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Urinary Incontinence After Prostate Surgery: Everything You Need To Know

Undergoing a prostatectomy (removal of the prostate due to cancer) can be difficult. And for many men, finding that they are incontinent post surgery may come as a shock.

But rest assured that there are many treatments available to manage incontinence treatment after surgery. Read below for some of the most common questions we receive about incontinence after prostate surgery.

WHAT CAUSES INCONTINENCE AFTER PROSTATE SURGERY?

Urinary incontinence is a potential side effect of prostate removal surgery. The prostate is located just below the bladder and surrounds the urethra. Removing it, or using radiation to treat it, can sometimes cause damage to the nerves and muscles of the bladder, urethra, and or sphincter, which controls the passage of urine from the bladder. This can result in urinary incontinence.

IS INCONTINENCE NORMAL AFTER PROSTATE SURGERY?

Approximately 6-8 percent of men who have had surgery to remove their prostate will develop urinary incontinence. (Cleveland Clinic) The good news is that most men will eventually regain bladder control with time.

HOW BAD IS INCONTINENCE AFTER PROSTATE SURGERY?

The degree of incontinence varies from person to person and can be anywhere from full on incontinence, to light dribbles. And, the amount you leak right after surgery will likely lessen as you continue with your recovery and any additional bladder or pelvic floor treatments you may be doing.

HOW LONG WILL I HAVE INCONTINENCE AFTER PROSTATE SURGERY?

Most men who experience a loss of bladder control have symptoms for 6 months to 1 year post prostate surgery. However, a small percentage of men may continue to experience problems past the one year mark.

DOES INCONTINENCE GO AWAY ON ITS OWN AFTER PROSTATE SURGERY?

For most men, urinary incontinence will go away within about 1 year. Performing pelvic floor exercises, also known as kegels, which help strengthen the muscles that are located in the base of the pelvis between the pubic bone may help to speed the recovery process along.

DOES INCONTINENCE HAPPEN IF I TREAT PROSTATE CANCER WITH RADIATION?

Some men need radiation therapy after prostate removal. During radiation therapy, some of the normal tissues around the urinary sphincter, urethra and bladder may be exposed, causing irritation to occur post therapy, leading to incontinence. This typically subsides within a few months after radiation therapy, however if it persists, additional treatments described below may be helpful.

HOW CAN I IMPROVE INCONTINENCE AFTER PROSTATE SURGERY?

Want to stop incontinence after prostate surgery? Kegels may be your answer! As mentioned above, kegels are a common treatment option for incontinence after prostate surgery. Among other things, the pelvic floor muscles help control bladder and bowel function and, like other muscles of the body, if they get weak they are no longer able to do their job effectively. To improve muscle function, kegels must be done regularly, every day. The good news is that they can be performed pretty much anywhere, anytime, and in a variety of positions (sitting, standing, lying down, etc.). For a complete guide on performing a men’s kegel, click here.)

Biofeedback can sometimes be used to determine if you are performing a kegel properly. And, electrical stimulation may also be used to help re-teach the muscles to contract.

WHAT TREATMENTS ARE AVAILABLE TO ME IF MY INCONTINENCE DOESN’T GO AWAY AFTER A YEAR?

While kegels and behavioral therapy work well for most men with mild to moderate leaking, they may not be completely effective for some. Luckily, there are still some options for treating bladder leakage after prostate surgery.

Another surgery is sometimes needed when bladder leaks persist for more than a year after surgery. This may consist of having a urethral sling procedure, or an artificial urinary sphincter.

With a urethral sling procedure, a synthetic mesh tape is implanted to support the urethra. Up to an 80% improvement has been seen with this procedure and some men stop leaking completely.

An artificial urinary sphincter is used in patients who have more severe urinary incontinence that is not improving, or for those patients who may have had a lot of damage to the sphincter muscle after prostate surgery. An artificial urinary sphincter is a mechanical ring that helps close the exit from the bladder.

As will all surgeries, these come with pros and cons and potential complications. Be sure to discuss these options with your doctor.

INCONTINENCE AFTER PROSTATE SURGERY FORUMS.

Going through prostate cancer and having your prostate removed can be a physically and emotionally trying time in life. Many men are unprepared for the extent to which they may experience bladder leaks after prostate removal and it can be disheartening to have undergone surgery only to experience a loss of bladder control for a period afterward.

