Post-Prostate Surgery Urinary Incontinence

Urinary leakage following radical prostatectomy and other procedures due to prostate cancer and/or an enlarged prostate

Causes

  • The prostate helps to maintain continence by creating closure of the urethra. Once this is removed, the urethra loses some of its closure mechanism, resulting in leakage of urine.

  • During surgery, nerves may be damaged through the process of removing all of the cancer. Nerve damage results in weaker pelvic floor muscles which are also involved in maintaining continence.

Signs & Symptoms

  • Leakage of urine with coughing, sneezing, laughing, standing from a chair, walking

  • Passive loss of urine (not feeling the leakage but noticing damp underwear)

Differential Diagnosis

  • Urinary Tract Infection

PROmotion Assessment 

  • Individualised and functional pelvic floor muscle exercises

  • Advice about fluids and diet

  • General exercise and strength training

  • Weight loss if indicated

How to Manage

  • Individualised and functional pelvic floor muscle exercises

  • Advice about fluids and diet

  • General exercise and strength training

  • Weight loss if indicated

References

  1. Sighinolfi, M. C., Rivalta, M., Mofferdin, A., Micali, S., De Stefani, S., & Bianchi, G. (2009). Potential Effectiveness of Pelvic Floor Rehabilitation Treatment for Postradical Prostatectomy Incontinence, Climacturia, and Erectile Dysfunction: A Case Series. J Sex Med, 6(12), 3496-3499. https://doi.org/10.1111/j.1743-6109.2009.01493.x