Topic Overview

Both
prostate cancer and its treatment may cause urinary
problems.

Urinary problems caused by prostate cancer

The
urethra-the tube that carries urine from your bladder and through your
penis-passes through the middle of the
prostate gland. When the prostate presses against the
urethra, you can have trouble passing urine. This could include trouble getting
started (urinary hesitancy), incomplete emptying, or a weak urine stream.
Sometimes, a urinary problem is caused by a prostate cancer tumor that is
pressing on the urethra. Most often, it is because of
benign prostatic hyperplasia (BPH), which is not
cancer but does make the prostate grow larger.

If you have urinary
symptoms, see your doctor to find out the cause. It may be cancer, or it may
not. If it is cancer, removing the cancer usually relieves the pressure on the
urethra. If prostate removal is not possible, surgery
to relieve the pressure on the urethra (TURP) may be
done.

Urinary problems caused by treatment for prostate cancer

Because the prostate surrounds the urethra and is right next to the
bladder, surgery to remove the prostate and its cancer may damage nerves or the
bladder outlet muscle (sphincter). This weakens support for the lower bladder,
and
stress incontinence may develop. Radiation therapy can
cause increased urinary frequency and urgency. It may also cause narrowing of
the urethra, which makes urination difficult.

Some men will have incontinence following surgery or radiation for prostate cancer. This usually improves and in some cases resolves completely in 6 to 12 months. If you do not recover your control over urination in the first few
months or year after treatment, additional treatment for incontinence may help.

Chronic
incontinence is long-term difficulty controlling
urine. Treatment is based on the type of incontinence and how much it affects your
life. For more information, see the topic
Urinary Incontinence in Men.

Home
treatment for urinary incontinence includes the following:

  • Do pelvic floor (Kegel) exercises to strengthen your
    pelvic muscles.
  • Manage liquids:
    • Avoid drinking more than 2 qt (2 L) daily
    • Avoid drinking alcohol drinks, coffee, tea, or soda pop
    • Avoid drinking a lot of liquids in the evening
  • Have a schedule of urinating every 3
    to 4 hours while you are awake, regardless of whether you feel the need.
  • If you are not able to empty your bladder all the way, practice
    “double voiding” by urinating as much as possible, relaxing for a few moments,
    and then urinating again.
  • Make a clearer, quicker path to the
    bathroom and wear clothes that are easily removed, if you have trouble
    reaching the bathroom before you urinate. Consider wearing clothing with
    elastic waistbands or Velcro closures, or keep a urinal close to your bed or
    chair.
  • Ask your doctor whether any drugs you take, including
    over-the-counter drugs, could be making your incontinence worse. See
    Medicines That May Cause Urinary Incontinence in Men.
  • Quit smoking. For more information, see the topic
    Quitting Smoking.
  • Increase the amount
    of fiber in your diet if constipation is a problem. Consider adding a small
    amount of wheat bran, even a spoonful, to dishes you normally eat. See your
    doctor if your constipation continues. For more information, see the Home
    Treatment section of the topic
    Constipation, Age 12 and Older.
  • Lose
    some weight if you are overweight. Remember that effective weight-loss programs
    depend on a combination of diet and exercise. For more information, see the
    topics
    Weight Management and
    Fitness.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Specialist Medical Reviewer Christopher G. Wood, MD, FACS – Urology, Oncology

Current as ofMay 3, 2017