What I treat · Continence after prostate treatment

Leaking after prostate treatment

Incontinence after a prostatectomy or radiotherapy is common, rarely discussed, and frequently endured for years on the assumption that it is permanent. It usually is not.

Prostate treatment can disrupt the valve that keeps you dry. Pelvic floor rehabilitation is the first step and works for many men within the first year. Recovery can carry on slowly for up to two years — but you do not have to stop recovering before you are entitled to an operation, and the artificial urinary sphincter remains the most reliable one there is.

The 2025 British Association of Urological Surgeons consensus is specific about the timing. Surgery should be offered after a minimum of six months where the leakage is severe, and twelve months where it is mild to moderate, to any man sufficiently troubled by it. The median wait from prostatectomy to continence surgery in England is 2.8 years. If you are past those thresholds and still in pads, that gap is worth raising rather than waiting out.

The honest trade-off Once a sphincter is fitted, no catheter may be passed by anyone who does not know the device is there and how to deactivate it first. That single fact belongs on a card in your wallet — or on a bracelet, which is what the national consensus suggests, since it speaks for you when you cannot — and it is discussed at length before any implant is agreed.

The sphincter guide → Continence questionnaire

Treatments offered

Artificial urinary sphincterBAUS leafletA25/144
Male slingBAUS leafletF25/154
Urodynamic assessmentBAUS leafletF25/039
Pelvic floor rehabilitation pathwaysBAUS leafletF25/023
Revision of previous continence surgery

The leaflets above are published by the British Association of Urological Surgeons (BAUS) and open in a new tab. They are linked, not hosted or altered.

Written and reviewed by Mr Musaab Yassin, Consultant Urological Surgeon & Andrologist. FRCS (Urol) · GMC 6118378 · Reviewed September 2026

Timing thresholds from the British Association of Urological Surgeons consensus on post-prostatectomy incontinence — Bhatt NR, Biers S, Sahai A, et al., BJU International 2025;135(6):887–901, doi:10.1111/bju.16726.

Illustration of an artificial urinary sphincter in place: a cuff around the urethra, tubing to a pump in the scrotum, and a pressure-regulating reservoir behind the abdominal wall.

The three components of an artificial urinary sphincter photographed together: a clear pressure-regulating balloon, an amber control pump, and the woven cuff, joined by kink-resistant tubing. — The whole device. **The balloon** holds the pressure, **the pump** is squeezed to open the cuff for a minute or two, and **the cuff** closes gently around the urethra and does the work.

Common Questions · Continence

The eleven questions men ask before they book.

Short, referenced answers to the questions that come before a diagnosis exists — written to be read at eleven at night, by someone who has not told anyone yet. Each is referenced to guidelines, systematic reviews and trials, with the studies listed at the foot of its page.

Incontinence

Leaking after prostate surgery or radiotherapy, and the operations that fix it.

BAUS says surgery should be offered from six months for severe leakage.

All fifty-five, across every condition, are on the practice page.

Before your visit

Fifteen minutes now saves twenty in the room.

Complete the questionnaire before you come. Nothing is saved or transmitted — you print the summary or copy it into an email, and it stays entirely in your control.

04 · Continence

Continence assessment

Pad use, the pattern of leakage, previous prostate treatment and pelvic floor work.

Open the questionnaire →

What to bring Three things

Any previous scans or reports, a list of your current medication, and the completed questionnaire if you have had time.

How long Allow up to an hour

The consultation itself takes at least twenty minutes. Allow up to an hour if you are having a flow test, a scan, bloods or a urine test on the day.

Coming with someone Welcome

Partners are welcome throughout, and for fertility discussions it is often better if you both come.

The other areas

Each area has a page of its own.

Booking, fees and the four ways to get in touch are on the practice page.

Prostate & urinary flowEnlarged prostate Male fertilityMale fertility Peyronie’s diseasePeyronie’s disease Erectile dysfunctionErectile dysfunction Continence after prostate treatmentContinence What I treatEveryday urology