Question

Since my prostatectomy for an enlarged prostate I've had trouble holding my urine. It's very embarrassing at times. Is there something that can be done?

Answer

It is really important for you to know that prostatectomy is often followed by months of difficulty controlling urine flow, a condition known as urinary incontinence. But new research suggests that this problem may go away more quickly if the men perform certain exercises to strengthen their pelvic floor muscles. We can appreciate your feelings of embarrassment, but you do not mention the time gap since your surgery was performed. Urinary incontinence which continues after some months is obviously a serious complication of prostate surgery. It is therefore critical for you to establish with your own treating urologist, the precise type of incontinence you have and its severity in order to try to predict its progress and, if need be, to decide on the most suitable treatment for you.
 

There are five relevant types of incontinence: (1) passive or persistent incontinence (2) stress incontinence (3) urge incontinence (4) mixed incontinence (5) after-dribble.- Please see first related link below for explanation of these five different types of incontinence.
The tincture of time and healing will cure the vast majority of cases within six months. Treatment required may include medication, pelvic floor (Kegel) exercises or possibly further surgery, depending on the type of incontinence experienced. Kegel exercises relax and contract the pelvic floor muscles may help to regain urinary control following surgery. It may be necessary to learn these particular exercises from a professional trained in this such as a urology nurse practitioner. If this is what is needed in your case it is not too late to learn these exercises and commence doing them. Researchers from the Kaiser Permanente Medical Center in Los Angeles, California, found that men who were taught how to perform pelvic floor exercises (commonly known as Kegel exercises) before and after surgery were more likely to have regained continence three months later.
 

Very occasionally the condition is found to be untreatable or else the treatment available is not suitable for you. There are then many different products which may help you to cope with and disguise your problem, thereby enabling you to lead a full, normal life, despite incontinence. Pads and pants, penile sheaths, body-worn appliances and dribble pouches are available for different needs. Should this be necessary, discuss your needs with your urologist who can guide you to the appropriate assistance. We wish you all the best and hope, as you no doubt do, that it will be merely the tincture of time and possibly Kegel exercises which are needed. If this is not the case, you are not alone, and there is much support available for urinary incontinence. See related links below for further information.
 

Related Links
Bladder Control after a Prostate Operation
Exercises Speed Return of Bladder Control After Prostate Surgery
Pelvic floor exercises for Men
Incontinence Support
Incontinence Support Group