What to Expect After Prostate Cancer Surgery

Incontinence and Impotence May Affect Your Quality of Life

Surgeons performing open heart surgery
Thierry Dosogne/Stone/Getty Images

During the first few days after prostate surgery, it's normal to experience some blood or small clots in the urine. A foley catheter will remain in place until your surgeon believes it should be removed. Typically the catheter will stay in place for 24 hours for procedures that shrink the prostate, and up to two weeks for surgeries that remove the prostate tissue.

Most patients can return to full activity within 4 weeks of the procedure.

For outpatient procedures, the recovery is much faster and often means full activity within a week of the procedure.

If your procedure requires incisions, good incision care is essential to your recovery. Preventing infection will help reduce any scars you may have and will significantly decrease your risk of complications in the weeks following surgery.

Leaking Urine After Prostate Surgery

Incontinence is a very common problem for men after having prostate surgery and occurs after your catheter (which drains the bladder continuously) is removed. 

There are different types of incontinence. Stress incontinence happens when pressure on the bladder is increased, such as when you sneeze, cough, or lift something heavy. This is the most common type of incontinence after surgery. Urge incontinence happens when the urge to urinate is accompanied by urination. Mixed incontinence is the term for experiencing both urge and stress incontinence.


For patients, even a small amount of urine leakage can be disturbing to their social life and self-esteem, so it's important to understand that most men will have mild to severe incontinence for the first month after surgery. Only a small percentage of men will require incontinence pads for urine control one year after surgery.

The good news is that there are ways to improve incontinence using a few simple techniques. These include:

  • Using the restroom as soon as the urge strikes, not "holding it"
  • Kegel exercises
  • Urinate frequently, even before the urge is felt
  • Urinate prior to going to bed at night

Erectile Dysfunction After Prostate Surgery

Sex after surgery is a very important topic for patients with prostate problems. The risk of erectile dysfunction and impotence after surgery is significant, especially in the time immediately following surgery.

There are a number of factors that determine the frequency of impotence including a patient's sexual functioning prior to surgery, and the type of surgery they have (e.g., nerve sparing radial prostatectomy versus non-nerve-sparing).

While some studies say that robotic procedures have a lower risk of long-term impotence, there are other studies that show that the type of surgery is less important than the skill of the surgeon and the number of surgeries the surgeon has performed.

Ideally, the right procedure, performed by the right surgeon will offer the greatest opportunity for sexual function after surgery.

Open communication with your partner is imperative to maintaining a sexual relationship after surgery. While intercourse is important, it is not the only way to experience sexual pleasure for men or women. Intimacy can be maintained, but it may require more effort than in the past.

In the end, it is important to balance the risk of impotence with the risks of not having surgery when making a decision. In some cases, organ damage or even death is a real possibility without surgery. The threat of death or kidney failure should outweigh the potential for erectile dysfunction.

The Bottom Line

Incontinence and erectile dysfunction are common after prostate procedures. But the good news is that both incontinence and erectile dysfunction tend to improve over time, and there are things you can do to improve them, like exercises or taking medication. If you are experiencing either after your procedure, be candid with your surgeon so you can optimize your healing and quality of life.  


Alemozaffar, M. et al. (2011). Prediction of erectile dysfunction following treatment for prostate cancer. JAMA. Sep 21;306(11):1205-14. 

Global Robotics Institute at Florida Hospital. (2010). Incontinence After Prostate Surgery. Laparoscopic Robotic Assisted Prostatectomy. University of Michigan Health System. 

Cedars-Sinai. Transurethral Electro-Resection of the Prostate. 

Urinary Incontinence Following Prostate Cancer Treatment: Incidence and Clinical Presentation. From the Service d'Urologie at the Hôpital Charles Nicolle, Rouen, France (PG), and the Genitourinary Program at the H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida. Medscape Today.

Continue Reading