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Post-Prostate Surgery Urinary Incontinence

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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.

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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

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