Intended for healthcare professionals


Urinary incontinence after treatment for prostate cancer

BMJ 2011; 343 doi: (Published 18 November 2011) Cite this as: BMJ 2011;343:d6298
  1. Ruth Doherty, specialist registrar in urology,
  2. Zaki Almallah, consultant urological surgeon
  1. 1Department of Urology, Queen Elizabeth Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK
  1. zaki.almallah{at}

Long term morbidity can be minimised by early referral to specialist centres

Prostate cancer is the most common cancer in men, making up 25% of all new diagnoses of cancer in men.1 Most cases are confined to the prostate at diagnosis and therefore amenable to radical surgery.2 The number of radical prostatectomies being performed in England has increased exponentially from 972 in 1998-9 to 3092 in 2004-5, so the incidence of post-prostatectomy urinary incontinence has probably increased. This problem can be expected only to get worse if routine prostate specific antigen screening is undertaken nationally.3

An estimated 14-20% of patients who have undergone radical prostatectomy will need to use absorbent pads as a long term means of managing their urinary incontinence.4 The morbidity of stress urinary incontinence in men who are relatively young and fit can be devastating and can lead to a loss of confidence, avoidance of social interaction, and even depression.5 Patients are often poorly advised about urinary containment options such as pads and external collecting devices.

Urinary incontinence after prostatectomy can be the result of bladder overactivity, …

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