Is Incontinence After a Prostatectomy Inevitable?

Outside of skin cancer, prostate cancer is the most common cancer among men, and an eye-opening 1 in 8 men will be diagnosed with the disease. This means the odds are good that you know a few people who've been down this road before you. If they had a prostatectomy, you might have heard a tale or two about the aftermath.

If you’re concerned about complications after a prostatectomy, such as incontinence, your concern isn’t misplaced, but there are some points we want you to consider. At our practice, urologist Dr. Robert J. Cornell is incredibly well-versed in prostate care, which includes post-prostatectomy urinary incontinence (PPI). 

Here’s what we want you to know about this common, and mostly temporary, issue.

Why the postsurgical incontinence?

Your prostate is a gland that encircles your urethra and is located just below your bladder. When a radical prostatectomy is performed, not only is this gland removed, one of the sphincters that control the flow of urine from your bladder into your urethra is also removed.

Under normal circumstances, your bladder relies on two sphincters that open and close to either keep urine in your bladder or to release it into your urethra. When we remove one of these valves, your bladder should adapt to using just one, but this may take some time.

How much time until urination is normal again?

There’s no definitive answer to this question, and it depends on your level of urinary control (or continence) before your surgery. 

If you had full continence, it may take a few weeks to a few months before you regain full control over any leakage. During this time, we recommend that you speed the process along with pelvic floor exercises and some behavioral training exercises, such as urinating on a schedule. In the end, most men regain their continence about three months after a radical prostatectomy.

If you had issues with incontinence that preceded your prostatectomy, it may take longer to address this new complication.

When incontinence persists

Between 6% and 8% of men struggle with PPI for longer than three months, at which point we can consider a few options.

First, we exhaust conservative measures such as behavioral training techniques and pelvic floor exercises. If, after 9-12 months, you’re still having trouble with incontinence, we offer a highly effective solution — the AMS 800™ Urinary Control System. This device acts as an artificial urinary sphincter that Dr. Cornell installs during an outpatient procedure.

We also offer the AdVance™ Male Sling System, which works well if you’re dealing with stress incontinence.

Our point in mentioning these solutions is to let you know that there are solutions. With any luck, you won’t need them, but we want to provide you with a little peace of mind before your prostatectomy.

If you have more questions about post-prostatectomy urinary incontinence, please contact our office in Houston, Texas, to schedule an appointment.