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Urinary incontinence and impotence
Source: Prostate Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: May 14, 2025 · Captured 2026-09-09.
Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary.
Urinary incontinence and impotence are complications that can result from radical prostatectomy and have been studied in multiple studies.
Evidence (urinary incontinence and impotence after radical prostatectomy):
A large case series of men undergoing the anatomic (nerve-sparing) technique of radical prostatectomy reported the following results:[43]
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A large case series of men undergoing the anatomic (nerve-sparing) technique of radical prostatectomy reported the following results:[43]
Approximately 6% of the men required the use of pads for urinary incontinence, but an unknown additional proportion of men had occasional urinary dribbling.
A large case series of men undergoing the anatomic (nerve-sparing) technique of radical prostatectomy reported the following results:[43]
About 40% to 65% of the men who were sexually potent before surgery retained potency adequate for vaginal penetration and sexual intercourse. Preservation of potency with this technique is dependent on tumor stage and patient age, but the operation probably induces at least a partial deficit in nearly all patients.
A national survey of Medicare patients who underwent radical prostatectomy in 1988 to 1990 reported more morbidity than in the case series reported above.[44]
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A national survey of Medicare patients who underwent radical prostatectomy in 1988 to 1990 reported more morbidity than in the case series reported above.[44]
More than 30% of the men reported the need for pads or clamps for urinary wetness, and 63% of all patients reported a current problem with wetness.
A national survey of Medicare patients who underwent radical prostatectomy in 1988 to 1990 reported more morbidity than in the case series reported above.[44]
About 60% of the men reported having no erections since surgery; about 90% of the men had no erections sufficient for intercourse during the month before the survey.
A national survey of Medicare patients who underwent radical prostatectomy in 1988 to 1990 reported more morbidity than in the case series reported above.[44]
About 28% of the patients reported follow-up treatment of cancer with radiation therapy and/or hormonal therapy within 4 years after their prostatectomy.
A population-based longitudinal cohort study (Prostate Cancer Outcomes Study) included 901 men aged 55 to 74 years who had recently undergone radical prostatectomy for prostate cancer.[45]
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A population-based longitudinal cohort study (Prostate Cancer Outcomes Study) included 901 men aged 55 to 74 years who had recently undergone radical prostatectomy for prostate cancer.[45]
15.4% of the men had either frequent urinary incontinence or no urinary control at 5 years after surgery.
A population-based longitudinal cohort study (Prostate Cancer Outcomes Study) included 901 men aged 55 to 74 years who had recently undergone radical prostatectomy for prostate cancer.[45]
20.4% of those studied wore pads to stay dry.
A population-based longitudinal cohort study (Prostate Cancer Outcomes Study) included 901 men aged 55 to 74 years who had recently undergone radical prostatectomy for prostate cancer.[45]
79.3% of men reported an inability to have an erection sufficient for intercourse.
A cross-sectional survey of patients with prostate cancer who were treated with radical prostatectomy, radiation therapy, or watchful waiting and active surveillance in a managed care setting showed substantial sexual and urinary dysfunction in the prostatectomy group.[46]
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A cross-sectional survey of patients with prostate cancer who were treated with radical prostatectomy, radiation therapy, or watchful waiting and active surveillance in a managed care setting showed substantial sexual and urinary dysfunction in the prostatectomy group.[46]
Results reported by the patients were consistent with those from the national Medicare survey.
A cross-sectional survey of patients with prostate cancer who were treated with radical prostatectomy, radiation therapy, or watchful waiting and active surveillance in a managed care setting showed substantial sexual and urinary dysfunction in the prostatectomy group.[46]
In addition, although statistical power was limited, differences in sexual and urinary dysfunction between men who had undergone either nerve-sparing or standard radical prostatectomy were not statistically significant. This issue requires more study.
Case series of 93, 459, and 89 men who had undergone radical prostatectomy by experienced surgeons showed rates of impotence as high as those in the national Medicare survey when men were carefully questioned about sexual potency, although the men in these case series were on average younger than those in the Medicare survey.[47-49] One of the case series used the same questionnaire as that used in the Medicare survey.[47] The urinary incontinence rate in that series was also similar to that in the Medicare survey.
Differences are often reported between population-based surveys and case series from individual centers. Reasons for these differences could include:
Age differences among the populations.
Surgical expertise at the major reporting centers.
Patient selection factors.
Publication bias of favorable series.
Different methods of collecting information from patients.
Publication references
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Preserved source evidence · Not medical advice