Losing urinary control is a common fear when facing prostate cancer treatment. For some men, incontinence can seem worse than impotence (erectile dysfunction). And it’s no wonder. After all, it affects your life every day. If you’re worried about urinary incontinence or are dealing with it already, here’s what you need to know.
What: Urinary incontinence after a prostatectomy can present as anything from a dribble to loss of urine when you sneeze or cough (stress incontinence) to total leakage. After radiation therapy, men may have a combination of leakage and a need to urinate frequently. While incontinence is more of an annoyance than anything else, loss of control over the release of your urine can be stressful and embarrassing.
Why: When you urinate, the muscles in the bladder wall contract while the muscles that surround the urethra—which carries urine from the bladder out of your body—relax. An enlarged prostate, which can be a symptom of prostate cancer, can cause urine retention by blocking your urethra. So when you remove the prostate (prostatectomy), it may result in leakage. A prostatectomy also may weaken the sphincter muscle that opens and closes to release urine and can cause damage to the nerves that control urination. Radiation, on the other hand, can shrink the capacity of your bladder and also can result in spasms, which is why the type of incontinence can be somewhat different, and why it can sometimes lead to fecal incontinence as well.
Who: Your risk for incontinence varies depending on what prostate cancer treatment you choose. About 6 to 8 percent of men who have a complete (radical) prostatectomy experience incontinence, while it affects 8 to 10 percent of men after radiation therapy. It’s important to know that most often it is not a permanent problem.
When: If you have any type of treatment for prostate cancer, temporary incontinence is likely immediately after. How long it takes to resolve—from a few days to up to a year—can vary, so patience and an open dialogue with your doctor are key.
Treatment: If you’re in the minority of men for whom incontinence sticks around, don’t lose hope. Depending on what’s causing your problem, there are many treatment options. Medications, bladder retraining, collagen injections, and procedures such as urethral sling surgery and artificial urinary sphincter all can help restore normal urinary control. The first step, though, is being willing to talk about it.
Learn more about prostate cancer and prostate cancer treatment.
Download a Prostate Surgery Guide to learn more about surgical treatment options.
David J. Cahn, MD, a board-certified urologist, brings years of experience to complex urological conditions that require surgical intervention. Dr. Cahn is one Colorado’s most experienced minimally invasive surgeons treating overactive bladder, and was among the first in the region to utilize InterStim technology. Dr. Cahn also specializes in advanced prostate cancer. He founded Foothills Urology in 2000 with the goal of providing state-of-the-art treatment in a small, personalized practice. Foothills Urology has since grown to become one of the region’s leading urology practices.