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 tumour 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 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 L (2 qt) 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.
• Increase the amount of fibre 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.