Urinary Incontinence (Loss of Bladder Control)
What causes it: Urinary incontinence is a common side effect after prostate surgery (prostatectomy). During surgery, the bladder must be reattached to the urethra after the prostate is removed. This process can stretch or damage the urinary sphincter muscle that controls urine flow. As a result, you may experience leakage or poor bladder control, especially in the first few weeks or months after surgery. Radiation therapy can also irritate the bladder and urethra, sometimes leading to urinary urgency or leakage, though this is usually temporary
How it affects daily life: Incontinence can range from small dribbles to a complete inability to hold in urine. You might need to wear absorbent pads or underwear liners if you’re leaking urine. This can be embarrassing or inconvenient. You may feel anxious about going out in public or exercising due to fear of an accident. It can also disrupt sleep if you have to get up frequently at night to change pads or use the bathroom. The good news is that for many men, urinary control improves within a year after surgery as the tissues heal and strengthen. Often, only mild leakage (a few drops, managed with one pad per day) persists long-term in a minority of men.
Ways to manage or reduce it: There are several strategies to regain bladder control. Pelvic floor exercises (Kegel exercises) strengthen the muscles that help hold in urine. Your doctor or a physiotherapist can teach you how to do these exercises correctly. Practicing them daily can speed up the return of continence. Be patient and consistent – improvements often happen gradually over weeks and months. Meanwhile, use incontinence products (pads or absorbent briefs) for confidence when you go out. If incontinence remains severe, medical interventions are available. One option is an artificial urinary sphincter, a surgically implanted device that helps close off the urethra and prevent leakage. There are also urethral slings (a mesh support for the urethra) that can be placed to reduce stress incontinence. Discuss these options with a urologist if incontinence is significantly affecting your life. Additionally, avoid bladder irritants like caffeine and alcohol which can worsen urgency. Empty your bladder regularly (even if you don’t feel a strong urge) to reduce overflow leakage. With time and the right strategies, most men see improvement in urinary control.