Temporary incontinence after surgery on the prostate is quite normal

After prostate surgery, many men experience temporary urinary incontinence. The good news first: In most cases, the incontinence alleviates on its own after prostate surgery. In order to go through everyday life without restrictions until then, incontinence products specially developed for men can serve as support. 
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Why does prostate surgery often lead to incontinence?

Surgery may be necessary for both benign and malignant enlargement of the prostate. We'll go into more detail about these two forms in the course of this article. 
If the prostate has to be surgically removed, parts of the urethra and its sphincter muscle are often affected. As the name suggests, this muscle at the bladder outlet is responsible for opening and closing the bladder. Damage can impair the ability of the sphincter muscle. 

However, it depends heavily on the age of the patient, certain pre-existing conditions, but also the surgical technique and the size of the prostate whether the sphincter muscle is actually affected. 

Alleviate stress and urge incontinence through targeted training 

If the muscle is injured during the operation, the result is often so-called stress incontinence, whereby "strain" in this case means an increased build-up of pressure due to sneezing, coughing, laughing or carrying heavy objects. This results in unwanted urine leakage. Stress incontinence – often referred to as stress incontinence – is the most common form of urinary incontinence after prostate surgery, but urge incontinence (often called overactive bladder) can also be a possible consequence. Those affected report a constant urge to urinate, even though the bladder is barely full. 

Unfortunately, it is anatomically very difficult not to injure the urethra during prostate surgery, as the prostate encloses the upper part of the urethra and parts of the sphincter. Fortunately, there is still the outer sphincter, which is usually not affected and can be strengthened through targeted training. The incontinence is thus alleviated again over time. 

Here are some simple pelvic floor exercises that you can easily incorporate into your daily routine. 

In addition to prostatectomy (removal of the prostate), treatment with radiotherapy can also weaken the bladder muscles and thus lead to male urinary incontinence. 

Causes of overflow incontinence in men

The fact that the prostate is enlarged is often manifested by problems with urination. As the prostate grows, the urethra becomes more and more constricted, which can lead to overflow incontinence (incontinence in chronic urinary retention) or urge incontinence. This happens in both benign and malignant enlargement. 
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Benign enlargement of the prostate gland

While the prostate gland in young men is still about the size of a walnut, the number of prostate cells increases steadily over the course of life. The prostate therefore grows and closes more and more tightly around the urethra. This change has nothing to do with prostate cancer, but it can still have an impact on continence. 

This is often associated with the following symptoms: 

Frequent urge to urinate, including at night. 

Difficulty starting urination. 

Weak urine flow and the feeling the bladder is never fully emptied. 

Unintentional urine leakage. 

The treatment of benign prostate enlargement depends on the individual symptoms and the size of the prostate. Medication can be used as well as prostate surgery can be considered. Your doctor will be happy to advise you on this. 

Risk factors for a benign prostate change include the use of hormones, hereditary factors, an unhealthy diet, smoking and alcohol consumption. 

Prostate cancer particularly affects older men

Prostate cancer is the most common type of cancer in men. According to the German Cancer Society3, 60,000 men in Germany are diagnosed with it every year. While this type of cancer is rare in younger men, the risk increases sharply with age. 

There are several methods for treating prostate cancer. One of them is the surgical procedure of radical prostatectomy (prostate removal). This therapy offers good prospects of recovery if the cancer has not yet spread. This is why it is the best treatment method for many patients, even though it may affect bladder function as a result and can lead to urinary incontinence. However, permanent incontinence occurs relatively rarely and only in severe cases. 

Incontinence often only temporary

Immediately after surgery, almost every man has difficulty controlling his bladder4. After about 3 months, every second man is still affected, but in the following months this number continues to decrease. 18 months after the radical prostatectomy, 4 to 21 out of 100 men still report that they lose urine involuntarily, especially in stressful situations such as coughing, sneezing or laughing. In these cases, the pressure in the abdomen and thus also on the bladder increases. After 5 years, about a quarter of those affected continue to use incontinence aids such as pads or disposable pants. In about 7%, urinary incontinence persists permanently. 

In addition to incontinence, erectile dysfunction can also occur after surgery on the prostate. As with incontinence, however, the symptoms improve in many men after a few months. 

Hygienic support for the time after prostate surgery

The ability to control the bladder and retain urine can vary in severity after prostate removal. 

The MoliCare® MEN products from HARTMANN enable an active life with a high level of comfort. These discreet incontinence products are adapted to the male anatomy and provide dryness and a feeling of security. 

For mild to moderate incontinence, even narrow hygiene pads and penis pockets help. Especially for active men, the MoliCare® MEN PAD are suitable. They are anatomically shaped and comfortable to wear thanks to the breathable textile backing. 

In the case of severe bladder weakness, it is important that larger amounts of urine are absorbed and do not leak. The disposable MoliCare® MEN PANTS have soft, leak-proof inner cuffs, are worn like normal underwear, and thus offer additional leak protection. 

You can find out more here: 

How to improve bladder control

Since part of the sphincter muscle is usually retained after a surgical removal of the prostate, it can be trained in a targeted manner and thus take over for the removed muscle. The difficulty is that many people do not know exactly where this muscle is located and how it can be strengthened. It is therefore advisable to work with a specially trained physiotherapist, especially at the beginning. You are welcome to find out more about this at the clinic. 

Basically, you can think of the pelvic floor as a muscle plate that supports the organs in the abdomen and has openings for the urethra and intestines. The better trained this muscle plate is, the more pressure it can keep away from the bladder, especially under strain. 

Pelvic floor exercises are easy to learn and can also be easily integrated into everyday life. Success usually comes after a few weeks, so be patient and keep at it. 

In addition, pelvic floor training can be supported by other measures. Modern biofeedback, electrical stimulation or surgical methods can be used for this purpose. 

You can find more information about pelvic floor training for men here: