After being diagnosed with localised prostate cancer in 2009, Tony decided to have surgery to remove his prostate. He describes his experience of urinary incontinence after surgery, and the different treatments he tried to make it better.

My experience of incontinence

My catheter was removed a week after surgery but unfortunately, I found I was totally incontinent. Although I had been warned that it might happen, it was still pretty depressing.

I tried different basic things to help me stop leaking urine, including a change in diet, drinking cranberry juice and doing pelvic floor muscle exercises. To supplement the exercises, I even tried a transcutaneous electrical nerve stimulation (TENS) machine, which uses an electrode in my anus that sends low electrical currents to stimulate my pelvic floor muscles. I gave up using pads at an early stage because they were becoming swamped very quickly. I switched to a urinary sheath and leg bag instead. That wasn’t ideal, but did allow me to go back to work.

After about three months, I found I could get out of a car at a motorway service station and make it to the gents without leaking, but that’s about as far as the improvement went. About a year after my surgery, I discussed the problem and possible treatment options with my urologist, and decided to try an internal sling as I still had a bit of control over my bladder, and the surgery wasn’t as invasive as the implant of an artificial sphincter.

Trying an internal sling

As soon as the sling was put in, there was a terrific improvement and to all intents and purposes, I was dry. This state lasted for about six months, but then the sling stopped working as well, and there was a steady decline in my continence. After about nine months, I was again using fairly heavy pads.

By the end of 2013, my level of incontinence could be lived with but it began to weigh on my mind quite heavily. After discussing the situation with my urologist, I decided to replace the internal sling with an artificial urinary sphincter.

Getting an artificial urinary sphincter

The operation to insert the artificial urinary sphincter involved two cuts; one low down in the abdomen to put in a small reservoir, and one between the scrotum and anus to install a cuff and the operating pump. After the operation I spent two nights in hospital with a catheter. I didn’t have much pain, but I did have a lot of bruising and swelling to the scrotum, much more than when I’d had the internal sling operation.

The pump couldn’t be activated straight away, so I had to keep wearing pads in the meantime. Eight weeks after the operation, I was healed enough for my urologist to activate the artificial urinary sphincter and it worked very well. At first, I would sometimes even forget it was there and wonder why there was a bit of a pain and no flow, but now, using it is just a part of life.

Living with the artificial urinary sphincter

I’ve found there is a definite technique for operating the pump. As it’s very slippery, I need two hands to operate it; one to keep the pump steady and the other to squeeze it. I’ve tried doing this one-handed, but it’s a bit like trying to get hold of the soap when you have dropped it into the bath. The result is that public urinals are still for emergency use only because of the amount of undressing needed.

Find out more about managing urinary problems or try our interactive guide.

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