Incontinence After Prostate Surgery is Normal and Treatable... Learn How!

Treatment for prostate conditions can lead to urinary incontinence. The 3 most common conditions of the prostate include Prostatitis, Benign Prostatic Hyperplasia (BPH), and prostate cancer. BPH and prostate cancer can often lead to surgical intervention and subsequent urinary incontinence.

​Urinary incontinence (UI) is defined as the involuntary leakage of urine. Both a radical prostatectomy and a prostate resection can lead to UI in patients that had none of these issues prior to surgery.

There are multiple reasons for this that can include damage to the nerve that controls urinary function, resection of one of the two sphincters that controls urine flow, and poor control of the pelvic floor. In 1996 Davidson et al. did a study in the UK to evaluate incontinence after radical prostatectomy. They found that at 3 months post-surgery, 21% of the participants were experiencing UI and 14% were still experiencing incontinence at 1 year. This percentage is significant when you consider that we do 90,000 radical prostatectomies per year in the US.

Despite the problems associated with prostate surgery, there are treatments that can be very effective at improving urinary control and sexual dysfunction. These treatments include pelvic floor exercises, biofeedback, urge suppression techniques, and lifestyle changes. Pelvic floor exercises should begin immediately after it is realized that someone needs prostate surgery. This has been shown to reduce the incidence of UI post-surgery. Tightening the pelvic floor can be done by tightening as if you were preventing passing gas or preventing urine from flowing. Often, we take for granted that our pelvic floor is functioning and this is not a safe assumption as we age. Once control of the pelvic floor is gained then patients can be progressed into more functional activities such as squatting and lifting.

There are also several lifestyle changes that can be adopted to reduce the incidence of UI. Men should be encouraged to drink no more than 3 pints of water per day unless exercising or eating salty foods. Reduction in caffeine and alcohol can also help as these two chemicals are irritants to the bladder. Smoking has also been shown to increase bladder irritation.

Despite some of the urinary control issues that arise from prostate surgery, it is often necessary to undergo a procedure, so we must find ways to improve quality of life post-surgery. One of the greatest barriers to treatment is lack of communication about this very sensitive issue. It is important for medical professionals to be open to talking about these problems and provide resources for patients to seek help. Having a physical therapist in your corner to help you navigate some of these sensitive issues can be of huge benefit. At HPT we have a male physical therapist that is willing and interested in improving your quality of life both pre and post prostatectomy.

John Oxley, PT,
​DPT, OCS, CSCS, Cert. MDT​

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