If you are leaking urine after prostate surgery, you are not alone. Some urinary leakage is common during recovery from a prostatectomy, and many men see their bladder control improve with time. But when leakage continues, it can become frustrating and interfere with everyday life. Maybe you are wearing pads every day. Perhaps you think twice about exercising, traveling or being away from a bathroom. You may even find yourself avoiding certain social activities because you are worried about leaking.
The important thing to know is that you don’t necessarily have to live with urinary leakage after prostatectomy.
Treatments are available for ongoing male urinary incontinence. Depending on the type and severity of your leakage, options may include pelvic floor therapy, a male sling or an artificial urinary sphincter (AUS).
Why Am I Leaking Urine After Prostate Surgery?
A prostatectomy removes the prostate, usually as a treatment for prostate cancer. Because the prostate is located close to the bladder, urethra and muscles that help control urination, surgery can temporarily or permanently affect bladder control.
It is common to experience some urinary leakage while your body heals. For many men, bladder control gradually improves during recovery.
For others, leakage continues.
One common cause is stress urinary incontinence, which means urine leaks when extra pressure is placed on the bladder. You may notice leakage when you:
- Cough or sneeze
- Laugh
- Stand up from a chair
- Bend or lift something
- Exercise
- Walk or participate in physical activities
The amount of leakage can vary considerably. Some men experience occasional drops, while others may need several pads each day.
How Long Does Urinary Incontinence Last After Prostatectomy?
Every man’s recovery is different. Bladder control can continue to improve as your body heals and the muscles involved in urination become stronger.
If you are still experiencing bothersome leakage after your initial recovery, it is worth talking with your urologist rather than assuming nothing more can be done.
A urologist who treats male urinary incontinence after prostate surgery can determine what is causing the leakage, how severe it is and which treatment options may be appropriate.
What Can I Do About Urinary Leakage After Prostatectomy?
Treatment depends on how much you are leaking, how long the problem has continued and what is causing it.
For some men, pelvic floor exercises or pelvic floor physical therapy can help improve bladder control.
When leakage continues despite these treatments, your urologist may discuss surgical options.
Two procedures commonly considered for male stress urinary incontinence are:
Male sling: A sling is placed beneath the urethra to provide additional support. It may be an option for some men with mild to moderate leakage, usually 3 pads a day or less.
Artificial urinary sphincter: An artificial urinary sphincter helps control the flow of urine by replacing some of the function of a weakened urinary sphincter. It is considered the gold standard surgical option to treat SUI, and can treat mild to severe stress urinary incontinence.
Your urologist can help you understand the differences between these treatments and which approach makes the most sense for you.
What Is an Artificial Urinary Sphincter?
An artificial urinary sphincter (AUS) is a small device placed inside the body to help men regain greater control over urination.
Think of it as helping to do the job of your natural urinary sphincter—the muscle that normally keeps the urethra closed until you are ready to urinate.
The device has three basic parts:
- A soft cuff that fits around the urethra
- A small pump placed inside the scrotum
- A fluid-filled component that helps control the cuff
All parts of the device remain inside your body, so nothing is visible from the outside.
How Does an Artificial Urinary Sphincter Work?
Most of the time, the soft cuff gently closes around the urethra to help prevent urine from leaking.
When you are ready to urinate, you squeeze a small pump located inside the scrotum. This temporarily opens the cuff so urine can flow.
After you finish, the cuff gradually closes again on its own to help prevent leakage.
Once you become comfortable using the device, operating it becomes part of your normal bathroom routine.
Who May Be a Candidate for an Artificial Urinary Sphincter?
An artificial urinary sphincter may be an option for men with any degree of stress urinary incontinence, especially when leakage continues after prostate surgery.
You may want to ask your urologist about an AUS if:
- You continue to need pads because of urinary leakage
- Leakage is affecting your daily activities or quality of life
- Pelvic floor exercises or other treatments have not provided enough improvement
- You experience significant leakage when standing, coughing, exercising or being physically active
An artificial urinary sphincter is not the right treatment for everyone. Your urologist will consider your type and severity of incontinence, previous prostate or urinary procedures, the health of your urethra, your overall health and whether you can comfortably operate the pump.
What Should I Expect After Artificial Urinary Sphincter Surgery?
After the device is placed, your body needs time to heal before you begin using it. The device typically remains turned off during this healing period for approximately 6 weeks.
When your urologist determines that you have healed sufficiently, the device can be activated. Your care team will show you how to use the pump and answer any questions you have.
There is usually a learning period, but using the device becomes more familiar with practice.
Your urologist will also explain activity restrictions, follow-up care and what you can expect during recovery.
Can an Artificial Urinary Sphincter Stop Urine Leakage Completely?
The goal of an artificial urinary sphincter is to significantly improve bladder control and reduce urinary leakage. Results vary from person to person, and the device does not guarantee that you will never experience leakage.
Your urologist can help you understand what level of improvement may be realistic based on your symptoms and individual circumstances.
When Should I Talk to a Urologist About Leakage After Prostatectomy?
If urinary leakage is continuing to interfere with your everyday life, it is reasonable to ask about your options.
You may want to schedule an evaluation if you are still regularly wearing pads, limiting activities because you are afraid of leaking or simply feel that your bladder control is not where you would like it to be.
There are treatments for urinary incontinence after prostatectomy, and you don’t have to figure out the options on your own and you do not necessarily have to accept it as a permanent part of recovery. A specialist in male urinary incontinence can evaluate your symptoms and help you understand your treatment options.
At the Conrad Pearson Clinic, Dr. Michael Granieri specializes in male stress urinary incontinence and prosthetic urology, including artificial urinary sphincters. He is a nationally recognized center of excellence for AMS 800 Artificial Urinary Sphincter. If you are experiencing persistent urinary incontinence after prostatectomy, schedule a consultation with Dr. Granieri at Conrad Pearson Clinic to discuss your treatment options.
