Experiencing urinary incontinence after prostate surgery (transurethral resection of the prostate or radical prostatectomy) is extremely common.   

While you don’t need to be immediately concerned about this post-surgery symptom, it can be challenging so it’s essential to educate yourself on how it can be prevented or managed.

ConfidenceClub’s National Clinical Educator, Sonya Meyer (BSN GradDipClinicalPrac), shares everything you need to know about urinary incontinence after prostate surgery… 

The prostate gland helps control the urinary tract. During surgery, some muscles and nerves around the prostate gland can be damaged or irritated.

This includes the bladder neck sphincter (the muscles where the bladder and urethra join), which controls the flow of urine. If this is damaged, it can mean that the flow of urine is no longer controlled.

If you undergo a radical prostatectomy (RP), the surgeon will remove both your prostate and the bladder neck sphincter. You will have an external urethral sphincter that remains, below the prostate area, which can be strengthened with pelvic floor exercises (more on this later) to help control the urine stream. However, RP can damage nerves, blood supply, muscle and supporting structures of the external sphincter which can lead to incontinence.

Approximately 6-8% of men who’ve had their prostate removed will develop urinary incontinence.
There are two types of urinary incontinence that can be experienced:

Stress incontinence 

Stress incontinence is when small amounts of urine leak during activities which increases abdominal pressure, causing pressure on the bladder.  

Urge incontinence

Urge incontinence is a sudden and strong need to pass urine. People with this problem may feel their bladder is fuller than it actually is and this causes the bladder to contract. Some may experience leakage before they get to the toilet and may also find they wake several times at night to go to the toilet (nocturia). 

This can vary from person to person and can span from light dribbles or leaks to full incontinence. It’s also common for the amount of leakage to be higher immediately after surgery, but this generally does reduce as you recover.

Incontinence after prostate surgery will usually improve over time, however, there are ways to help you regain control over your bladder.  

Pelvic floor exercises

You might be used to hearing about pelvic floor exercises being beneficial for women, but the same goes for men too - especially after prostate surgery! 

Learning how to strengthen and control your pelvic floor muscles can help speed up your recovery and reduce leakage. You should also be doing these in the lead up to your prostate surgery, as well as following.

In terms of how to exercise your pelvic floor, it’s recommended to seek guidance from a pelvic physiotherapist, urology nurse or a continence nurse. For more resources regarding pelvic floor health, visit Pelvic Floor First. 

Absorbent pull-ups, pads & guards

Depending on your need level, incontinence aids such as pants, pads and/or guards can be extremely helpful in managing post-surgery leaks. 

Pull-up pants can be worn as underwear throughout the day for higher absorbency needs. Our range here at ConfidenceClub come in a variety of absorbency levels and are slimline and anti-leak, making them discreet and comfortable to wear.  

Pads and guards are helpful for men with light bladder leakage. Our range of pads for urinary incontinence are designed to keep you (and your clothes) dry and comfortable, and include features such as:  

• The ability to quickly absorb fluid, and trap it in an absorbent core, keeping the top layer and your skin dry 
• An anatomical shape to ensure a good fit, and side barriers to protect you from leakage
• A silky soft top layer that is dermatologically tested and latex free to protect your skin 
• Built in odour control to keep you feeling fresh 
• A secure adhesive strip to ensure the pad stays firmly in place

Our line of male guards are anatomically designed for men specifically to fit discreetly and securely. They are suitable for active wearers. Use it a bit like a cricket box inside your underwear to absorb minor to moderate urine output.

Bed protectors 

If you find you experience urine leakage during the night, bed protectors are a product to consider. They’re essentially large, disposable pads that protect your sheets and mattress by absorbing urine leaks. 

Click here to see our range of bed and chair incontinence protectors. They really are a great last line of defence for incontinence.  

Medical interventions   

There are more medical management options out there, including: 

• Urinary sheaths 
• Penile clamps 
• Internal male sling (small piece of mesh material surgically inserted against the urethra to support the urinary sphincter to keep it closed) 
• Artificial urinary sphincter (surgical procedure) 
• Medication to help keep urethra closed and/or calm an overactive bladder 

Of course, any of these options should be considered as a last resort as for the most part, incontinence can be managed with absorbent products (pants, pads and guards) and pelvic floor exercises. If you do need or want to explore this route, you can discuss it with your doctor. 

It can take between three and 12 months for men to be fully recovered post surgery and regain bladder control. Again, this is dependent on the individual, and a diagnosis for one man may not be the same for another.

During this time you need to follow the above management tips to ensure you’re making the best possible progress. 

If after six to 12 months you’re still experiencing incontinence after prostate surgery, the best thing to do is to contact your surgeon and/or pelvic floor nurse. They can help advise what management options are right for you.  

In fact, make sure you keep in contact with them throughout the recovery process to ensure everything is progressing as it should. 

We hope this article has helped shed some light on what to expect regarding incontinence after prostate surgety. Why not check out our other helpful articles while you’re here?

If you have any questions about our product range, you can speak to our customer service team 6 days a week, by calling 1800 86 11 99 or emailing hello@confidenceclub.com.au. We also have an online chat on our website. We’re here to help!