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Does prostate surgery leave you incontinent?

If you've had prostate cancer surgery, you might experience stress incontinence, which means you might leak urine when you cough, sneeze or lift something that is heavy. This happens because of stress or pressure on the bladder. There is also a type of incontinence that is called urge incontinence.

my.clevelandclinic.org - Incontinence After Prostate Cancer Surgery - Cleveland Clinic
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Overview

What is urinary incontinence, and how is it related to prostate cancer surgery?

Urinary incontinence is the loss of the ability to regulate urination (peeing). Urinary incontinence sometimes occurs in men who've had surgery for prostate cancer. If you’ve had prostate cancer surgery, you might experience stress incontinence, which means you might leak urine when you cough, sneeze or lift something that is heavy. This happens because of stress or pressure on the bladder. There is also a type of incontinence that is called urge incontinence. When this happens, you are hit with a sudden need to urinate right away and have leakage before you can make it to the bathroom.

What is the prostate's role in urination?

When urine is emptied into the bladder from the kidneys, it's kept inside the body by a couple of valves (sphincters) that stay closed until your body “tells” them to open when you urinate. If you’ve had your prostate completely removed, you’ve had a surgery called radical prostatectomy. Along with the prostate gland, the surgeon has to remove one of the valves outside the prostate that open and close to let urine out or keep it in. Usually having one working valve is enough, but there might also be also be some effect on the nerves and muscles in the area from the surgery that allows urine to leak. Approximately 6% to 8% of men who've had surgery to remove their prostates will develop urinary incontinence.

How long does urinary incontinence after prostate surgery last?

It's impossible to say exactly how long it lasts. The chances of you having urinary problems may be influenced by your age, weight and the physical characteristics of your urethra (the tube that moves urine from your bladder out of your body). However, a majority of men are eventually continent (able to regulate urine) after a radical prostatectomy. In many cases, men are able to go safely without any kind of incontinence product (pads or adult diapers) after about three months. This is especially true of men who are healthy overall and fall into the age range of 40 to 60 years. If you are having persistent problems, it’s important to know that there are ways to treat urinary incontinence after prostate surgery.

How is urinary incontinence after prostate surgery treated?

If you find you’re having issues with mild to moderate leakage after surgery, your healthcare provider might suggest starting with noninvasive therapies like medications or physical therapy exercises for the pelvic floor muscles. These treatments may also cut down on the number of times that you have to get up each night to pee. These methods can sometimes help men who have mild to moderate leakage. Men who have persistent leakage or a more severe problem may need surgery if they do not want to continue to use pads.

What kinds of surgeries treat urinary incontinence after your prostate is removed?

There are two types of surgery for urinary incontinence: the urethral sling and the artificial urinary sphincter. Usually, the incontinence needs to last for about one year after the prostatectomy to be sure there is not going to be further improvement before your healthcare provider suggests this type of therapy.

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