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Tips for Urinary Control After Prostate Surgery

Last updated: April 2022

Many of the treatment options for prostate cancer, including prostatectomy, external beam radiotherapy, or brachytherapy, can cause urinary problems after the treatment. Despite the use of nerve-sparing techniques, nerves and muscle tissue can sometimes get damaged during the treatment process.

When this happens, it is hard to predict how long it will take for you to get back control of your bladder and urinary function. This varies from one man to another and how long it may take depends on the type of surgery you had and whether you had any problems before or during your operation. Most men can regain control of their bladder within 3 to 6 months of their operation. But for some men, it may take as long as 1 or 2 years. Other men might need further surgery to get back their bladder control.

There are a variety of tips and strategies that men with urinary symptoms can use to help lessen the impact of urinary symptoms on their daily activities.

Post-catheter recovery

When you wake up from your operation you have a tube into your bladder (catheter) to drain urine. You will have this in place usually for a couple of weeks and then you go back to the hospital to have the catheter removed.

You are likely to have some urine leakage when the catheter is taken out. It’s a good idea to have a supply of incontinence pads at home and to take a couple with you to hospital. You can buy these at supermarkets and pharmacies. You also want to plan to have someone drive you.

Frequent urination or urgency

To help deal with frequent urination and/or the urgent need to urinate it may be helpful to reduce the number of drinks you consume daily that contain alcohol and caffeine. Some beverages and foods can be more likely to irritate your bladder than others, and it may be helpful to try to determine if you have any of these sensitivities. You may find that reducing your intake of the more irritating foods and beverages may help. In addition to alcohol and caffeine, some men find that their bladders are sensitive to carbonated drinks, chocolate, tomatoes, acidic fruits and juices, spicy foods, and artificial sweeteners.

Pain or burning

To help relieve the symptom of pain or burning during urination, it can also be helpful to avoid drinks that contain any of the irritants mentioned above and to drink more water to help dilute irritants that you do consume. There are some prescription and over-the-counter medications that can be used to help treat painful urination, but you should talk to your healthcare team before you start using medications or supplements for urinary symptoms.

Nighttime frequency

To help reduce the number of times you need to urinate during the night, it can help to avoid drinking fluids in the evening several hours before you go to bed. You do want to make sure to drink enough water during the day, however, so that you stay hydrated. You may want to wear a pad if you are not sure you can make it through the night.

Urine leakage

If you have the urgent need to urinate and you are worried about the possibility of urine leakage, it is tempting to run to a bathroom! However, this can actually make the feeling of urgency worse, which can make leakage more likely. Try to walk slowly and in control if you can. You may find that it helps you to try to relax and take a couple of slow, deep breaths when you have a feeling of urgency and that gives you the extra time to make it to the bathroom without rushing.

Ongoing issues with incontinence

Another way to help control frequent urination, as well as urine leakage and incontinence, is to strengthen the muscles around the bladder and the urethra. Pelvic floor exercises, also called Kegel exercises, involve tightening and then relaxing the pelvic floor muscles, which are the same muscles that you would use to stop your stream of urine while urinating.

Strong pelvic floor muscles can also mean increased sensitivity during sex and stronger orgasms. Strengthening and training the pelvic floor muscles over time can help many men reduce the symptoms of erectile dysfunction.

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