Understanding Incontinence After Prostate Cancer Treatment

Losing control of your urine 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 can severely effect your quality of life. If you’re worried about urinary incontinence as a prostate cancer side effect, having good information can help you make decisions about the best prostate cancer treatment for you.

What: Urinary incontinence is the inability to control your urine. It is a possible side effect of standard prostate cancer treatment, including prostate surgery and radiation therapy to treat prostate cancer. Urinary incontinence after a prostatectomy can present as anything from a dribble or loss of urine when you sneeze or cough (stress incontinence) to total leakage. After radiation therapy for prostate cancer, it’s more common for men to have a combination of leakage and a need to urinate frequently, as well as the possibility of fecal (stool) incontinence.

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 sometimes 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. Prostate surgery also may weaken the sphincter muscle that opens and closes to release urine and can cause damage to the nerves that control urination. Radiation therapy for prostate cancer, on the other hand, can shrink the capacity of your bladder and also 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 undergo. 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 for prostate cancer. Men who undergo focal therapy for prostate cancer very rarely experience incontinence after treatment. In all cases, however, urinary incontinence is usually not a permanent side effect of radical prostate cancer treatment, but it can be for some men.

Treatment for Incontinence After Prostate Cancer: If you’re in the minority of men for whom incontinence does not resolve within a few months after prostate cancer treatment, don’t lose hope. Depending on what’s causing your problem, there are many treatment options to make it better. Medications, bladder retraining, collagen injections, and procedures such as urethral sling surgery, all can help restore normal urinary control. The first step, though, is being willing to talk about it.

To learn more about urinary incontinence, we recommend reviewing information provided by the National Institutes of Health.