Continence management following prostate surgery

Bladder weakness, or urinary incontinence, is experienced by many men following prostate surgery (prostatectomy or TURP). This is a common problem and often men find this the biggest challenge they have to cope with during the recovery process.

Most men regain their bladder control over time and are fully recovered within 6 to 12 months. However, it is important to get professional advice to help cope with bladder weakness during this time.

Why does it happen?

The prostate gland is a male reproductive organ. It is about the size of a walnut and sits at the base of the bladder. The thin tube (urethra) that carries urine and semen out of the penis runs through the centre of the prostate gland. At the point where the bladder and urethra join, there is a ring of muscles known as the bladder neck sphincter, which opens and closes like a camera-shutter. The bladder neck sphincter is closed most of the time to prevent urine leaking out but when it gets permission from the brain, it opens to allow urine to be passed. Another (external) sphincter is part of another set of muscles below the prostate called the pelvic floor. These muscles are also involved in bladder control. If the bladder neck sphincter is damaged during prostate cancer surgery, this can lead to urinary incontinence.

What are the symptoms?

Urinary incontinence usually occurs when you undertake activities that increase the pressure inside the abdomen, and push down on the bladder. If the pelvic floor muscles (external sphincter) are not working well, urine will leak out. This is known as 'stress incontinence'. Typical activities that can cause leakage are coughing, sneezing, shouting, laughing, lifting, walking, bending, pushing, pulling and moving from lying to sitting or sitting to standing positions.

Will it go away by itself?

Incontinence will usually improve with time but by learning how to control the pelvic floor muscles, you can speed up the recovery process and reduce the leakage. If you don't strengthen these muscles, the leakage may persist.

For more information about the pelvic floor muscles and how you can regain control visit the pelvic floor section of our website.

Where can I get help?

There are a number of health professionals who can help you with incontinence following prostate surgery. Continence nurse advisors or urology nurses can give you advice about diet, exercise (including pelvic floor muscle exercises) and products. Continence physiotherapists specialise in pelvic floor muscle exercises and can develop an individual program to suit your needs. If your incontinence persists beyond 12 months, talk to your urologist as there are a range of surgical alternatives to help you achieve dryness.

Remember, incontinence can be treated, managed and in many cases cured. If you are unsure who you need to see, contact the National Continence Helpline on freecall 1800 33 00 66.

For more information about prostate cancer or to find your local support group visit the Prostate Cancer Foundation of Australia.