Fortunately, this is usually resolved within a year. During that time though, you may find that you need someone to talk to about your experience. Finding a forum or message board filled with people who can relate can help ease some of the tensions that you may be going through.

The NAFC message boards are a great way to connect with others who may also be experiencing incontinence, due to prostate surgery or other conditions. They’re free to join and the forum is anonymous so you can speak freely without the worry of feeling embarrassed or ashamed. NAFC is proud of this amazing group of individuals who visit the forums and courageously share their stories, offer support, and provide inspiration to each other. We encourage you to check it out!

Comments

25 Responses

  1. 6 weeks agoI had surgery to reduce the size of my prostate. It has made me incontinent, going through three diapers per day. Being 79 years old, my urologist will prescribe only mybetriq due to cognitive concerns. She wants me to get Interstim implanted. But I am afraid of the difficulties with that implant. I also fear botox injections. Consequently, I am leaning toward just living with this incontinence indefinitely. Please advise.

  2. I had surgery 7 months ago and I do pelvic sleeve for many times a day but still using 3 pads a day sometimes even 4 and don’t know If I had to go for the other surgery what are the consequences will I be better or much the same can you help
    Thank you

  3. I had a prostatectomy in June 2020. Despite Kegel exercises I have had no improvement in18 months. i use two to three full size large pads every 24 hours. I have been prescribed, by my urologist, various medications to no effect. On my last visit he glibly informed me that the medical system in Cyprus meant that unless I went private he could do no more. Added to this I have erectile dysfunction and the usual pills do not help. I have been shown and have used Cav Jet injections. Your optimistic statements on recovery process leave me cold. The Hypocratic Oath says do no harm. At present I feel badly harmed. All that has happened is that I have swapped quality of life for longevity. If I had known at the outset what the outcome of this procedure was to be I would not have had it.

  4. I had radical prostatectomy in august 2019. They call it nerve sparing but I feel that may not be true. They do cause a lot of damage in the area leaving me with erectile dysfunction and urine incontinence. Still suffering with urine incontinence. Cannot sleep at night without a diaper. The medicines for urine incontinence have serious side effects and they don’t do any help with this issue. New surgical options are being put forward. Not sure if I should trust these options. Has anyone ever benefited from these surgical options not sure?

  5. The first year after my surgery the leakage was light, now yrs later it is uncontrollable. Going through multiple pads and many times having the seat in my pants soaked, this added to an already nonexistent sex life …. don’t have words to describe it, but I chose drug use over suicide and now I am dead just kinda existing. So I know what you guys feel and then some.
    Good luck

  6. Can someone tell me if going through 5-6 dipers a day after my Nov. 22nd surgery is normal? Roday is Dec. 10th. I have resumed walking \ light house work that is 10,000 steps a day for exercise. I feel pretty much OK….but the urine just does not stop.

    Can anyone tell me it will be 5-6 diapers a day — then go to 2-3 diapers a day in 30 – 60 days – then maybe 12 diapers a day for 12 months as a norm?

    My docotr just tells me to do these Kegels but they seem ineffective so far. It is very annoying (you feel subhuman) and lack of control is drving me insane….any positve words of encouragemnt from someone who has felt like me and gotten better would help ease my anxiety….

  7. I have lost all bladder control, I’m doing my kegels constantly but they always force some out before they hold any in. The whole thing has taken over my life completely. Some of the horror stories I’m reading suggest I should just give up trying, stay home and just let it flow.

  8. I concurred with all the previous comments concerning prostate surgery. I had the freezing of the prostate procedure done back in 2012 and have incontinence problems and erectile dysfunction that persist to day; I was told that these problems would stop over time, but they have not stop at the present time. The medication Myrbetriq and Duloxetine does noting to treat incontinence and Viagra and the like medications does not work for erectile dysfunction; why do urologist prescribe them.

