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Prostate Cancer: Urinary Incontinence

Urinary incontinence, or the loss of the ability to control urination, is common in men who have had surgery or radiation for prostate cancer. You should prepare for this possibility and understand that, for a while, at least, urinary incontinence may complicate your life.

There are different types of urinary incontinence and differing degrees of severity. Some men dribble urine whereas others will experience a total leakage. Loss of urine with a cough, sneeze or laugh is called stress incontinence and is the most common type of urine leakage men experience after prostate surgery. On the other hand, the need to frequently urinate with episodes of leakage is the type seen most often after radiation treatment. Doctors continue to improve treatments for prostate cancer to reduce the chance of having incontinence after surgery or radiation.

Incontinence (OAB) Types and Concerns

Urinary incontinence affects about 12 million Americans -- more women than men. It happens when you lose urine by accident.

Other Types of Incontinence

Slideshow: Urinary Incontinence in Women

Urinary incontinence, or loss of bladder control, is a frustrating problem for more than 13 million Americans. View the slideshow.

Why Do Prostate Cancer Treatments Cause Urinary Incontinence?

It helps to know a bit about how the bladder holds urine. When urine is emptied into the bladder from the kidneys, it is stored inside the bladder until you have the urge to urinate. The bladder is a hollow, muscular, balloon-shaped organ. Urine flows out of the bladder, and leaves the body through a tube called the urethra. Urination happens when the muscles in the wall of the bladder contract, forcing urine out of the bladder. At the same time, muscles that surround the urethra relax and allow the flow of urine. The prostate gland surrounds the urethra. Because enlarged prostate glands can obstruct the urethra, a man with an enlarged prostate can have urination retention or other problems with urination.

Removing the prostate through surgery or destroying it through radiation (either with an external beam or with radioactive seed implants) disrupts the way the bladder holds urine and can result in urine leakage. Radiation can decrease the capacity of the bladder and cause spasms that force urine out. Surgery can, at times, damage the nerves that help control bladder function.

What Are Some New Techniques that Reduce the Chance of Becoming Incontinent?

When removing the prostate, surgeons try to save as much of the area around the bladder and the sphincter muscles around the urethra, thus limiting damage to the sphincter. Doctors have also fine-tuned the process of placing radioactive seed implants, using sophisticated computer projections that allow the seeds to destroy the prostate while limiting damage to the bladder.

Still, at this point, any man who is undergoing radiation or surgery to treat prostate cancer should expect to develop some problems with urinary control. With newer techniques, some men will have only temporary problems controlling their urine, and many will regain full control of their bladder in time.

WebMD Medical Reference

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