Problems after surgery (radical prostatectomy)
Surgery can cause urinary problems, including:
This is the most common urinary problem after surgery. When you wake up after surgery, you’ll have a thin tube called a catheter in your penis. This allows urine to drain out of the body. Most men can’t control their bladder properly when their catheter is first removed. This is because surgery can damage the muscles and nerves that control when you urinate.
You might just leak a few drops when you exercise, cough or sneeze (stress incontinence). Or you might leak larger amounts. Some men also leak urine when they get an erection or during sex.
Leaking urine usually improves with time. It can be hard to deal with, but there are treatments and products that can help, as well as things you can do to help yourself.
Your treatment options will depend on how much urine you’re leaking, and how recently you had your prostate cancer treatment. Talk to your doctor or nurse about treatments and products that may be suitable for you.
Absorbent pads and pants
These can be worn inside your underwear, or instead of underwear. They soak up any leaks and are usually very discreet, so people won’t know you’re wearing them. Services vary from area to area, but your local NHS service may provide some pads for free. Talk to your doctor, nurse or continence advisor for more information.
Pelvic floor muscle exercises
These can strengthen the pelvic floor muscles, which help control when you urinate.
Urinary sheaths (external catheters)
These look like condoms with a tube attached to the end, which drains urine into a bag. The sheath fits tightly over the penis and you can strap the bag to your leg – under your clothes – and empty it as needed.
Artificial urinary sphincter
This involves surgery to fit a small device that consists of:
- a fluid-filled cuff that fits around your urethra
- a balloon in front of your bladder
- a pump in your scrotum (the skin around your testicles).
The device lets you control when you urinate. The fluid-filled cuff presses the urethra closed so that you don’t leak urine. When you squeeze the pump in your scrotum, the cuff stops pressing your urethra closed so that you can urinate.
Internal male sling
This is a small piece of material that presses gently on your urethra to keep it closed and stop urine leaking. You’ll have an operation to fit the sling. It should be tight enough to stop urine leaking out, but loose enough to let you urinate when you want to.
This involves surgery to place two small fluid-filled balloons around your urethra. The balloons press on the urethra to stop urine leaking out – but you should still be able to urinate when you want to.
You may be offered a medicine to help keep the urethra closed, or to calm your bladder down. This can help to reduce leakages.
Some men may find it difficult to urinate after surgery. This is caused by scarring, which can cause the urethra to become narrow. This isn’t very common after surgery.