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Prostate cancer: Urinary incontinence

Problems urinating can be a side effect of some treatments for prostate cancer for many men, including those who have had operations, high intensity ultrasound, cryotherapy freezing treatment or radiotherapy.

Urinary problems include:

  • Incontinence or leaking urine, which can range from considerable leaking to a few drops.
  • Stress incontinence, which is dribbling or leaking urine during exercise, coughing or sneezing.
  • Needing to urinate a lot more often than usual.
  • Having to get up in the night a lot to urinate, called nocturia.
  • Urge incontinence, having a sudden urge to urinate but not always getting to the toilet in time.
  • Urine retention, not fully emptying the bladder or a weaker or slower stream of urine.

Treatment and help is available for urinary problems as a result of prostate cancer through the cancer care team or with a referral to a specialist NHS continence service.

Why do prostate cancer treatments cause urinary incontinence?

Removing the prostate through surgery or destroying it through radiotherapy or other methods disrupts the way the bladder holds urine and can result in urine leakage. Radiotherapy 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.

When removing the prostate, surgeons try to save as much as they can 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.

The risk of urinary problems should be explained by doctors when recommending a type of treatment.

Some men will have only temporary problems controlling their urine, and many will regain full control of their bladder in time.

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