For many men, beating prostate cancer is a major victory—yet the journey doesn't always end when treatment does. One of the most common and often unexpected challenges afterward is urinary incontinence. While it can feel discouraging, men are far from alone, and there are effective solutions.
According to Dr. Phillip Westbrook, reconstructive urologist with Lexington Urology, "Incontinence after prostate cancer treatment is incredibly prevalent, and there are many ways we can help men regain control and confidence."
Why Incontinence Happens
The prostate sits just below the bladder and wraps around the urethra, which carries urine out of the body. Treatments like surgery, radiation, and ablation can affect the muscle responsible for controlling urine flow.
"During treatment, the urinary sphincter—the muscle that acts like a valve—can be weakened or damaged," explains Dr. Westbrook. "When that happens, men may experience leakage, especially during moments of pressure like coughing or lifting."
This type of leakage is called stress urinary incontinence, and it can vary from mild to severe.
First Steps: Conservative Treatment Options
Many men improve significantly without surgery. Dr. Westbrook emphasizes that "conservative therapies are always our starting point."
These options include:
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Pelvic floor (Kegel) exercises to strengthen muscles involved in bladder control.
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Lifestyle changes, such as reducing caffeine and alcohol, adjusting fluid intake timing, and maintaining a healthy weight
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Absorbent pads or protective underwear for day-to-day security
"These strategies help many men regain control," he says. “They're simple, safe, and often very effective."
When Conservative Treatments Aren't Enough
If symptoms persist, surgical treatment may offer long-term relief. Dr. Westbrook notes that "when leakage continues to interfere with life—even after pelvic floor therapy—men may be great candidates for surgery."
There are two main surgical options:
- Male Sling: This mesh sling lifts and supports the urethra to reduce leakage. "It's a great option for mild to moderate incontinence," Dr. Westbrook says. "However, men who have had radiation aren't typically candidates for a sling."
- Artificial Urinary Sphincter (AUS): Widely considered the gold standard, the AUS is ideal for moderate to severe incontinence. Dr. Westbrook describes it as "a small device implanted inside the body that lets men control urination by pressing a tiny pump hidden in the scrotum. It's discreet and highly effective."
Who Qualifies for Surgery?
Men may be candidates if they:
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Still experience significant leakage despite pelvic floor therapy
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Are at least 6–12 months post-treatment
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Are healthy enough for a surgical procedure
"We want leakage to be stable and predictable before we operate," Dr. Westbrook explains. "That helps ensure the best long-term outcome."
What Recovery Looks Like
Most procedures are outpatient or require only a short hospital stay.
"Most men can return to light activity within a couple of weeks and feel fully recovered in 4–6 weeks," says Dr. Westbrook.
For devices like the artificial urinary sphincter, the pump is usually activated after about six weeks. "Once it's turned on, men often experience life-changing improvement," he adds.
You're Not Alone—and Help Is Available
Incontinence can feel isolating, but Dr. Westbrook emphasizes that support and solutions are within reach.
“It's important for men to know that this is a medical issue—not something they have to 'tough out.' We have excellent treatments, and no one should hesitate to ask for help."
If you or a loved one is dealing with urinary leakage after prostate cancer treatment, a visit with a urologist can be the first step toward regaining comfort, confidence, and quality of life.
Phillip A. Westbrook, MD, Lexington Urology
Phillip A. Westbrook, MD, Lexington Urology
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