Incontinence Advice

Incontinence After Prostate Surgery: How Long Does It Last?

Urinary incontinence after prostate surgery is common, particularly following what's known as radical prostatectomy (surgical removal of the prostate gland). Most men notice improvements in bladder control within 3 to 6 months, although recovery can take 12 months or longer for some. Urine leakage typically happens when the urinary catheter is removed after surgery. This usually becomes less frequent as the muscles responsible for controlling urine flow recover. However, some men experience persistent incontinence longer and may need additional treatment.

In this guide, we explain how long incontinence lasts after prostate surgery, why urine leakage happens, what affects recovery and how to manage it while regaining bladder control.

Key Takeaways

  • Urinary leakage is common after prostate surgery, particularly prostate removal because surgery can affect the muscles and structures responsible for controlling urine flow.

  • Recovery takes time. Many men notice improvements in bladder control over the first 3–6 months, although recovery can take up to 24 months.

  • The severity and duration of leakage vary. Factors such as the type of surgery, pelvic floor muscle strength, age and general health can influence recovery.

  • The right incontinence products like male-specific pads, absorbent underwear and pull-up pants can make recovery more comfortable. 

  • Seek medical advice if leakage is not improving or is affecting daily life. Worsening symptoms, pain, burning when urinating or difficulty emptying the bladder should also be assessed.

In this article

How Long Does Incontinence Last After Prostate Surgery?

Urinary incontinence after prostate surgery is usually temporary. Most men gradually regain bladder control over a few months. It is normal to experience leakage because the muscles and structures responsible for controlling urine flow need time to recover. Some men leak only a few drops when coughing or sneezing. Others might experience more frequent leakage and need absorbent pads throughout the day.

According to one systematic review study done by Moretti et al., urinary continence rates tend to improve progressively during the first year after surgery. The study analysed data from 193,618 patients who underwent radical prostatectomy. It found that depending on the surgical technique, approximately 34–42% of men were continent after one month. The figures increased to 62–65% after three months, 73–79% after six months and 81–86% after 12 months. 

The following timeline provides a general guide to what men may experience during recovery after prostate surgery:

Time after surgery What to expect
First few weeks Urine leakage is common, particularly after catheter removal. Some men experience occasional dribbling, while others need several absorbent pads daily.
1–3 months Bladder control often begins improving as the urinary sphincter and surrounding muscles recover.
3–6 months Many men experience substantial improvements in leakage and bladder control.
6–12 months Further improvements are possible, although some men continue to experience urinary leakage.
12–24 months A smaller number of men may continue to experience gradual improvements, while others may need additional treatment for persistent incontinence.

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Does Incontinence Last as Long After TURP?

Not necessarily. Transurethral Resection of the Prostate (TURP) is different from radical prostatectomy.

During TURP, a surgeon removes part of the prostate tissue through the urethra, not the entire prostate gland. The procedure is commonly used to treat an enlarged prostate, otherwise known as Benign Prostatic Hyperplasia (BPH).

Some men experience temporary urinary leakage, urgency or difficulty controlling their bladder after TURP. These symptoms often improve as the urinary tract heals. The typical recovery time after TURP can take up to six weeks.

What Percentage of Men Have Incontinence After Prostate Removal?

Urinary leakage is very common immediately after radical prostatectomy, particularly when the urinary catheter is first removed. However, the percentage of men who experience incontinence depends on when it is measured and how researchers define continence.

For example, the Moretti et al. study found that incontinence is widespread, affecting roughly 58% to 66% of patients at 1 month. However, as the pelvic floor heals, incontinence drops significantly over the first year, leaving only 14% to 19% of men with long-term incontinence at 12 months.

That said, there is no single percentage that accurately represents every man who has undergone prostate removal. The likelihood of persistent leakage depends on the patient’s health, surgical factors and the definition of incontinence used in each study.

How Surgery Can Affect Prostate Incontinence

The removal of the prostate gland, alteration through treatments like radical prostatectomy, radiotherapy, or High-Intensity Focused Ultrasound (HIFU) can lead to what is known as prostate incontinence. These treatments, while effective in combating prostate cancer, may affect the nerves and muscles involved in bladder control, leading to conditions such as stress incontinence, where activities that increase abdominal pressure cause unintended urine leakage.

