Incontinence (urinary leakage) is a common problem after treatment for prostate cancer. This can occur after surgery (prostatectomy), radiation, or other treatments (for example, cryotherapy). Leaking after prostate cancer treatment can be a devastating problem for men. Fortunately there are ways to help, both before and after surgery.

Here’s an introduction to urinary incontinence and prostate cancer treatment.

Is incontinence after prostate cancer treatment common?

Prostate cancer itself is common. In fact, it is one of the most common cancers in men worldwide. As a result, many men are diagnosed with prostate cancer each year and undergo treatment. The most common types of curative treatments include surgery or radiation. Unfortunately, urine leakage can occur with both. Incontinence rates vary a lot in reported research. For example, rates generally range between 5% and 30% after surgery.

Why are incontinence rates so different?

For many reasons. One common reason is that incontinence rates depends on the definition of incontinence. Some researchers define no incontinence as using 0 or 1 pad daily. This definition means that a man could have a mild amount of leakage that requires only one pad per day but still be considered continent. Thus, this definition would be associated with better continence rates. Other researchers define incontinence as no pads and no leakage … ever. Using these strict definitions, more men will be considered incontinent.

Is all incontinence the same?

Generally not. The degree of incontinence can vary, with many men reporting mild incontinence. This is generally light leakage that occurs infrequently. Moderate to severe incontinence is less common.

Why is incontinence so common after prostate surgery?

The prostate is right next to the urinary sphincter, which is the muscle that is responsible for a large portion of a man’s continence. During prostate treatment, physicians must remove (surgery) or irradiate (radiation) the prostate to get rid of all the cancer cells but, at the same time, completely avoid weakening the sphincter muscle. Because the prostate and sphincter muscles are so close, this is a challenge!

What is stress incontinence?

There are two more common types of urinary incontinence, stress and urge incontinence. Stress incontinence is loss of urine associated with activity, such as coughing, sneezing, lifting, exercise. This type of incontinence generally arises from sphincter muscle weakness and is the type of incontinence that generally affects men after prostate treatment. Stress incontinence is also quite common in women.

Another type of incontinence is called urge urinary incontinence, which is loss of urine associated with a sudden sense of urgency. Many people with this problem say, “I can’t make it to the bathroom in time”. Urge incontinence is commonly associated with other symptoms, which include urgency (rushing to the bathroom), frequency of urination, and getting up at night. This type of incontinence is less common after prostate treatment.

Is there anything I can do to help before my prostate treatment?

Yes! A risk factor for incontinence after prostate treatment is bladder problems before your treatment. Foremost, it is important to ask questions about incontinence to your doctor before treatment! Don’t be afraid to how common incontinence is in their patients and how they provide support after surgery to optimize bladder and muscle strength.

Also, work on your pelvic floor BEFORE surgery. Strengthening your pelvic floor and learning how to perform pelvic floor exercises beforehand will make things much easier after surgery. And, this will help you optimize your chances of continence.

This blog is part of our blog series on incontinence after prostate treatment. Be sure to check out our other blogs:

1. Urinary incontinence after prostate surgery or radiation.
2. Pelvic floor exercises after prostate surgery or radiation.
3. Surgery to fix incontinence after prostate surgery or radiation.

Also, feel free to reach out to us at [email protected] for more education about pelvic floor health.