Urinary incontinence, accidental or involuntary leakage of urine, is a common side effect of treatment that is usually temporary.
After prostate surgery, most men have some degree of incontinence for 3–6 months. Some men may lose a few drops when they cough, sneeze, strain or lift something heavy. For others, symptoms may be more severe and require the use of incontinence pads. Incontinence is usually worse shortly after surgery, but generally improves within a year.
Although rare, radiotherapy can reduce the capacity of the bladder to store urine, irritate the bladder, narrow the urethra and weaken the pelvic floor muscles. This can lead to urinary urgency and difficulty passing urine. Talk to your doctor or a continence nurse or physiotherapist if these problems occur.
Surgery for incontinence may be considered if incontinence hasn’t improved significantly after 12 months. There are two surgical options: a sling or an artificial sphincter. These devices work by putting pressure on the urethra to close it off and control urinary flow. Talk to your doctor or urologist to see if surgical treatment may be an option for you.
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Some men notice a small leakage of urine during intercourse and orgasm. This is due to damage to the sphincter muscle that controls urine flow. This can be embarrassing, but is not harmful to your partner.
If this is a problem for you, empty your bladder (urinate) before sex. Speak with your doctor if you are still concerned.
Coping with urinary incontinence
- Men who do pelvic floor exercises before surgery are less likely to have ongoing urinary incontinence after surgery. Exercises are also important after surgery. Ask your doctor, urologist, physiotherapist or continence nurse for more information.
- Limit drinks that irritate the bladder such as tea, coffee, alcohol and carbonated drinks.
- Drink plenty of water as concentrated urine can irritate the bladder.
- Avoid restricting your fluid intake because you are afraid of leakage. Dehydration can cause constipation, which can also lead to leakage.
- Continence aids that help absorb urine loss include absorbent pads to wear in your underpants, and sheets and chair covers. A continence nurse can inform you about continence aids that might be suitable for you.
- Ask your GP about the Continence Aids Payment Scheme. This assists men who have severe or long term incontinence with the cost of continence products.
- The Continence Foundation of Australia offers resources: Pelvic Floor Muscle Training for Men and Continence and Prostate. Call 1800 330 066 or visit continence.org.au.