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, radiation therapy 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 who have had a prostatectomy notice a small leakage of urine during intercourse and orgasm. This is due to damage to the sphincter muscle that controls urine flow.
Urine leakage during sex can be embarrassing, but is not harmful to your partner. If this is a problem for you, empty your bladder (urinate) before sex. You can use a condom or a constriction ring (available from sex shops) at the base of the penis during sex to prevent leakage. Speak with your doctor if you are still concerned.
Coping with urinary incontinence
- Find out about pelvic floor exercises. Men who do pelvic floor exercises before surgery are less likely to have ongoing urinary incontinence after surgery. The exercises are also important after surgery. Ask your doctor, urologist, physiotherapist or continence nurse for more information.
- Drink plenty of water to dilute your urine − 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.
- Limit tea, coffee, alcohol and carbonated drinks – these can all irritate the bladder.
- Talk to a continence nurse about continence aids if needed. These aids can include absorbent pads to wear in your underpants, and bed and chair covers. The nurse may also recommend medicines or special clamps.
- Ask your continence nurse or GP about the Continence Aids Payment Scheme. This assists men who have ongoing incontinence with the cost of continence products.
- If incontinence hasn’t improved after 12 months, talk to your doctor or urologist about whether surgical treatment is an option. For example, a surgically inserted sling or artificial sphincter works by putting pressure on the urethra to close it off and control urinary flow.
- Call Cancer Council 13 11 20 or see Exercise during cancer treatment for more information on pelvic floor exercises.
- Get more resources from the Prostate Cancer Foundation of Australia (1800 22 00 99 or prostate.org.au) and the Continence Foundation of Australia (1800 33 00 66 or continence.org.au).