Post-Prostatectomy Incontinence FAQ

Q: After having surgery on my prostate, incontinence is a constant worry. What exactly is male urinary incontinence?

A: Urinary incontinence is the accidental release of urine. It is not a disease; it is a symptom of a problem with a man's urinary tract.

Q: How can I tell if I am experiencing post-prostatectomy incontinence?

A: If you have recently undergone a prostatectomy, keep an eye out for the following signs of incontinence:

  • Any degree of urinary leakage may indicate an incontinence problem
  • Any problems holding in urine may indicate detrusor hyperreflexia, characterized by small bladder capacity (also know as overflow incontinence)
  • Any problems emptying your bladder may indicate Intrinsic Sphincter Deficiency (ISD) or Stress Urinary Incontinence (SUI)

Q: What is Clinical Incontinence? How does it differ from non-clinical incontinence?

A: Clinical Incontinence refers to incontinence as a result of a procedure, for example:

  • Post-Radical Prostatectomy Incontinence
  • Post-Transurethral Resection of the Prostate (TURP) Incontinence
  • Post-Radiation Incontinence
  • Post-Cystectomy Incontinence

Q: Are problems with urination common after prostate surgery? How likely am I to suffer from incontinence?

A: Incontinence is a common problem for both men in general and men who have undergone a radical prostatectomy.

  • Patient surveys estimate that 35% of men require a pad to protect against incontinence after a prostatectomy
  • 75% to 85% of men report an occasional leak of urine after prostate surgery
  • 350,000 men in the U.S. are diagnosed with prostate cancer every year
  • 180,000 radical prostatectomies are performed in the U.S. every year

Q: What treatments are currently available for male incontinence?

A: There are numerous treatments that can be used help alleviate the symptoms of male prostate-related incontinence:

  • Behavioral Modification Incontinence Treatments:
    • Avoid drinking excess fluids after dinner
    • Empty your bladder frequently to avoid emergencies
    • Kegel Exercises (repeatedly contracting and relaxing the pubococcygeus muscles on the pelvic floor)
    • Electrical stimulation
    • External penile clamps to prevent leakage
    • Lifestyle adjustment
  • Medical Therapy for Incontinence
    • Anticholinergics to inhibit nerve impulses responsible for involuntary movements in the urinary tract
  • Surgical Therapy for Incontinence
    • Collagen injections near the neck of the bladder to prevent leakage
    • Artificial urinary sphincters are inflated to hold in urine and can be relaxed so urine can flow out
    • Urethral slings involve surgically inserting a mesh-like material to compress the urethra and reduce leakage of urine
  • Ostomy Products

Q: What are the risk factors for male incontinence?

A: Risk factors for urinary incontinence after prostate surgery include:

  • Having a pre-existing dysfunction voiding your bladder
  • Increasing age
  • Obesity/High Body Mass Index (BMI)
  • Previous transurethral resection of the prostate (TURP)
  • Previous XRT (radiation therapy)
  • Bladder neck contracture (BNC)
  • Problems with urethral structure
  • Inadequate surgical skill during your prostatectomy

Please call Dr. Scherr at (212) 746-5788 or visit our contact page for more information on dealing with male urinary incontinence.