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Incontinence after a TURP?

Posted 13 Mar 2023 at 10:15

Hi everyone,

My father has advanced prostate cancer, diagnosed 5 months ago, he underwent a TURP and is now on hormone therapy (injections and apalutamide). He lives outside the UK so the treatment protocols may be a tad different. Anyway, since his TURP, he has been wearing incontinence pads/adult diapers. He wears the sort that need to be "wrapped" around and needs help putting them on/taking them off. So he needs pretty much round-the-clock care, with one change during the night. As you can imagine, this is affecting his quality of life BADLY and he can't think of travelling anywhere while this is the case.

His urologist is puzzled that he is incontinent as he says he went nowhere near the sphincter muscles during the surgery. He thinks that my dad was just using his inflamed prostate to somehow control urine flow for years, and so his sphincter muscles have gone to sleep.

He did not suggest anything apart from doing some muscle "tensing" exercises twice a day to try and regain control. My dad says he doesn't leak, but instead the urine gushes out uncontrollably once it reaches a certain limit. The urologist gave him a measuring cup to pee into, but he has no idea how to fill it, especially when he is wearing diapers all the time. I know - the medical care could be a LOT better (and he's having to pay for all of it) but it is what it is.... and he has to make do with what he's got.

I know there are simple Kegle exercises one can do, but does anyone have any advice for how he can get over this? It has been 5 months and he says there has been no improvement. He is 81 and feeling very pessimistic about his future. I feel utterly helpless as he is very depressed. :-(

Would appreciate any thoughts, pointers to resources etc.

Thank you all!

Worried daughter


Posted 13 Mar 2023 at 13:00

His urologist is puzzled that he is incontinent as he says he went nowhere near the sphincter muscles during the surgery. 

Puzzled about this as the external urethral sphincter sits below the prostate and so it seems to me that the scope used during the procedure would have passed through it. Certainly, the NHS site lists short or longer term incontinence as a risk (see below) 

Some men also lose the ability to control their bladder (urinary incontinence), although this usually passes in a few weeks. In rare cases, it may be persistent and need further treatment.

Best of luck. Peter

Edited by member 13 Mar 2023 at 13:02  | Reason: Not specified

Posted 13 Mar 2023 at 15:30

WW, doing PFEs to retain continence is probably the Ideal way to go ,but if that is not going to work then other options may need considering.

Look up male incontinence products, there are a number of external devices. The adhesive sheath system may prove to difficult and expensive for him. 

There are a couple of makes of external funnel that sits over the penis, is attached with a strap and has an outlet that connects to a leg or night bag. I did try them, I can't say they were great but I think I was to activate for them. I used the afex brand but there are other makes.

Thanks Chris 

Posted 29 Oct 2023 at 14:52

Before I developed locally advanced PC I had a TURP 11 years previously for an enlarged but otherwise benign prostate. I recall that post-op I was given very strict instructions that involved frequent pelvic floor exercises and absolutely no caffeine - so no tea or coffee just water or herbal infusions, mint 'tea' being a favourite (of the specialist nurse, not me). It took six months of hard work but after that period my continence was back to normal with no leaks or urgency. I was 65 at the time. You can find out how to perform the exercises online. I hope this helps. It worked for me. All the best.

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