What is urinary incontinence?​

Urinary incontinence is the accidental release of urine (pee).

It’s common for you to lose some bladder control after treatments for cancer of the pelvis, like radiation or surgery. This can be embarrassing and can disrupt daily activities.

Even if you have good bladder control during the day, you might still have incontinence when you sneeze, cough, or laugh. This is called stress incontinence. Stress incontinence happens when the muscle that holds the bladder’s outlet closed isn’t strong enough to hold back the urine. Incontinence usually gets worse later in the day because the muscles in the pelvic floor get tired.

There are treatments for incontinence and ways to help you manage it at home.

How long does incontinence last?

After pelvic surgery, like for prostate cancer, you may have incontinence for at least 3 months. It’s usually better after 6 months.

Pelvic floor physiotherapy

Pelvic floor physiotherapy is exercises you can do to strengthen your pelvic floor. Pelvic floor muscle strength is an important part of bladder control. Strong pelvic floor muscles can help decrease incontinence, help the bladder hold urine when you feel the urge, and make harder erections.

To do pelvic floor exercises, you will be tightening and relaxing your pelvic floor muscles. When the muscles in your pelvic floor are tightened, it should feel like you’re tightening the same muscles you use to stop the flow of urine or to pass gas. It feels like you’re lifting your scrotum up and inward. When the muscles in your pelvic floor are relaxed, it should feel you’re relaxing like when you pass urine.

To do pelvic floor exercises:

1. Empty your bladder and get into a sitting position.
2. Tighten your pelvic floor muscles as strongly as you can. It should feel like you’re lifting or pulling that area up. Don’t tighten the muscles in your stomach or buttocks and don’t hold your breath while you do the tightening.
3. Hold the tightening for 3 seconds, 5 seconds, or 10 seconds. Hold it only as long as you can fully hold it. It’s better to do a few really good tightening exercises than doing many that aren’t fully tightened.
4. Let go and relax.
5. Repeat this 10 times. The more you practice, the more muscle strength you’ll build up. If you keep doing the exercises, eventually you’ll be able to hold for 10 seconds.

Practice these pelvic floor exercises during the day. You can do the exercises while sitting, standing, lying down, or walking. Your muscles will get stronger if you do the exercises 3 to 5 times every day.

If you do pelvic floor exercises regularly, your incontinence may get better after a couple of months. If your symptoms don’t get better, talk to your doctor.

Managing incontinence and sex

Some couples struggle with urine leaking during sex. These ideas might help:

• Lay a towel out on the bed before sex. If urine leaks, the towel will absorb it.
• Keep a warm, wet cloth near you for easy clean up if needed.
• Remember that urine doesn’t have any germs in it, so it isn’t harmful if it leaks while having sex.
• Try having sex in the shower or bath.
• Use an erection ring (like the kind used with a vacuum erection device) to help prevent leaking.

 

Even if you have good control of your bladder during the day, you might still leak urine when you become aroused or have an orgasm.

If your incontinence isn’t getting better

Some people with severe stress incontinence might need surgery. Your doctor might want you to wait until after your cancer treatments to have surgery. Many doctors recommend waiting at least 1 year before having surgery for incontinence.

Your doctor will tell you what surgery is best for you. There are different types of surgery for incontinence:​​​​

• artificial sphincter
• urethral bulking
• bulbourethral sling (a sling is put under the urethra to support it and is attached to muscle or the pubic bone)
• electrical stimulation ​