other incontinence product after only about three months (usually men in good health between the ages of 40 and 60). However, for a small number of men, the symptoms can persist. 

There’s no reliable way to say how long that might be, and there are a number of factors that can influence your particular symptoms. Age, weight and the physiology of your urethra (that’s the tube that you use to remove urine from the bladder) can all play a part in how long your leaking lasts.  

Even if your symptoms go beyond a year, there are proven, effective ways to treat your condition. Pelvic floor exercises are a great place to start, and the NAFC has an easy-to-follow guide to help you get going right now. And that’s just the beginning of what can be done – there are many other treatments out there, including biofeedback, electrical stimulation, compression devices and more, any of which could make a real difference in your leakage. Make an appointment with your physician today, explain that you don’t seem to be getting back to normal following your procedure and you’ll be surprised at just how many options are available to you. 


What Can I Do To Recover From Leaks After Prostate Surgery?

If you find that you have instances of leaking after prostate surgery, you’re not alone. While most men who’ve had their prostate removed experience incontinence to some degree or another for a short period after their surgery, it turns out that about 6% to 8% of men who’ve gone through a prostatectomy deal with incontinence for the long term. 

That doesn’t mean you should feel disheartened. There are lots of highly effective approaches that you can try, starting with noninvasive treatments like medication or physical therapy to strengthen your pelvic floor muscles. Physical therapy may be particularly beneficial because not only can it improve your ability to hold urine in general, but it can also help cut down on the number of times you have to get up at night to pee. 

Of course, no medical treatment is equally effective for everybody, and if you have more persistent or heavier leakage, surgery might be an option worth considering. Most of us tend to avoid more invasive procedures if they’re not absolutely necessary, but for some of us, surgery is far more preferable than a lifetime of pads and discomfort. The only way to know for sure if you’re a candidate is to visit your physician for a complete assessment.

What If My Leaks Don't Go Away?

While most men who have prostatectomies only experience bladder leakage for anywhere from three months to a year following the procedure, a certain percentage of them don’t seem to recover so quickly.

If you’re one of those whose leaks aren’t going away, there are two types of surgery that may generate the relief you’ve been looking for: the urethral sling and the artificial urinary sphincter (also known as the “AUS”).

For the urethral sling, a synthetic mesh tape is placed around part of the urethra – the tube that removes urine from the bladder – to change its position in the body. This is a highly successful procedure, reducing or eliminating symptoms for many men with mild to moderate incontinence who haven’t seen improvement from more conservative methods. Better yet, it’s minimally invasive, which means that it only requires a single, small incision.

As far as the AUS is concerned, it’s a potential solution for men with moderate to severe incontinence that has resulted from poorly functioning muscles or sphincter valves following prostate cancer surgery. In fact, 90% of men report that it produces either satisfactory or very good results.

There are three parts to the procedure: an inflatable cuff, a pump and a small balloon that is used to regulate pressure. Patients press on this pump when they feel the need to pee, and the added pressure opens the cuff to allow urine to flow through. Once you’re finished, the cuff closes again all on its own.

Ask The Doc - NAFC Logo.The NAFC Ask The Doc series provides answers to some of our reader’s most common questions from a group of experts in the fields of urology, pelvic floor health, bowel health, and absorbent products. Do you have a question you’d like answered? Click here to Ask The Doc!


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