According to the Prostate Cancer Research Institute, there are over 200,000 cases of prostate cancer in the US each year. People who choose to have their prostate gland removed may find that they have incontinence after prostate cancer surgery. The majority of men will recover within 6 to 12 months, yet incontinence is a huge challenge for these men to face. It is important, during this time, to get professional help for bladder weakness.

Why Do I Have Incontinence After Prostate Surgery?

Men control their bladders using two different types of sphincter muscles, the internal sphincter and the external sphincter. The incontinence usually occurs as the internal sphincter muscle is completely removed when the prostate is taken away. While this sphincter doesn’t give you full control of your bladder, its removal can lead to the weakening of the external sphincter (the muscle that gives you all the control). During the surgery, your nerves, blood supply or supporting structures around this muscle may also be damaged, so the external sphincter may struggle to work and it might be difficult for you to control your bladder.

Types of Incontinence After Prostate Surgery

Urgency Incontinence

After prostate surgery, your bladder behaves differently. When you have the sudden urge to urinate, you may not be able to make it to the toilet in time. This is due to bladder spasms, but it can be controlled with medical therapy. 

Stress Urinary Incontinence

If your external sphincter muscle was damaged during the surgery, you may find that you involuntarily leak urine when you exert any strength. This can happen when you lift something, change your position, cough or even sneeze, and it is common for men straight after the catheter is removed. 

How to Manage Incontinence After Prostate Surgery

There is no clear way to help prevent incontinence, but it is important to try and find out what works best for you. By talking to your doctor or a support group, you can get the help you need to manage your incontinence.

1. Pelvic Floor Exercise

It is important to strengthen the muscles you squeeze when you’re trying to hold in urine. This can be done through Kegal exercises or biofeedback programs.

2. Lifestyle Changes

Lifestyle changes such as drinking less alcohol, avoiding caffeine and visiting the bathroom regularly can all help to reduce the amount of accidents you have. You may also want to talk to your doctor about any medication you are on, as this may have something to do with your incontinence.

3. Medication

There are medications available that can reduce your need to urinate and increase your bladder capacity. New medications are also in development to help prevent this issue.

4. Neuromuscular Electrical Stimulation

In neuromuscular electrical stimulation, a probe is placed in the anus to allow a low level of current to pass through your body, causing your muscles to contract. At the same time, you need to squeeze your muscles to help train and strengthen them, reducing the risk of incontinence after prostate surgery.

5. Artificial Sphincter

This is a device that you can control to prevent urine from leaking. There are three parts in this device: a pump, a balloon to regulate pressure, and a cuff that goes round the urethra. This has been known to work for up to 80% of patients who suffer from incontinence after prostate cancer surgery.

6. Bulbourethral Sling

A sling can be used for some types of incontinence. Made from synthetic material or even your own tissue, a sling suspends and compresses the urethra, helping you achieve bladder control.

7. Surgery

A type of surgery in which rubber rings are placed around the tip of your bladder can help you hold the urine.

8. Catheters

A catheter can be used to collect urine in a bag. You can place a condom catheter over your penis to avoid leaking urine. Alternatively, use a self-catheterization process. A thin tube can be put into your urethra and drain your bladder. This option can be done safely at home by yourself.

9. Incontinence Products

For anyone experiencing incontinence after prostate surgery, there are a range of incontinence products available, including bed pads and mattress covers, as well as personal pads or adult underwear that is specifically designed to absorb urine and keep you comfortable and active.