  9. I had robotic prostatectomy in Feb 2022. Cancer was found in nerves on one side of prostate, which were removed, along with a few lymph nodes, one was cancerous, and seminal vesicles, also positive.
    A few months later my PSA was O.096, below 0.01 is the target, and 3 months later gone up to 0.116.
    I have zoom with uro doc in a week about that result. I expect he will talk about radiation and hormones, neither of which I am keen on.
    I am using 1-2 pads a day. I can go through the night without leakage and till about noon. Often by mid afternoon I am leaking with the pad full by 5-6pm. I might user a second pad if I have to leave the house for any reason, otherwise I use 9 oz plastic cup tucked into Depends and empty it periodically. After shower at 9-10pm I start a new pad when I get into bed.
    I have checked medications I take for any with side effects of bladder irritation and reduced dosages if necessary. I have one drink at about 7am, or none until 11 after I get back from work.
    I like to drink coffee and wine, both not recommended, possibly because of the acidity irritating the bladder. I have tested the acidity of these, and decaf and acid-free coffee and acid-free decaf, and my urine, all which seem to make no difference. Nevertheless I am currently drinking water and milk only and testing that.
    I urinate into a 16 oz pyrex glass jug so I can measure my bladder volume when I need to pee. This shows whether that volume, and hence muscle control is improving.
    I do Kegels three times daily which helped in the first 6 months but less so now.
    E-stim is a common modality for treating women with urinary incontinence, it stimulates pelvic floor muscles. A product sold in England, Innovo, is approved for e-stim in men and women. Use in men is not FDA approved in USA, but women’s use is. It’s a pair of neoprene shorts with eight 4×5″ electrodes. Thirty minutes use each day is supposed to show benefit within three months. The shorts are unisex and I ordered a pair last week from the US branch.
    I’m not sure about future treatment for me. At 72 years old quality of life is more important than duration, and I have some traveling to do. For anyone in a similar situation Google Joe Tippens, and do the research on fenbendazole.

  10. I had a RARP on November 15 this year[5 weeks ago] and have unrelenting issues with urinary incontinence.This has dramatically impacted my quality of life and at this stage I am wondering if I could have made a better choice.Possibly Proton Beam Therapy as opposed to Radiation Therapy.
    I am also using at least 5 to 6 level 3 pads and 3 to 4 level 3 Incontinence underwear pants per day and having as many as 7 showers and 3 baths per day.
    At age 71 the loss of sexual function does not bother me but the incontinence is not improving and at this stage I am deeply regretful at my surgical outcome.

  11. I’m 62 years old, my prostate was removed 11 days ago and the probe was removed 4 days ago. At the moment I’m having small dribbles, 4-6 times a day.

    What improvement can I expect, what can I do to eliminate it, and how long will it be extinguished, since it is a small leak?

  12. I had a TURP procedure 18 months ago. Recommended by my trusted urologist.
    Wish I had looked at the blogs before I agreed.
    Incontinent ever since.
    Diapers…….. embarrassing, inconvenient, and pricey.

  13. Interesting reading these comments as I was not aware incontinence could be an issue following prostate surgery. I had the HOLEP procedure in March 2022 which was successful and I now have a strong flow and able to empty my bladder. Incontinence started after the operation, and whilst it has improved I still need to wear a pad when walking, playing golf or other activities. Fortunately I no longer need to wear a pad at night. I did try the exercises for a while, but am not convinced they have much effect. For the past 5 months I have also been prescribed Solifenacin, but again I am not sure they have improved the situation.

  14. I am a man 54 years. I undergone brachytherapy in 2018 and radiation therapy in 2021. This left me with urinary incontinence. I am currently using male incontinence care products (condom catheters and urine leg bag) together with male incontinence pads. My urologist suggested implantation of AUS (Artificial Urinary Sphincter). I have doubts about the operation for implantation of artificial urinary sphincter. Can you assist by providing me with more information on the POSSIBLE COMPLICATIONS and/or DISADVANTAGES of artificial urinary sphincter.

  15. I had radical prostrate surgery on Oct 13 2022 and a” went well . I am doing kegel exercisez daily and am able to control the flow except when I get up of bend to put on shoes etc when a small amount flows out into the pad, I use a pad inside a diaper as an additional protection so I am able to go through the whole day much without changing the b pad or the diaper. If pad does get full I can take it out and then use the diaper the rest of the day also. The trick is to use a tight underwear over the diaper also to keep it snug on you so there are less chances of wetting the underwear and then the trouser when you r outside the house. I also use a macintosh on my bed mattress when sleeping so as not to wet the mattress pad or mattress very important.

