Incontinence After Prostate Surgery: A Guide to Recovery and Care

By Kelly Burgess

After Linwood Wright, 68, of Danville, Va., had his prostate removed following a diagnosis of prostate cancer, he experienced incontinence that he thought would eventually clear up on its own. Although it did get better, now, five years after his surgery, he is still dealing with what he terms a "minimal" problem with bladder control.

Wright’s case is not uncommon, as incontinence is a frequent side effect of prostate surgery. However, according to Dr. Judd Moul, director of the Center for Prostate Disease Research in Washington, D.C., in most cases it lasts only a few weeks. Occasionally, though, it may linger, leaving the patient to manage a permanent case of incontinence.

A Prostate Primer

Many prostate conditions can cause bladder weakness or other urinary problems in men. This is because the prostate gland surrounds the urethra, which is the tube that carries urine through the penis. Until puberty, the prostate is the size of a small marble, but after puberty it gradually grows to about the size of a golf ball. After about age 50, the prostate begins to grow again.

Sometimes this growth doesn’t cause any problems at all. However, in some men, the prostate enlarges to the point that it acts as a "clamp" against the urethra, resulting in symptoms such as difficulty starting urination, frequent urination or incontinence. If the problems become severe enough, surgery may be required to correct them.

Men may also experience incontinence as an aftereffect of surgery to remove a cancerous prostate. According to the American Cancer Society, prostate cancer is the second most common cancer in men. However prostate cancer has an overall cure rate of 97 percent, and when caught early, has a cure rate of 100 percent.

Prostate cancer and prostate enlargement share many of the same symptoms, so it’s important to see your doctor if you experience any changes in your urinary habits.

Prostate Surgery

While surgery is the most common treatment for both benign prostate conditions and prostate cancer, the procedures are different. In surgery for prostate cancer, the prostate gland is either partially or totally removed. Surgery to relieve an enlargement, however, generally does not require removal of the prostate gland, only the enlarged tissue. Even though the surgeries for both conditions take different approaches, the recovery process is remarkably similar. With either procedure, Dr. Moul says the patient typically spends three to 10 days in the hospital, with a further recovery period of at least several weeks.

Because both surgeries involve significant trauma to the urethra, bladder weakness may result. Dr. Charles Myers, founder of the American Institute for Diseases of the Prostate and a prostate cancer survivor, says Medicare statistics indicate that one-fifth of men experience incontinence after prostate surgery. Of that number, around 10 percent still experience some form of incontinence one year after surgery.

Lingering incontinence is can be caused by the removal of a part of the bladder that controls urine flow along with the diseased prostate. However, men may be able to train the remaining muscles in the bladder to take over that function over time.

Managing Incontinence

For men who experience incontinence during the recovery period from surgery, Dr. Moul and Dr. Myers both recommend disposable absorbent garments, such as DEPEND® Guards for Men, which are ultra-thin, super-absorbent pads designed to fit a man's anatomy.

Wright is a prostate cancer survivor who continues to have incontinence beyond the recovery phase. Now, several years after his surgery, he uses one pad per day since he needs only light protection. "I value the use of DEPEND® for men because they provide protection without discomfort," he says.

And while incontinence is certainly manageable, Dr. Moul also recommends that men discuss bladder control problems with their doctor during follow-up appointments after the surgery. This allows their healthcare provider to determine if it is part of the recovery process and not a separate problem that needs to be evaluated.

The Bigger Picture

It's also important to remember that men are also dealing with the emotional ramifications of surgery and often a diagnosis of cancer, and their doctors should help them manage all of the aftereffects.

"In the first year after prostate surgery men are supposed to be seen by their urologist every three months," says Dr. Moul. "A good urologist should be paying attention not just to the incision or the disease, but to the other health factors as well, such as emotional recovery, sexual recovery and urinary recovery." All of which are important to getting back on the road to a full and active life.

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Good information, I had my prostate removed a year and a half ago and still have some incontinence and can only get an erection with aids. My urologist keeps an eye on my PSA but I haven't seen him for over a year now. I will now get an appointment to see him and check out my problems. Thanks

4/21/09 8:25 AM



If urinary incontenance continues for 2% of those who have had prostate surgery, count me, six years later, in that 2%(under-reported ?). At the second or third follow-up with the Urologist after surgery, he said about my incontenance, "I've done all I can, its up to you." Talk about abandonment--I haven't seen him since. I have had two rounds of bio-feedback with no change. Besides the button Depends (three a day) I am now trying the Depend Boost product, but had to mail order.

8/21/09 1:18 AM



I have to challenge the "ultra thin" label applied to the guards for men. I purchased these and was overcome with the bulky nature of the pad. Completely inappropriate for exercise. And I have yet to find more than type of pad at my various retail locations, WALMART, Target, and other grocery stores. Men need a product designed for the more common stress incontinence that we deal with after prostate surgery.

12/10/09 7:44 AM



As a first-time visitor I see that most of the comments are related to Prostate surgery/removal. I elected to have "seeding" done, which appears to have been a bad choice! My Prostate has been "Fried" from the radiation. Daytime is not much of a problem, but I am waking up almost every hour to urinate at night. My urologist is not offering me any hope, and I am resigned to these wake-ups for the rest of my life. (I am 66). Can anyone off me some alternatives? Thanks.

3/18/10 7:21 AM



I am an 11 year prostate cancer survivor having had radical prostate surgery. I have tried the exercise, every time that I see my urologist he says keep on trying. I have to use two pads a day. (one morning one at night.) He has suggested injection at the op site but I have rejected this so far. At 77 I don't know what to do as this is an embarrassment. I do not get erections but this is not a problem with such an understanding wife, of 47 years. Any advise would be appreciated. Signed Radioman.

8/26/10 1:11 PM



I had radical prostate removal in 2006 and have incontinence and have to wear depend pads
and change every two hours. Is there no hope for Me? There has to be something!

1/10/11 4:56 AM



I too had prostate surgery 6 and half years ago and I am still incontenent. I wear pull-ups during the day and briefs at night. Stress and urge incontinence. I have tryed the muscle excercises but they don't help.

3/28/11 2:34 AM



Jan 28, 11my prostate enlarged to the extent I could not urinate. . A catheter was inserted which releaved the problem. Surgery was not done till Feb. 15th. Prostate had strangled uretha. Surgeon opened prostate. Since then have had constant leakage 24/7. Am using Depends new mens underware. . Need assit in diet which eliminates strong urine odor. Am 93, 158 lbs, 5'11" Physically and mentally active. Unable to accept living too much longer with a constant wet crotch.

4/6/11 7:10 AM



Jan 28 experienced stoppage urine. Catheter inserted. Feb 15 surgery opened prostate releaving strangled uretha. Since have contuous drip when standing, partial when seated and prone. Using Depends new mens underware. What foods, liquids devoid of stuff to create odor in urine. Hope things become normal shortly.

4/6/11 7:17 AM

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