How to control leaks and other urinary problems after prostate cancer

Close up of Black man wearing glasses

Leaks and sudden trips to the bathroom can affect how confident you feel in public or at home. After some prostate cancer treatments, many men experience leaking of urine (pee) immediately after or in the months following treatment. They may also need to urinate more often or have difficulty urinating.

Controlling urinary leaks after a radical prostatectomy

After surgery for prostate cancer many men experience urinary leaking. The leaking is usually worse straight after treatment and improves in the months following.

Leaks can happen at any time and catch you off guard. For some men, leaks happen more in the evening than during the day. This is because our muscles get weaker as we get tired later in the day. Just like your other muscles, the muscles controlling your urine get tired too.

Try products designed to control leaking

To keep you comfortable and protected no matter what time of day, you might want to try incontinence products such as:

  • Pads that sit inside your underwear.

  • Underwear briefs that slide on and absorb leaks easily—many men say these feel just like regular underwear.

These products are meant to keep you confident and comfortable, day or night, so you can continue to do the things you love without slowing down. There are a variety of options available depending on where you live. Your doctor or nurse can recommend some good options that may be cheap and convenient.

Tip: Some men prefer to use women’s pads. Women’s pads are often very absorbent and designed to be comfortable and undetectable.

Where can you buy incontinence products?

Ask at your local pharmacy or look in the health product aisles of supermarkets to find the products to try. It’s important to find what works for you and then you can stock up.

If you’re worried about buying them in person, check online for options that can be delivered to your door.

"Incontinence was a big change for me. I started wearing pads because I couldn't control the leakage, but I had a hard time getting used to having them in my life every day. But once I learned how to use them more effectively, I learned how to handle it a lot better."

Michael, 67

For more on finding the most suitable continence product for you, visit Continence Product Advisor or the Continence Foundation of Australia.

Talk to your doctor, nurse or care team

If your leaking is heavy and preventing you from doing your usual daily activities, speak to your family doctor or a continence nurse specialist about getting help. In Australia, your GP can refer you to a local continence service that specialises in urinary problems.

Controlling urinary problems after radiation therapy (radiotherapy)

Needing to urinate more often and difficulty urinating are two common problems after radiation therapy. To take control, there are things you can do at home and treatments your doctor might recommend.

Needing to urinate more often (urinary frequency)

If you're experiencing urinary frequency, your doctor might recommend various treatments, including:

  • Bladder retraining. A specialist continence nurse or physiotherapist can give you information about a technique called bladder retraining that can help you control when you urinate and have to go less often.

  • Medicines. Anti-cholinergics are drugs that can help reduce frequency, urgency, and leaks. Speak to your doctor to see if these can work for you.

  • Percutaneous tibial nerve stimulation (PTNS). A doctor places a needle under the skin, just above the ankle, and a low electrical current is passed through the needle. This affects the nerves that control urination, with the goal to stop the bladder from emptying before it’s full.

  • Botox. Having a botox injection in the wall of the bladder can help with urinary frequency and urgency.

Difficulty urinating and urinary irritation

Radiation therapy can irritate the lining of your bladder and urethra, and make your prostate swell a bit, which can make it difficult to urinate. It can be hard to start, may burn a little and you may not feel like you’re emptying your bladder completely because the prostate might be blocking your urethra.

    To help improve things, your doctor might recommend using:

  • A catheter to drain urine.

  • Surgery to widen the urethra or the opening of the bladder.

  • Medicines (alpha blockers or 5-alpha-reductase inhibitors).

If you suddenly can’t urinate and it’s painful, head to your nearest emergency department or call your doctor or nurse right away. This needs treatment immediately.

Lifestyle changes to help you manage urinary issues

Constipation can make your leakage worse by adding pressure against your bladder. Make sure you’re getting plenty of fibre daily to get your bowels moving. Start with small portions and gradually increase the amount of higher fibre foods in your diet.

Learn more about healthy eating.

When you don’t drink enough water and fluids, your urine becomes darker and more concentrated. This can irritate your bladder wall and cause leaks. Make sure you stay hydrated to improve your bladder control and bowel function, avoiding alcohol and caffeine. You can start by sipping fluids slowly throughout the day, versus drinking large amounts at once.

Quitting smoking can improve your health all around. Talk to your doctor about options to help you stop smoking or gradually cut back.

Some men will find it helpful to reduce caffeine, as caffeine can irritate your bladder and affect how well it works.

    Food and drinks with caffeine include:

  • Chocolate.

  • Coffee.

  • Tea.

  • Fizzy drinks, such as Coca Cola and Pepsi.

  • Energy drinks.

In the early stages of recovery, you may need to adjust your exercise routine. High impact exercise can increase leakage. If your routine includes heavy strength training (using weights), reduce your weights. Speak to your doctor or nurse about a suitable exercise program for you.

Find more information on exercise.

Some medications can affect your urinary health. Please talk to your doctor or pharmacist to ask any questions and understand what you’re taking.

Some foods can also irritate your bladder. These include spicy foods, some acidic citrus foods such as oranges and grapefruit, fruit juices, and tomato-based foods. You can try using a food diary. Eliminate these foods for about a week and re-introduce them back, one by one, to see if there is any change.

Continence services and resources

Look for continence services and resources

The Continence Foundation of Australia is a good place to start and has a database that you can search to find a service near you. There’s also a free helpline you can call if you need to talk or have questions.

Know where to find a toilet

To help ease your mind and to make sure you know where to find toilets when you’re out, you can use a toilet finder tool to find the public toilet nearest you.

In addition, the Master Locksmiths Access Key (MLAK) offers a key that may help get you access to locked public toilets. If you live in Australia and meet the requirements, you can order a key using the online form.