Coping with incontinence

Short and long-term solutions

Urinary incontinence is a troubling 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.


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Types of incontinence

If your loved one leaks urine when he coughs, laughs or sneezes, it is called stress incontinence. Other types include:

  • Urge: a man has a sudden urge to urinate and may not always make it to the bathroom in time
  • Overflow: 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: 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 (both of which are reported to help with urinary control)

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.  

Tip: As your man recovers, he may be able to use a woman's pantyliner until he is completely dry.

You can buy these 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), which are available in some drug stores.

As your loved one gains more urinary control, certain types of activity may cause him to dribble, such as:

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. 

Tip: Not waiting until the last minute to urinate may also help.

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Your loved one's doctor may also recommend Kegel exercises to help strengthen the bladder muscles.

If leaking continues

Unfortunately there are some men who do not 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, after surgery for prostate cancer, some men develop scar tissue.

If the doctor determines there are no other problems, one of the following options may be suggested:

Medications
Collagen injections
Sling procedure
Artificial urinary sphincter

Updated 7/14 

Return from coping with incontinence to homepage

References:
Doherty R, Almallah Z. BMJ. 2011.
Atiemo HO, Moy L, Vasavada S, Rackley R. Cleveland Clinical Journal of Medicine. 2007.
Grise P, Thurman S. Cancer Control. 2008.

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