This article is for information only and does not replace follow-up by your urologist. Seek medical advice promptly if you have a fever, pain, blood in your urine or if you can no longer pass urine.
Why does leakage happen after the operation?
The prostate surrounds the beginning of the urethra, just below the bladder. During a radical prostatectomy, often carried out for cancer, the surgeon removes the prostate and reconnects the bladder to the urethra. But the prostate and the area around it play a part in continence. After the operation, the sphincter below the prostate has to keep the bladder closed on its own. It needs time, and often rehabilitation, to manage this.
The typical leakage after a prostatectomy is stress leakage: it happens when you cough, stand up, lift something or walk for a long time. It is often worse at the end of the day, when the muscles are tired.
Other prostate procedures, such as a transurethral resection for an enlarged prostate (benign prostatic hyperplasia), can also cause leakage, generally less often and for a shorter time.
How long does the leakage last?
There is no single answer. Progress depends on your age, the condition of the muscles before the operation, the surgical technique, any radiotherapy and rehabilitation. The most common pattern is as follows:
- When the catheter is removed: leakage is often heavy. This is normal and expected.
- The first few weeks: control returns first when lying down, then sitting, then standing.
- The first few months: leakage gradually decreases, especially with regular pelvic floor exercises.
- Up to a year, sometimes longer: improvement can continue. Some men keep light stress leakage in the long term.
Your urologist can tell you what to expect in your situation. Keep a note of how things change (number of pads per day, situations in which you leak) so you can discuss it with them.
Pelvic floor rehabilitation
Pelvic floor rehabilitation is the foundation of treatment. Recommended by your urologist and carried out with a pelvic floor physiotherapist, it teaches you to contract the right muscles at the right time and to strengthen them. It can start before the operation and continues after the catheter is removed.
The physiotherapist will also teach you exercises to do at home, often called Kegel exercises: tighten the muscles that hold back urine, hold for a few seconds, relax, repeat. What matters is identifying the right muscles and being consistent. Get guidance rather than training alone by trial and error.
Living with leakage during recovery
Absorbent pads
Essential at the beginning, when leakage is heavy. You then move on to thinner products as things improve.
The penile clamp
Once leakage becomes light to moderate, a penile clamp can replace pads during the day. It gently compresses the urethra during exertion and is removed to pass urine. Ask your urologist when you can start using one, and never wear it at night. Our soft silicone clamp,SEAL, was designed for this situation. To compare models, read our guideHow to choose a penile clamp.
Good everyday habits
- Drink normally: drinking too little concentrates the urine and irritates the bladder.
- Cut down on coffee, tea and alcohol if you notice they make leakage worse.
- Tighten your pelvic floor before any effort (coughing, lifting, getting up from a chair).
- Return to gentle physical activity, such as walking, as advised by your medical team.
What if the leakage persists?
When leakage remains troublesome despite several months of rehabilitation, your urologist may suggest other options. For light to moderate leakage, a male sling (suburethral tape) can be fitted. For heavy leakage, the reference treatment remains the artificial urinary sphincter. These operations are discussed case by case.
In the meantime, or if you do not want surgery, a penile clamp or pads let you keep an active life.
Key points
- Leakage after a prostatectomy is common and usually improves over time.
- Pelvic floor rehabilitation with a physiotherapist is the first step.
- A penile clamp can replace pads during the day once leakage becomes moderate.
- If leakage persists, other treatments exist: talk to your urologist.
To find out more, see our general guide to male urinary incontinence.