Urinary Dysfunction After Prostate Cancer Treatment

The term urinary dysfunction includes:

• Urinary incontinence, which can range from some leaking to complete loss of bladder control

• Irritative urination symptoms, including increased urinary frequency, urgency, and pain upon urination


Following Prostatectomy

Incontinence is the primary urinary side effect and is common, but it usually occurs only temporarily after surgery. On average, in the hands of a skilled surgeon, about 10-15% of men report frequent leakage or no control and a need to use absorbent pads at six months after treatment. By three years, fewer than 10% report using pads at all.

Up to 50% of men with normal function before treatment will report some increase in urinary symptoms and urgency after prostatectomy. This seems to be reduced if a nerve-sparing technique has been possible. Conversely, men with some irritative or obstructive urination symptoms from an enlarged or inflamed prostate experience relief from these symptoms after surgery

Following External Beam Radiotherapy

Radiotherapy can irritate both the bladder and the urethra, causing inflammation or swelling of the prostate. Most symptoms lessen over time with little or no intervention: Up to 45% of men report irritative urination symptoms after six months, but the majority resolve by one year. However, the symptoms can persist and even worsen in some men.

Following Brachytherapy

Urinary dysfunction following brachytherapy tends to be more severe initially. Over 70% of men have symptoms requiring medication within six months after seed implantation, but the rate drops to 25% or less after two years and to under 10% by three years. However, 20% to 40% of men with normal urinary function before treatment will have persistently increased urinary symptoms three years after receiving brachytherapy.

Management of Urinary Dysfunction

In cases of persistent urinary incontinence after prostatectomy, surgical procedures, including a sling that relieves pressure buildup in the abdomen or artificial sphincters provide long-lasting results.

Because the urinary symptoms following radiation therapy are irritative in nature, drugs that improve urinary flow and treat irritative bladder symptoms are commonly prescribed to men following radiation therapy for at least a few weeks. They are gradually withdrawn as symptoms improve.

Bowel Dysfunction After Prostate Cancer Treatment

The broad term of bowel dysfunction includes:

• Diarrhea or frequent stools

• Fecal incontinence or the inability to control bowel movements
• Rectal bleeding


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