Radiation therapy, in particular, might irritate or damage the surrounding healthy tissues, exacerbating issues with bladder storage and control, thus contributing to urge incontinence, where there is a frequent, urgent need to urinate.

Types of Urinary Incontinence After Prostate Surgery

Men may experience different types of urinary leakage depending on the structures affected and their bladder function.

Stress urinary incontinence

This is particularly common after radical prostatectomy. It occurs when urine leaks during activities that put additional pressure on the bladder, such as:

  • Coughing or sneezing.

  • Laughing.

  • Walking or exercising.

  • Lifting heavy objects.

  • Standing up or changing position.

Urge urinary incontinence

This occurs when a sudden, intense urge to urinate is followed by involuntary leakage. It may be associated with an overactive bladder.

Mixed urinary incontinence

Some men experience both stress and urge incontinence, meaning they leak urine during physical activities and also experience sudden urges to urinate.

What Factors Affect Recovery After Prostate Surgery?

The timeline for recovery from incontinence after prostate surgery can vary greatly. Key factors influencing this include the patient's age, overall health, and the condition of bladder control prior to surgery. 

Younger, healthier patients may find their recovery period shorter, often regaining full control within a few months. Conversely, older patients or those with pre-existing health conditions might face a longer road to recovery.

Despite these challenges, the outlook is usually positive. Most patients will notice a significant reduction in urine leakage over time, with consistent improvement. Engaging in targeted exercises to strengthen the pelvic floor muscles is a crucial step in this recovery process. These exercises enhance the support for the bladder and the remaining external valve, improving control over urine flow and reducing overflow incontinence in men.

Why Does Incontinence Happen After Prostate Surgery?

The prostate gland sits just below the bladder, surrounding the upper part of the urethra; the tube which carries urine out of the body. Urine flow is controlled by muscles known as the urinary sphincters, which are there to help keep the urethra closed until you are ready to urinate.

When the prostate gland is removed it can affect the urinary sphincter, its supporting structures and the nearby nerves involved in bladder control.

Here are some of the reasons men experience temporary or persistent difficulty controlling urine following prostate surgery: 

Damage or weakening of the urinary sphincter

The urinary sphincter muscles help keep the urethra closed between trips to the toilet. During prostate removal, the external urinary sphincter or the tissues supporting it can be affected. When the sphincter cannot close tightly enough, urine may leak whenever you cough, sneeze, lift or walk.

Pelvic floor muscle weakness

The pelvic floor muscles provide support to the bladder and help maintain urinary control. If these muscles become weakened or lose their coordination following surgery, they may be less effective at supporting the urinary sphincter.

This can make it harder to control urine. This tends to happen particularly when moving, exercising or putting pressure on the abdomen.

Changes in bladder function

Prostate surgery can also be followed by changes in how the bladder stores urine. Some men develop bladder overactivity, which causes the bladder muscle to contract involuntarily.

This can lead to urinary urgency, frequent urination and urge incontinence, where urine leaks before reaching the toilet.

Nerve irritation or damage

Nerves surrounding the prostate help coordinate bladder function and urinary control. Although surgeons try to preserve important nerve structures, surgery and the body's subsequent healing process can affect nearby nerves.

This may interfere with the coordination of bladder storage and emptying, contributing to urinary symptoms during recovery.

How to Manage Incontinence After Prostate Surgery

Although urinary leakage can be frustrating, there are several ways to manage it while bladder control recovers.

Practise pelvic floor exercises

Pelvic floor muscle exercises, commonly known as Kegel exercises, help strengthen the muscles that support the bladder and control urine flow.

These exercises are frequently recommended before and after radical prostatectomy to support continence recovery.

A specialist nurse or pelvic floor physiotherapist can explain how to identify and exercise the correct muscles.

It is important to follow the exercise programme recommended by your healthcare team rather than repeatedly contracting the muscles without guidance.

