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Urinary incontinence is a loss of bladder control. It can be as mild as a small leakage or as severe as a complete inability to hold urine. UI is a common complication of prostatectomy, and it is usually temporary. However, the condition lasts longer than a year in up to 8 percent of men.
The loss of bladder control after a prostatectomy is directly related to the surgery. Structures called sphincters hold urine in the body. When you relax these sphincters, urine flows out. Normally, there are two sphincters in the male urinary tract. One sphincter is at the bottom of the bladder; the lower sphincter sits below the prostate, behind the base of the penis. Because the urethra goes through the middle of the prostate, the prostate also holds some pressure on the urethra.
When surgeons remove the prostate, the only sphincter left in the urinary tract is the lowest one, closest to the penis. Because this sphincter is not used to working alone, it may not be strong enough at first to keep urine in the bladder.
Symptoms of UI in men can range from just a few drops of urine to a complete loss of bladder control. Doctors know that UI may become an issue after a prostatectomy, and they generally advise men to wear incontinence pads to trap urine and keep clothes dry. As you recover from surgery, the amount of leaking urine should go down over time.
Urinary incontinence can be embarrassing. The condition may also affect your sleep, since you may have to go to the bathroom multiple times a night.
To diagnose urinary incontinence, your doctor will take your medical history. You should talk about any illnesses, medical conditions, or surgeries you have had, including your prostatectomy. They will also need to know how much fluid you drink, whether you consume caffeine and how much, and any medications you take. Before your appointment, it may be helpful to keep a diary of when you notice any leaks and other urinary habits.
You may need other tests to determine exactly why you are leaking urine. These include:
There are several possible treatments for UI after prostatectomy. Doctors try the simplest treatments first.
Some nonsurgical treatments include:
Surgical treatments include: