TENA’s Guide to Prostate Surgery and Recovery

A lot of men experience urinary symptoms after treatment for cancer, including urinary incontinence.  It’s a common side effect of treatment, and can often add another stage of discomfort and distress after an already difficult experience.

There are many different types of urinary symptoms associated with prostate cancer treatment which vary in severity, from post prostate surgery to urge and stress incontinence. If you’re considering prostate surgery or any other kind of treatment for prostate cancer, it’s important to be aware of the possible complications and bladder issues you might experience as a result, as well as how to recover. 

With that in mind, we’ve put together a list of common treatments for prostate cancer and the different urinary problems they could cause. Remember, if you are undergoing any of these procedures and are unsure about potential side effects or complications, ask your doctor for more information about what to expect.

What causes post prostate surgery incontinence?

To understand the link between prostate cancer and incontinence, it’s useful to know how the bladder works. Urine is passed from the kidneys and stored inside the bladder until you need to urinate. It then leaves the body through the urethra, which the gland surrounds. If the prostate gland becomes enlarged it can obstruct the urethra and cause urinary problems.

Prostate surgery can remove part or all of your prostate – depending on how much has been affected by cancer.

If the prostate is completely removed, in a procedure called a radical prostatectomy, it’s common to then experience . This is due to damage to the nerves that control the bladder, or the surgeon removing one of the valves outside the prostate that releases urine.

Post prostate surgery incontinence

Many men experience stages of incontinence after a prostatectomy, the most common of which is urine leakage. During prostate surgery, a tube called a catheter is inserted into the urethra to drain urine from the body, which stays in for about seven to ten days. Because surgery often damages the nerves around the bladder and urethra, a lot of men find it difficult to control their bladder when the catheter is first removed. 

The severity of after a prostatectomy differs depending on the individual. Some men only experience little leaks from pressure put on the bladder when they exercise or sneeze, called stress incontinence, while others may leak larger amounts.

Similarly, the recovery time from post prostatectomy incontinence also varies. While most cases improve after one to six months, some men experience post prostate surgery incontinence for a year or longer and others never fully recover. In either case, incontinence pads or pants can help protect against post prostate surgery leakage and help you keep control.

Treating incontinence after prostate surgery

If you’re experiencing post prostate surgery your doctor might suggest a number of treatments. This will depend on the type and severity of the incontinence. Medical procedures to treat incontinence after surgery include:

Urethral sling – a minimally invasive procedure where a small piece of material is placed around part of the urethra to keep it closed and prevent urine leakage. 
Artificial urinary sphincter – an artificial urinary sphincter can help men who experience more severe incontinence due to a poorly functioning sphincter valve post prostate surgery. An AUS is usually only recommended for men who still leak large amounts of urine six months after surgery.

Aside from these operations, your doctor might recommend non-invasive treatments, such as medications and lifestyle changes. Both incontinence and frequent urination can be treated with bladder training so you don’t have to go as often, monitoring your fluid intake, and exercises to strengthen your pelvic floor. These can also help you to manage bladder weakness at night. 

In either case, from pads to pants our range of incontinence products for men can help protect you from mild to moderate urine leakage. Visit our product site to shop now. 

Possible side effects of prostate surgery and radiotherapy

Radiation cystitis

There are non-surgical approaches to treating cancer, and one of these is called radiotherapy. Radiotherapy to destroy the prostate can also affect the bladder, decreasing its capacity, and perhaps causing spasms. This effect on the bladder can lead to or other urinary symptoms. The condition is called radiation cystitis, and its symptoms include:

a burning sensation when you urinate

bladder or urethral pain

difficulty urinating

blood in your urine
more frequent or urgent urination, including at night (Nocturia)

See your doctor if you experience any of these symptoms to get a recommendation for treatment. You can try to manage these symptoms yourself by drinking plenty of fluids and avoiding caffeinated drinks and alcohol, and spicy foods – all of which can aggravate the bladder.

Urinary frequency and urgency

A lot of men who have had radiotherapy for prostate cancer feel the need to urinate more often and urgently, a condition called urinary frequency. When this happens at night, waking you from your sleep with the need to urinate, this is known as Nocturia. 

Other men may experience urge incontinence after radiotherapy. This is the feeling of being in constant or urgent need to urinate, resulting in being unable to control the bladder and subsequently urine leakage. 

Urine retention

Some men may have difficulty passing urine after radiotherapy, known as urine retention. This can happen if the nerves that control the bladder are damaged, or the urethra becomes narrowed. Radiotherapy can also cause the prostate to swell and block the urethra, resulting in retention.

Bladder problems after high intensity focused ultrasound (HIFU)

Another procedure used to treat cancer is called high intensity focused ultrasound (HIFU). Following treatment, some men will experience the following symptoms:

Stress incontinence – having HIFU can cause many men to experience urine leakage as a result of sneezing or exercise, known as stress . This is more likely if you’ve already had radiotherapy. 
Urine retention – HIFU can also cause swelling to the prostate, necessitating a catheter to drain the urine. HIFU may also cause the urethra to narrow, resulting in retention.
UTI – Some men may get a urinary tract infection after having HIFU, which can be treated with antibiotics.

Available support

Here at TENA, we understand that experiencing urinary symptoms, such as , can impact daily activities and lead to a decline in mental health. For more information, including advice about what support is available, see our article on Mental Health and Incontinence. If you're looking for support with incontinence, check out which TENA Men product is best for your needs.