Use suitable male incontinence protection

Male incontinence protection products are a practical way to manage urine leakage during recovery after prostate surgery. MoliCare® has a wide range of incontinence products designed to absorb urine, retain moisture and help control odours.

You can choose the right incontinence product depending on how much urine you lose, how often leaks occur and the level of protection you need throughout the day and night.

There are several types of men's incontinence products available:

  • Male-specific incontinence pads: There are small pads like MoliCare® Pad 2 Drops which are designed to fit the male anatomy. They are discreet pads suitable for light to moderate leakage..

  • Absorbent underwear: If you prefer not to wear a separate pad, MoliCare® MEN Absorbent Underwear provides built-in absorbency in a boxer-short style.

  • Pull-up incontinence pants: For moderate to heavier leakage, pull-up pants like MoliCare® premium Mobile 5 Drop Small gives a familiar underwear-style fit with different absorbency options.

  • Larger shaped pads: Large pads like MoliCare® Premium Form MEN 6 Drops offer a larger absorbent option for men who need more coverage than a small male-specific pad.

  • All-in-one fixation briefs: For heavier leakage or when additional coverage is needed, products like MoliCare® Premium Elastic are available in different absorbencies.

 

Maintain good skin hygiene

Frequent urine leakage can expose the skin to moisture and increase the risk of irritation.

To help protect the skin:

  • Change wet or soiled incontinence pads regularly.

  • Clean the affected area gently using suitable cleansing products.

  • Pat the skin dry rather than rubbing it.

  • Use an appropriate skin protection product if recommended by your healthcare professional.

The MoliCare® Skin range has products like foam and barrier creams to help support daily hygiene and keep skin comfortable. 

Using suitable cleansing and skin protection products alongside the right absorbent incontinence product can help make managing postoperative leakage more comfortable.

Maintain healthy hydration and identify bladder irritants

Drinking enough fluids is important for general health and normal bladder function. That said, reducing fluid intake too much can lead to concentrated urine, which may irritate the bladder.

Some drinks can also increase bladder sensitivity and make urinary symptoms worse.

Some of common examples bladder irritants include:

  • Coffee and other caffeinated drinks.

  • Alcohol.

  • Fizzy drinks.

You don’t  necessarily need to avoid these completely. Instead, monitor whether particular drinks make your symptoms worse and discuss any changes with your healthcare professional.

Monitor your progress

Keeping a simple record of your recovery can help you understand whether bladder control is improving.

You could record:

  • How many incontinence pads you use each day.

  • Whether leakage occurs during physical activities or at rest.

  • How frequently you experience sudden urges to urinate.

  • Whether nighttime leakage is improving.

This information can also help your urologist or continence nurse assess your progress during follow-up appointments.

Treatment Options for Incontinence After Prostate Surgery

For men whose urinary leakage persists despite pelvic floor exercises and other conservative measures, further treatment options may be considered. The most appropriate approach depends on the type and severity of incontinence..

Pelvic floor physiotherapy

A specialist physiotherapist can assess pelvic floor muscle function and provide a structured exercise programme.

Guided pelvic floor muscle training may help men improve urinary control and manage postoperative leakage.

Medication

Medication may be recommended for certain bladder symptoms, particularly urgency and overactive bladder.

However, medicines are generally less effective for stress urinary incontinence caused by weakened sphincter function.

A healthcare professional can assess the symptoms and recommend suitable treatment.

Male sling procedure

A male sling is a surgical treatment that provides additional support to the urethra, helping improve urinary control. It may be suitable for selected men with mild to moderate stress urinary incontinence after prostate surgery.

Artificial urinary sphincter

An Artificial Urinary Sphincter (AUS) is a device designed to replace the function of a weakened urinary sphincter. It consists of an inflatable cuff placed around the urethra, a control pump positioned in the scrotum and a pressure-regulating balloon.

Whenever you want to urinate, you activate the pump to temporarily open the cuff and allow urine to pass.

An AUS may be recommended for men with persistent, particularly moderate to severe, stress urinary incontinence.

