Why You're Still Leaking Months After Prostate Surgery

26 Aug

Prostate surgery, such as a radical prostatectomy, can be life-saving. But one of the most common side effects is urinary leakage. For most men, this improves within the first few months. But what if you’re still leaking after 6, 9, or even 12 months?

The good news: you’re not alone and you’re not broken. Persistent leakage is common, and there are solutions.

Why Leakage Happens After Surgery

During prostate surgery:

The urinary sphincter muscles may be weakened or partially removed.
The pelvic floor muscles lose some of their natural coordination.
Nerves that help bladder control may be temporarily or permanently affected.

This combination explains why leakage often happens when you cough, sneeze, laugh, lift, or move suddenly (stress incontinence).

How Long Is “Normal”?

Most men notice gradual improvement in the first 3–6 months.
By 12 months, a large proportion have regained continence.
However, 10–20% of men may still leak beyond a year.

👉 If you’re still leaking months after surgery, it doesn’t mean nothing can be done, it just means your recovery needs more support.

Common Reasons You’re Still Leaking

Pelvic floor weakness: muscles haven’t fully recovered their strength or endurance.
Poor coordination: knowing when and how to contract (and relax) is as important as strength.
Overactive bladder: urgency and frequency can develop after surgery.
Lifestyle factors: constipation, straining, heavy lifting, or high caffeine intake increase pressure on the bladder.
Scar tissue or nerve changes : sometimes add complexity to recovery.

How Physiotherapy Can Help

Evidence-based guidelines recommend pelvic floor physiotherapy as the first-line treatment for post-prostatectomy incontinence. A physio can help you:

Learn correct pelvic floor activation (many men initially do it wrong)
Train both strength and relaxation
Use biofeedback or ultrasound for real-time guidance
Retrain bladder habits to reduce urgency and frequency
Safely return to exercise and sport without worsening leakage

When to Seek Extra Support

If leakage continues beyond 12 months despite physiotherapy, your urologist may discuss other options, such as:

Medications
Bulking injections
Male sling procedures
Artificial urinary sphincter

Still leaking months after prostate surgery? You are not alone. This is a common, treatable issue. With pelvic health physiotherapy and medical support, many men see significant improvements even a year or more after surgery.

✨ Still struggling with leakage? Book a consultation with our men’s pelvic health physiotherapists at Renard Clinic for evidence-based, personalised care..