Until puberty, the prostate is about the size of a marble. After puberty, it gradually increases to around the size of a golf ball, before growing again after the age of about 50.
For some men, the prostate enlarges to the point where it acts as a ‘clamp’ against the urethra. This can result in problems with urination, including difficulty starting to urinate, a frequent need to go, or incontinence.
An enlarged prostate, or benign prostatic hyperplasia (BPH), is common, particularly amongst older men. Depending on its severity, BPH can be managed with lifestyle changes, medication or surgery. Some of these treatments, namely surgery, can lead to incontinence.
Prostate cancer is when a malignant tumour forms in the prostate gland. The cancer can spread throughout the body and cause significant health problems. Prostate cancer is the most common type of cancer in men.
A common cure for this is to remove the prostate via surgery. After this procedure, some men experience incontinence.
Prostate cancer and prostate enlargement share similar symptoms, so it’s important to see your doctor if you notice anything abnormal.
Incontinence after prostate surgery
Surgery is the most common treatment for prostate enlargement and cancer, but the procedures are different.
In the former, surgery rarely requires the removal of the prostate gland, just the enlarged tissue. For prostate cancer, the gland is partially or completely removed. Despite these differences, the recovery process is similar. Both surgeries involve trauma to the urethra, which can cause bladder weakness.
If the prostate is removed or damaged through radiation, it can disrupt the way the bladder holds urine, resulting in incontinence. Prostate surgery can damage the nerves that help control bladder function, whilst radiation can decrease the capacity of the bladder and cause spasms that force urine out.
Lingering incontinence can be caused when the part of the bladder that controls urine flow is removed. Some men, however, train the remaining muscles in the bladder to take over that function over time.
How to improve prostate health
The causes of prostate cancer aren’t completely known, but there are steps you can take to help prevent it. This includes:
- Giving up smoking: smoking does more harm to your body as you get older, and men that smoke are more likely to die from prostate cancer, or experience a recurrence of the condition, than those that don’t.
- Exercising regularly: this can reduce your risk of getting prostate cancer. If you don’t regularly exercise already, speak to your doctor about the best method of exercise for you.
- Maintaining a healthy weight: obesity can increase your chances of developing prostate cancer, so aim to keep your BMI below 30.
- Eating plenty of fruit and vegetables: broccoli and tomatoes, in particularly, have been shown to reduce the risk of prostate cancer. Lycopene, the red pigment in tomatoes, and isothiocyanates in broccoli, are what doctors believe can help.
- Having regular prostate examinations: as you approach middle age, you should be having regularly check-ups. In addition, if you notice difficulty, pain or blood when you urinate, you must see your GP.
Improving symptoms of incontinence
Incontinence isn’t an uncommon side-effect of prostate surgery, but there are ways you can improve symptoms after surgery:
- Regular pelvic floor exercises: squeeze the same muscles you use to stop urinating mid-stream to strengthen your Kegel muscles.
- Avoid caffeine and alcohol where possible: these are diuretics, meaning they encourage the production of urine. Try to drink a little less before going to bed too.
How to talk to your doctor about incontinence
The best way to find out more about potential treatments or methods to manage your incontinence is to speak to your doctor.
Remember, the condition is not new to them and there is no reason for you to feel embarrassed. The sooner you seek advice, the sooner you can carry on as normal.
To get the most out of your appointment, try writing down information that might help with diagnosis, such as when you experience incontinence, how often, how much you leak, and any potential triggers you have noticed. This will help your GP to suggest a suitable treatment.
In the meantime, try using an incontinence product for men, such as a shield or guard, to allow you to carry on with your day, worry-free.
Treatments for incontinence
The best treatment for incontinence after prostate surgery will differ between men, but below are some of the options available:
- Medication: there are various medications available that increase bladder capacity, meaning the need to go to the toilet will be less frequent.
- Neuromuscular electrical stimulation: this is used to improve bladder control by strengthening weak urinary muscles. It works by sending a mild electrical current to nerves in the pelvic muscles or lower back.
- Artificial sphincter: this device is made of silicone rubber and fits around the urethra to prevent urine from leaking.
- Male bulbourethral sling: a synthetic mesh sling is inserted to support the urethra and restore bladder control.
- Other surgery: other surgical methods include placing rubber rings around the tip of the bladder to help hold urine.
Managing incontinence after surgery
If you’re experiencing incontinence after prostate surgery, try using incontinence guards, shields or underwear to help you manage the condition and allow you to continue enjoying your favourite activities.