Thomas Frye, DO, a urologic oncologist at Wilmot Cancer Institute, said on Mar. 11 that men undergoing prostate cancer treatment should be aware of the risk of incontinence and the options available to manage this side effect. Frye regularly performs surgery on men with prostate cancer and provided information about ongoing clinical trials aimed at reducing or eliminating urinary leakage.
Incontinence is a common concern for men treated for prostate cancer, particularly following surgical removal of the prostate. The proximity of the prostate to the bladder means that treatments can affect urination. “The prostate’s main function is to provide fluids and nutrients to the ejaculate that can help sperm transit,” Frye said. He explained that while not essential for life beyond reproduction, its location makes it significant for urinary control.
Frye described two main types of incontinence: urge incontinence, which involves a sudden need to urinate leading to leakage, and stress incontinence, which occurs during physical activities such as coughing or lifting heavy objects. He noted that after surgery, men often rely solely on their pelvic muscles to hold urine back because the narrowing created by the prostate is gone. “This can be a big change that the muscles may not be ready for,” he said.
Radiation therapy does not typically cause stress incontinence since the prostate remains intact, but other side effects are possible. The choice between surgery and radiation depends on factors such as tumor size and location, patient age, personal values, and willingness to cope with certain side effects.
Recovery from incontinence varies among individuals. “Leakage is present for all men at first, but as the body heals and relearns how to squeeze those muscles without a prostate, leakage often improves,” Frye said. Physical therapy focused on pelvic floor exercises can help reduce symptoms. Patients are encouraged to stay attuned to their bodies and maintain regular follow-ups with their urology team.
Clinical trials at Wilmot Cancer Institute are exploring new ways to address post-treatment incontinence. One approach involves using a tube designed to recreate a narrower opening between the bladder and where the prostate was removed, aiming to minimize leakage.
Frye emphasized the importance of research: “Clinical trials are vital for identifying new or improved ways to treat cancer.” More information about health research opportunities is available through University of Rochester Health Research.
