Experiencing urinary incontinence after prostate surgery (transurethral resection of the prostate or radical prostatectomy) is extremely common.
While you don’t need to be immediately concerned about this post-surgery symptom, it can be challenging so it’s essential to educate yourself on how it can be prevented or managed.
ConfidenceClub’s National Clinical Educator, Sonya Meyer, shares everything you need to know about urinary incontinence after prostate surgery…
The prostate gland helps control the urinary tract. During surgery, some muscles and nerves around the prostate gland can be damaged or irritated.
This includes the bladder neck sphincter (the muscles where the bladder and urethra join), which controls the flow of urine. If this is damaged, it can mean that the flow of urine is no longer controlled.
If you undergo a radical prostatectomy (RP), the surgeon will remove both your prostate and the bladder neck sphincter. You will have an external urethral sphincter that remains, below the prostate area, which can be strengthened with pelvic floor exercises (more on this later) to help control the urine stream. However, RP can damage nerves, blood supply, muscle and supporting structures of the external sphincter which can lead to incontinence.
Approximately 6-8% of men who’ve had their prostate removed will develop urinary incontinence.
There are two types of urinary incontinence that can be experienced:
Stress incontinence is when small amounts of urine leak during activities which increases abdominal pressure, causing pressure on the bladder.
Urge incontinence is a sudden and strong need to pass urine. People with this problem may feel their bladder is fuller than it actually is and this causes the bladder to contract. Some may experience leakage before they get to the toilet and may also find they wake several times at night to go to the toilet (nocturia).
This can vary from person to person and can span from light dribbles or leaks to full incontinence. It’s also common for the amount of leakage to be higher immediately after surgery, but this generally does reduce as you recover.
Incontinence after prostate surgery will usually improve over time, however, there are ways to help you regain control over your bladder.
You might be used to hearing about pelvic floor exercises being beneficial for women, but the same goes for men too - especially after prostate surgery!
Learning how to strengthen and control your pelvic floor muscles can help speed up your recovery and reduce leakage. You should also be doing these in the lead up to your prostate surgery, as well as following.
You may choose to consult with a pelvic physiotherapist, urology nurse or a continence nurse for more information on pelvic floor exercises.
Depending on your need level, incontinence aids such as pull-up pants, pads and/or guards can be extremely helpful in managing post-surgery leaks.
Pads and guards are best at handling lighter leaks, drops or dribbles, while our Pants provide full coverage for moderate to heavy leaks.
If you find you experience urine leakage during the night, bed protectors are a product to consider. They’re essentially large, disposable pads that protect your sheets and mattress by absorbing any leaks.
There are more medical management options out there, including:
These options should be discussed with your advising medical professional.
It can take between three and 12 months for men to be fully recovered post surgery and regain bladder control. Again, this is dependent on the individual, and a diagnosis for one man may not be the same for another.
During this time you need to follow the above management tips to ensure you’re making the best possible progress.
You should get in touch with your doctor, surgeon or other advising medical professional in order for them to make suggestions and give advice tailored to your unique situation.
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