Can prostate problems cause incontinence?

Prostate health is a crucial aspect of men’s overall well-being, yet it often doesn’t receive the attention it deserves. Prostate Cancer UK, a leading men’s health charity, works tirelessly to provide information and support to men and their families. In collaboration with John Robertson, a specialist nurse at Prostate Cancer UK, we aim to shed light on prostate health, common prostate problems, and the support available.

The prostate is a small gland located beneath the bladder. Its main role is to help produce semen, the fluid that transports and nourishes sperm. Despite its small size, the prostate can significantly impact a man’s health, especially as he ages.

Prostate trouble in men includes prostate enlargement (an extremely common condition that affects more than 1 in 3 men over 501), prostatitis (inflammation of the prostate), prostatitis discharge, as well as prostate cancer. 

Benign prostate enlargement, also known as an enlarged prostate, is a common condition as men get older. Early on, it may not cause any symptoms. However, as the prostate grows, it can lead to urinary issues such as:

• Increased frequency of urination, especially at night
• A weak or interrupted urine stream
• Difficulty starting urination
• A feeling that your bladder hasn’t emptied properly
• Dribbling urine after you finish urinating
• A sudden urge to urinate – you may sometimes leak before you get to the toilet.

You may not get all these symptoms, and some men with an enlarged prostate don’t get any symptoms at all. These symptoms can also be caused by other things, such as cold weather, anxiety, other health problems, lifestyle factors, and some medicines. If you have any symptoms, visit your GP to find out what may be causing them.

Blood in your urine may be a symptom of an enlarged prostate. But this is rare and is usually caused by something else. Tell your doctor if you have blood in your urine.

One common myth is that urinary changes are just a normal part of ageing and should be ignored. While ageing can bring about some changes, it’s important to talk to your GP about any symptoms you have and to not ignore them. Early detection and treatment can prevent complications. 

No, having an enlarged prostate does not increase your risk of getting prostate cancer. The two problems usually begin in different parts of the prostate. But men can have an enlarged prostate and prostate cancer at the same time.

It is also a misconception that male incontinence is a symptom of prostate cancer. Men with early prostate cancer will often have no symptoms because of the way the cancer grows. You’ll usually only get symptoms early if the cancer grows near the tube you urinate through (the urethra) and presses against it, changing the way you urinate (wee). But because prostate cancer usually starts to grow in a different part (usually the outer part) of the prostate, early prostate cancer doesn’t often press on the urethra and cause symptoms.

In the UK, about 1 in 8 men will be diagnosed with prostate cancer in their lifetime but early prostate cancer often has no symptoms. This is why it’s important that every man understands his risk of getting prostate cancer. The three main risk factors are:

Getting older – it mainly affects men over 50

Having a family history of prostate cancer

being Black.

If you have concerns about prostate cancer or if you have any of the prostate cancer risk factors, speak to your GP. They can talk to you about your risk, and about the tests used to diagnose prostate cancer. The first step in finding if there is anything wrong with your prostate is a simple blood test known as a PSA test.

You can also Check your risk in 30 seconds using Prostate Cancer UK’s risk checker tool and find out more information at Prostate Cancer UK’s website. 

To understand why  incontinence after prostate surgery or treatment occurs, it’s important to first explain how the bladder works. Urine is made in the kidneys and then gets stored in the bladder until it is full, and you have the urge to go to the toilet. The muscles around your urethra relax, which allows urine to flow away from the bladder and out of the body.

In men, the prostate gland surrounds the urethra. It’s about the same size and shape as a walnut - although it tends to get bigger as you get older - and its main job is producing the thick, white fluid that combines with sperm to make semen. Due to its position, an enlarged or inflamed prostate can obstruct the urethra and cause difficulty with urine retention or other issues such as incontinence. If you require surgery or radiation therapy on your prostate, this can also result in issues with incontinence, although these may be temporary.

Incontinence is common in men who have had surgery or radiation therapy for prostate cancer.² Prostate cancer surgery, called a radical prostatectomy, aims to remove the whole prostate and the prostate cancer cells inside it - while keeping the chances of side effects as low as possible. This can also damage the nerves and muscle that control the bladder but thankfully, newer techniques mean surgeons can  save the bladder muscles as much as possible. This  means problems with incontinence are often not as long lasting. Leaking urine tends to improve over time, with most men seeing an improvement one to six months after surgery.³

Radiotherapy aims to destroy prostate cancer cells without causing too much damage to healthy cells.. Although modern techniques allow clinicians to target the cancer directly, radiation can disrupt the bladder, which can result in leakage. Radiation can also decrease the capacity of the bladder or cause spasms that force urine out.

The most common type of leakage after surgery is stress incontinence, which is usually experienced by men after the prostate gland has been removed, whereas urge incontinence can occur after radiation treatment.

If you’re about to undergo prostate surgery, talk to your doctor or surgeon about the possible side effects so you can weigh up your options and be prepared.

If you’re currently experiencing incontinence issues because of your prostate problems, it may be useful to modify your behaviour (for example, by not drinking as much fluid, especially before bedtime, or avoiding caffeine and alcohol), or look into how kegel exercises (pelvic floor exercises) can help, alongside talking to your GP.

Men who have had prostate surgery may benefit from attending a prostate cancer support group where you can get support and talk to people suffering from the same issues.

For more information and support, don’t hesitate to reach out to Prostate Cancer UK and their Specialist Nurses. Your health is important, and taking proactive steps can make a significant difference.

If you want to continue learning, read our interview all about the prostate and male urine leakage with Professor Ralph Peeker.

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¹https://www.nhs.uk/conditions/prostate-problems/

²https://prostatecanceruk.org/prostate-information/living-with-prostate-cancer/urinary-problems

³https://prostatecanceruk.org/prostate-information/living-with-prostate-cancer/urinary-problems