Non-Surgical Options for Incontinence After Prostate Surgery

Of course, it is better to opt for non surgical options before considering surgical choices, as most of these can be handled naturally and in your free time.

Bladder Training Techniques

This method is useful for those unsure of how many times a day to urinate, and therefore stabilise bladder capacity and control. By gradually increasing the time between urination, you can significantly improve your ability to hold urine, reducing the frequency and urgency of bathroom trips.

Medication Options

For symptoms of an overactive bladder, medications provide another layer of support. Antimuscarinics such as Oxybutynin, Tolterodine, and Solifenacin, along with beta-3 agonists like Mirabegron, relax the bladder muscles, increasing its storage capacity and reducing leakage. Your healthcare provider will recommend the most suitable medication based on your specific symptoms and health profile.

Lifestyle Adjustments and Support Tools

These include the following:

When Should You See a Doctor About Urinary Leakage After Prostate Surgery?

Urinary leakage will often improve gradually after prostate surgery. However, speak to your urologist if you are not noticing improvements, or leakage continues to affect your everyday life.

Further treatment may be considered if stress urinary incontinence persists despite pelvic floor exercises and other conservative measures. 

For men with severe leakage and little improvement, surgical options may be discussed from around six months after prostate treatment. For others with persistent, bothersome leakage, surgery is generally considered at around 12 months.

You should not wait this long to seek medical advice. Contact your healthcare team if:

  • Your urinary leakage is worsening rather than improving.

  • Incontinence remains bothersome or affects your daily activities.

  • You experience pain or a burning sensation when passing urine.

  • Your urine becomes cloudy or unusually smelly, particularly alongside other signs of infection.

  • You have difficulty emptying your bladder.

  • You suddenly cannot pass urine, especially if accompanied by lower abdominal pain or swelling. Seek urgent medical attention in this situation.

Your urologist can assess your symptoms, investigate underlying causes and discuss suitable treatment options based on your recovery and the severity of your leakage.

FAQs

How long does incontinence last after prostate surgery?

Most men notice improvements in urinary incontinence within 3 to 6 months following radical prostatectomy. However, some men take 12 months or longer to regain bladder control fully. A smaller number experience persistent leakage and may need additional treatment.

How long does incontinence last after robotic prostatectomy?

Urinary leakage after robotic-assisted radical prostatectomy usually improves over several months. Many men notice improvements within 3 to 6 months, while studies show that continence generally improves towards pre-surgery levels by 12 months. In general, recovery varies between individuals.

What percentage of men have incontinence after prostate removal?

Most men experience some urinary leakage immediately after the catheter is removed following radical prostatectomy. However, the percentage experiencing persistent incontinence varies depending on the studies, follow-up period and definition of continence. Most men regain urinary control within 12 months, although some continue to experience leakage.

Why do men experience urinary incontinence after prostate surgery?

Urinary incontinence can occur because radical prostatectomy affects the urinary sphincter and surrounding structures responsible for controlling urine flow. Changes to pelvic floor muscle function and bladder activity can also contribute to leakage.

How do you stop urine leakage after prostate surgery?

Pelvic floor exercises are commonly recommended to help improve bladder control after prostate surgery. Other management strategies include using suitable male incontinence pads, maintaining good skin hygiene, drinking enough fluids and identifying potential bladder irritants. Men with persistent leakage should discuss further treatment with their urologist.

How long does incontinence last after TURP?

Urinary symptoms after TURP usually improve as the urinary tract heals. Recovery following the procedure can take up to six weeks, although individual experiences vary. Persistent or worsening leakage should be discussed with a healthcare professional.

Can alcohol make incontinence worse after prostate surgery?

Yes. Alcohol may irritate the bladder and increase urine production, potentially making urgency or leakage worse in some men. Reducing alcohol intake may help manage symptoms during recovery. However, its effects vary between individuals.

Is it normal to still leak urine six months after prostate surgery?

Some men continue to experience urinary leakage six months after radical prostatectomy. Although many notice significant improvements within the first three to six months, recovery can continue for longer. Speak to your urologist if leakage remains bothersome or has not improved. Further assessment and treatment may be appropriate.

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