Did I choose the wrong treatment?

How often do men regret prostatectomy?

In a 2025 multicentre prospective study of 590 men, 79% reported low decision regret at a median 23 months. Better urinary continence and erectile function were strongly associated with greater satisfaction.¹ In other words, regret is not the majority experience, but functional outcomes matter greatly to it.

Does incontinence prove the decision was wrong?

No. A complication or side effect can occur after a reasonable decision made with the information available at the time. The correct treatment choice depends on cancer risk, age, life expectancy, baseline urinary/sexual function, anatomy, competing health risks and personal priorities.

Could radiotherapy have avoided leakage?

Radiotherapy generally has a lower risk of stress urinary incontinence than prostatectomy, but can produce bowel symptoms, urinary irritation/obstruction, erectile decline over time and other late effects. Active surveillance avoids immediate treatment toxicity but is suitable only for selected cancers and carries its own surveillance/transition trade-offs.

What if my expectations were unrealistic?

That is a counselling issue, not a personal failure. “Most men recover continence” can sound like “I will definitely be dry quickly.” Patient-facing counselling should include a distribution of outcomes, explain different continence definitions, and make clear that surgical treatment exists if leakage persists.

What can be done now?

Separate the past decision from the current problem. Quantify the leakage, establish its mechanism, optimise rehabilitation or bladder treatment, and consider a continence specialist referral. Treating the side effect can be more useful than trying to re-litigate the cancer decision.

Bottom line

Persistent incontinence can understandably create regret, but it does not prove that the original cancer treatment choice was wrong. What matters now is accurate assessment, honest expectations and access to effective continence treatment if recovery is incomplete.

I cannot give you the counterfactual and neither can anyone else. What I can do is separate the past decision from the present problem, which is treatable — and say plainly that if you were told most men recover and heard I will be dry quickly, that was a counselling failure rather than yours.