Urinary incontinence is an unpleasant side effect that can occur after treatment for prostate cancer.
While there are different types — and varying levels of leakage — it is generally described as the inability to control or stop urine from flowing.
This is common after treatment for prostate cancer, due to either damage or removal of a bladder sphincter, which is a muscular valve that keeps urine from escaping the bladder. Men have two bladder sphincters. One of them is typically removed during radical prostatectomy.
Types of incontinence
If a man leaks urine when he coughs, laughs or sneezes, it is called stress incontinence. Other types include:
- Urge incontinence: when a man has a sudden urge to urinate and may not always make it to the bathroom in time
- Overflow incontinence: when a man has difficulty completely emptying his bladder. Urination may take a long time and he may have a weak stream of urine or dribbling
- Continuous incontinence: when a man loses all ability to control urination
Estimates of incontinence after radical prostatectomy have been reported to range from as low as 2.5% to as high as 87%. These numbers may vary so much because there are differences in how incontinence is defined.
Tip: Ask your loved one’s doctor what his or her definition of incontinence is before treatment.
Recovery takes time
After surgery for prostate cancer, a man is expected to regain control of his bladder within a few months.
Age is a factor and whether he had any previous urinary problems. Other factors include whether he:
- Had nerve-sparing surgery
- Still has both nerve bundles (having both is reported to help with urinary control)
Tip: As your man recovers, he may be able to use women’s pantyliners until he is completely dry.
Recovery may occur gradually over time to the point where he only dribbles a little. He may need to wear heavy pads or absorbent briefs at first, then just use a thin pad.
You can buy pads at most supermarkets and drugstores. You can also consider buying a protective plastic sheet for your bed and a plastic chair pad for when the catheter is first removed. They are usually available in drug stores.
Dealing with dribble
As your loved one gains more urinary control, certain types of activity may cause him to dribble some urine, such as:
- He may also leak urine during sex
Tip: Not waiting until the last minute to urinate may help.
Some men find that they may dribble more at the end of the day. Caffeine can increase both frequency and urgency of urination, so it is a good idea to stay away from any drinks or foods that have caffeine.
The doctor may also recommend Kegel exercises to help strengthen the bladder muscles.
If leaking continues
Unfortunately there are some men who never regain complete urinary control.
Urinary leakage can be a great source of frustration and embarrassment — perhaps even greater than impotence — because a man is reminded of the problem every day.
If this is the case, your man should speak with his doctor to see if there are any other physical issues causing urinary leakage. For example, some men develop scar tissue after surgery for prostate cancer.
If the doctor determines there are no other problems, one of the following options may be suggested: