Prostate Restored
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How long does it take for the bladder to heal after prostate surgery?

Most people regain control in the weeks after we remove the catheter. The vast majority of men who had normal urinary control before the procedure achieve it again within 3 to 18 months after the surgery.

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A concern that many men understandably share in considering prostate surgery is its possible effect on their bladder control. Most people regain control in the weeks after we remove the catheter. The vast majority of men who had normal urinary control before the procedure achieve it again within 3 to 18 months after the surgery. At Mount Sinai, our track record is better than the national average. Some men have immediate bladder control and do not leak urine after the surgery. However, for most men, regaining full control of their urine is a gradual process that takes several weeks or months. By six months, most men who were continent before the surgery no longer need pads, though some prefer to wear just a liner for security even if they do not leak.

The two types of incontinence following prostate surgery are:

Stress incontinence is the involuntary loss of urine that can occur during physical activity, like lifting a heavy object, or when you laugh or sneeze, putting increased "stress" or pressure on the bladder. Stress incontinence accounts for the majority of incontinence problems. is the involuntary loss of urine that can occur during physical activity, like lifting a heavy object, or when you laugh or sneeze, putting increased "stress" or pressure on the bladder. Stress incontinence accounts for the majority of incontinence problems. Urge incontinence is the sudden need to urinate due to bladder spasms or contractions. To hasten the recovery of urinary control, we teach you pelvic floor exercises to strengthen the urinary sphincter. These exercises are known as Kegel exercises. Basically, they consist of tightening the urine control muscle (the sphincter muscles) 10 to 20 times every hour to strengthen the muscle that controls urine flow. We may recommend other behavioral strategies as well, including timed voiding, double voiding, and reduced fluid intake, which can significantly help facilitate urinary control and can be started shortly after surgery.

Continence Treatment

In about 5 percent of patients, there can be damage to the urinary sphincter or the nerves nearby, resulting in temporary or permanent incontinence. A minority of patients may have delayed healing of the bladder/urethra connection and thus require longer catheterization or may require re-insertion of the catheter because of swelling at the connection. We tailor our continence treatment to your medical history, physical condition, and personal preferences. We use a biofeedback program that speeds up the process of urinary recovery. Most patients report that they are fully continent and have a stream of urine that is better than pre surgery stream (due to enlarged prostate) within a few months after surgery. If continence problems persist, there are minimally invasive surgical options that are highly successful, such as the male urethral sling and the artificial sphincter. At Mount Sinai, we do these surgeries as outpatient procedures.

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How long does prostatitis take to clear?

Treatment depends on the type of prostate infection. For acute prostatitis, patients take antibiotics for 4 to 6 weeks. For chronic bacterial prostatitis, patients take antibiotics for 4 to 12 weeks. About 75 percent of all cases of chronic bacterial prostatitis clear up with this treatment.

Why do physicians have trouble diagnosing prostatitis?

With the exception of acute prostatitis, the diagnosis of prostatitis can be very difficult and sometimes quite frustrating for the patient and his physician. The symptoms are variable and there is much overlap in symptoms between the various types of prostatitis. Once the patient has been treated with antibiotics, it can be difficult to differentiate a bacterial prostatitis from chronic pelvic pain syndrome.

Why are some patients not cured after being treated for chronic bacterial prostatitis?

Patients with chronic bacterial prostatitis can have persistence of their infectious problem despite antibiotic use. This is because of the difficulty antibiotics have in penetrating the prostate gland to completely kill all the bacteria deep within the prostatic ducts.

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