  16. I had radical prostate surgery via de Vinci method in 2005. Afterwards did a lot of kegel exercises. My incontinence gradually improved, although I was never confident enough to go without a pad. I eventually got down to 1 pad a day, and did not have to use one when walking or working out. However, in last 3 months the incontinence has become worse, sometimes 3 pads a day. I have tried to completely avoid soft drinks, and caffeinated coffee. I have found that sometimes the way I sit in a chair seems to cause some leakage that I don’t feel until later. I was told by new doctor that kegel exercises would do no good this far away from the surgery. I have thought that performing kegel exercises would help.

    I am 75 years and otherwise am blest to be in very good health. I am asking for suggestions.

  17. The urethal sling operation does help with the incontinence problem – also the Botox injection via day surgery is good to stop incontinence for 6-9 months – at least this provides a break in dealing with the problem

  18. Urethal sling operation achieves good results in a large number of cases and the Botox injection via day surgery gives good relief from Incontinence for around 6-7 months – at least this gives some happiness for this period of time and operation can be repeated for further relief

  19. When posting please let us know your age, urinary problems if existed before surgery, what you were told before surgery, and where surgery was done. Surgical skills affect the outcome. This will help everyone, especially, who is considering surgery. Thank you ALL.

  20. I had my RRP on Dec 13, 2022, good continence and erection before, I have urge now, I void but besides that I leak, I’m wearing three pads a day, occasionally 4, I’m 72 years old and feel uncomfortable with the situation, do you know of anybody my age regaining continence and erection, thanks.

  21. I had a HoLEP on October 13, 2022. The leaking has not subsided one bit since the day of the operation. With so many similar conditions in here after a HoLEP, I’m wondering if urologists are aware of the after effects, but just don’t care because it’s a quick and easy procedure, and it pays them good. Maybe they have stock in Depends which I use 2 boxes every 6 days at a cost of $30. There has been no letup in the flow and it stinks and is cold in the winter. It’s a terrible way to live.

  22. I had had my prostate removed over 10 years ago. Much leaking at the beginning. Kegels were my life and pads. I wore pads for about 3 years and have off and on over the years too. I have had only limited pads and no cancer for seven years. Very grateful. I am taking ED medication which is working. Grateful for that too. Now, not leaking ususally, but I’m finding I’m now leaking with an erection during intercourse which is a big turn off for my partner. Can’t explain it away. It doesn’t bother me because I know what it is and why. But to go into that whole story: “well….i’ve got a story for you”. This is how I ended up on this site and I’m glad for honest people sharing their true experiences. Back to kegels and asking for help. I’m 63 now, no more surgeries for me please. That’s how it’s been for me, something new happens, and it gets figured out. Keep talking.

  23. I am 68 years of age. I had a robotic prostatectomy in Sept 2022. My cancer was contained to the prostate.The surgery was done by Alister Campbell at the John Flynn hospital in Tugun on the Gold Coast. The surgeon told me to expect some incontinence for the first 6 to 12 months. The Catheter was removed after 1 week and I started with one pad for the day and one at night. After four months I no longer need the day pad and only use one at night. Coughing or sneezing can still cause small leakage. I still have erectile dysfunction and the surgeon has me using a vacuum device needles and Viagra. He said keeping the blood flow in the penis to keep it healthy is important and that the erectile dysfunction may improve with time. He has also suggested a penile implant as a last resort if there is no improvement after 12 months. Has anyone had one of these implants and if so can you please let me know on the pros and cons of having one.

  24. I had radical prostatectomy on Halloween 2022. I use depends and pads. I do kegel exercises and pelvic floor exercises. I am use a depends and pad in the morning and change the pad during the day as needed and when I go to bed I use a depends and pad. I think I am using 4 pads a day. I am hoping it gets better doing more kegels now hoping for improvement. My cancer was undetectable on my first checkup . That’s good news. Hoping less pads . It’s tough when I laugh or cough causing leakage. I can see some improvement. I look at it as it could be worse. I am thankful they removed the cancer.

  25. Im 59 years old and I had robotic prostate surgery three years ago with nerve sparring on one side. Six months later I had to have follow up radiation treatment with little adverse effects are up until now where I have been passing blood clots from blisters in my bladder. PSA is less than 0.01 which I’m very happy about. My incontinence problems is quite strange in the fact that I can go all day without needing to wear a pad but quite regularly I suffer from nocturia which is problematic. I found that if I sleep on my side im usually ok but if I end up on my back im in floods. Since my operation I haven’t been able to get an erection and all medications doesnt seem to work, which is very depressing. Anyone else suffer from nocturia ??

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