What is urinary incontinence?

Urinary incontinence or leaking urine is a common side effect of prostate cancer treatment. Some treatments for prostate cancer, such as prostatectomy and radiotherapy, can cause damage to the nerves and muscles needed for peeing. Your individual risk of developing urinary incontinence will depend on your treatment and whether you have had problems with leaking urine before.

Will urinary incontinence improve over time?

Urinary incontinence can range from mild, where you leak small amounts of urine when you cough or sneeze, to severe, where you leak more frequently. Incontinence following surgery is usually temporary but it can take up to six months to improve. There are also many treatment options available, and you can speak to your doctor to decide which treatment is most suitable for you.

Most people find that leaking urine after surgery is temporary and that they can manage their urinary incontinence with pelvic floor exercises, absorbent products and lifestyle changes.

Pelvic floor exercises

The muscles you need for peeing are called pelvic floor muscles and exercising these muscles helps with urinary incontinence. The NHS recommends that you sit comfortably and squeeze these muscles 10 to 15 times. If you are unsure of where to find these muscles, you will be able to feel them if you imagine that you are trying to stop the flow of urine when you pee. Be aware that stopping the flow of urine midstream can harm your bladder, so do these exercises at another time.

Absorbent pads

Absorbent pants and absorbent pads that can be worn inside underwear are available. There are different types and sizes available depending on the amount of absorbency that you need and your own personal preferences.

They are designed to be as discreet as possible and can make it easier to manage leaks. It is important to change pads regularly and clean the skin around the area to prevent soreness. Depending on where you live, you may be able to get free products on the NHS, but they are available in most supermarkets and pharmacies. Products can also be ordered online and most retailers will offer discreet packaging and delivery.

Penile sheaths are an alternative to absorbent pads. These fit over the penis like a condom and a tube attaches the sheath to a drainage bag that collects any leaking urine.

Access to public toilets

It can be reassuring to know that you can access public toilets easily when out. The charity Bladder and Bowel UK offer free Just Can’t Wait cards. You can show in shops, restaurants and other establishments to access a toilet quickly and without further explanation. The card cannot guarantee access to a toilet, but it is accepted and recognised by most establishments.

Order your free Just Can’t Wait card here: https://www.bbuk.org.uk/just-cant-wait-card-request/

Lifestyle changes

Smoking causes coughing, which puts pressure on the pelvic floor muscles, so stopping smoking may help. You should also avoid drinking caffeine and alcohol as they irritate the bladder.

Maintaining a healthy weight is important as excess weight can add additional strain. Lifting heavy objects and high-impact exercise such as running can add pressure to pelvic floor muscles. Strengthening exercises such as Pilates can help to strengthen these muscles and relieve symptoms.

Ensure you are drinking enough water (the current recommendation is six-to-eight glasses per day). Reducing the amount of water that you drink can cause dehydration and reduce bladder capacity. This can make incontinence worse.

Constipation can put pressure on the pelvic floor muscles, so it’s important to eat a fibre-rich diet and drink plenty of fluids. If you do become constipated, seek treatment as soon as possible.

Sling surgery

If lifestyle changes and pelvic floor exercises don’t help and you are still leaking urine, your doctor may recommend sling surgery. This involves an operation to insert a sling to support the urethra  and prevent leaks. The urethra is the tube that runs through the penis and enables urine to pass out from the body. Sling surgery may not be suitable if you experience heavy leaking or if you have had radiotherapy.

Following surgery, you may experience stinging when peeing and some people have difficulty in emptying their bladder completely when they pee.

Artificial sphincter

Another option is an artificial urinary sphincter, which is inserted via an operation. Following the surgery, you may notice blood in your urine and a slight burning sensation when you pee.

The artificial sphincter is made up of three parts:

  • A cuff that surrounds the urethra. When filled with fluid, the cuff tightens around the urethra, preventing urine from leaking.
  • A small pump placed in the scrotum, which connects to the cuff. This pump is used to control the fluid in the cuff, depending on whether you want to stop the flow of urine.
  • A balloon or fluid-filled reservoir is placed in the tummy. Fluid is passed between the reservoir and the cuff to control urine flow.

Unfortunately, for some people the artificial sphincter will stop working so they will need to have another operation.


If lifestyle changes and pelvic floor exercises don’t help and you are unable to have surgery, your doctor may prescribe medicines. There are a variety of medicines that can relieve urinary incontinence. You and your GP will decide which medicine is best for you, based on your personal experience and any other health conditions you may have.

Emotional wellbeing

Talk to people

It can be difficult to talk about urinary problems but expressing how you feel may help. You can talk to people that you know and trust, such as friends and family. Some people find it easier to talk to someone they don’t know. Your doctor may be able to refer you to a counsellor.


Consider a support group

Some men find support groups extremely valuable. They provide a safe space to ask questions, share experiences and listen to others in a similar situation. This can help you understand your own emotions and realise that you are not alone.

For more information and contact details for support groups and other useful organisations:

Prostate Cancer Help

Prostate Cancer Help
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