What Is Normal Urine Leakage After Prostatectomy?

By: Rachel Neiheisel, PT, DPT, Founder of The Pelvic Platform

If you’ve recently had your prostate removed, one of your biggest questions is probably:

“Is this amount of leaking normal?”

The short answer is yes—some urinary leakage is extremely common after prostate surgery. In fact, nearly every man experiences some degree of urinary incontinence immediately after the catheter is removed.

The good news? For most men, bladder control gradually improves over time. Understanding what is considered normal, what may slow recovery, and what you can do to help yourself recover can make this process much less stressful.

Why Does Leakage Happen After Prostate Surgery?

The prostate sits just below the bladder and surrounds part of the urethra. During a radical prostatectomy, the prostate is removed, removing a part of the urethra and the internal urethral sphincter, and the bladder is reconnected to the remaining urethra.

Although surgeons work carefully to preserve the structures involved in continence, the surgery can temporarily affect:

• The urinary sphincter muscles

• The pelvic floor muscles

• The nerves that help control the bladder

• Coordination between the bladder and pelvic floor

Sometimes nerves can be spared to help control this better but other times, the nerves cannot be spared, and this may impact the recovery and long term outcomes. Immediately after surgery, these structures need time to heal and regain strength and coordination.

How Much Leakage Is Normal?

Every recovery is different, but there are some general patterns that many men experience.

The First Few Days After Catheter Removal

Many men notice:

• Leaking when standing up

• Leakage when walking

• Leakage when coughing or sneezing

• Leakage when getting out of bed or a chair

• Difficulty making it to the bathroom in time

Some men may soak several pads and depends each day during the first week.

While this can feel discouraging, it does not necessarily predict your long-term outcome.

During the First Month

Most men begin noticing gradual improvements, although the improvements may be small for some and for others, not feel like much is improving at all.

Common experiences include:

• Using fewer pads

• Smaller leaks

• Better nighttime control

• More dry periods while sitting or lying down

Leakage often becomes more noticeable later in the day as the pelvic floor muscles become fatigued.

Three to Six Months

Many men continue making meaningful improvements during this time.

It’s common to notice:

• Less leakage with walking

• Better bladder control during normal daily activities

• Improved confidence leaving the house

• Reduced need for protective pads

Some men may still leak with:

• Heavy lifting

• Exercise

• Coughing

• Sneezing

• Yard work

• Golf

• Running

This type of leakage is known as stress urinary incontinence, meaning urine leaks when pressure inside the abdomen increases.

Six to Twelve Months

Recovery often continues for many months.

Some men regain complete continence within a few months, while others continue making steady progress throughout the first year after surgery.

Recovery depends on many factors, including:

• Age

• Overall health

• Preoperative bladder function

• Surgical technique

• Nerve preservation

• Previous pelvic radiation or TURP procedure

• Individual healing

Because everyone’s recovery is unique, try to avoid comparing your progress with someone else’s.

How Many Pads or Adult Diapers Is Normal?

There isn’t a “correct” number of pads or diapers to use.

Some men use:

• Several pads and diapers per day during the early weeks

• One or two pads by a few months

• A thin liner only during exercise later in recovery

Rather than focusing only on the number of pads, pay attention to whether:

• Pads are becoming less wet

• You’re changing them less often

• You’re staying dry longer

• Your confidence is improving

Small improvements add up over time.

Why Do Some Days Feel Worse?

Recovery is rarely perfectly linear.

Many men notice increased leakage after:

• Being more physically active

• Walking long distances

• Fatigue

• Heavy lifting

• Constipation

• Repeated coughing

• Drinking larger amounts of fluids in a short period

• Sometimes even with arousal

Having a “bad day” doesn’t necessarily mean you’re losing progress.

What Can Help Recovery?

Although healing takes time, there are several things that may support your recovery.

Learn How to Contract Your Pelvic Floor Correctly

Pelvic floor muscle exercises (often called Kegels) can be helpful—but only if they are performed correctly.

Many men accidentally:

• Hold their breath

• Tighten their buttocks

• Squeeze their thighs

• Push downward instead of lifting the pelvic floor

• Perform too many repetitions

Quality matters much more than quantity.

If you’re unsure whether you’re doing the exercises correctly, working with a pelvic floor physical therapist can provide valuable guidance.

Stay Active

Gentle walking is one of the best activities after surgery.

Walking promotes:

• Circulation

• Healing

• Endurance

• Overall recovery

Increase activity gradually as directed by your surgical team.

Avoid Constipation

Straining during bowel movements places additional pressure on the pelvic floor.

Helpful strategies include:

• Staying hydrated

• Eating adequate fiber

• Remaining physically active

• Following your healthcare team’s recommendations if stool softeners are needed

Practice Good Bladder Habits

Healthy bladder habits can reduce unnecessary urgency and leakage.

Try to:

• Stay well hydrated throughout the day

• Avoid “just in case” bathroom trips every few minutes

• Limit fluids shortly before bedtime if nighttime urination is a concern (unless instructed otherwise by your healthcare provider)

Be Patient With Recovery

The pelvic floor muscles, urinary sphincter, and surrounding tissues all require time to heal.

Consistent practice and realistic expectations are often more helpful than trying to speed the process.

When Should You Talk With Your Healthcare Provider?

While leakage after prostatectomy is common, it’s important to let your healthcare team know if you experience:

• Fever or chills

• Burning or significant pain with urination

• Blood in the urine that worsens or persists

• Difficulty emptying your bladder

• Sudden onset of severe constipation/bloating abdominally

• A sudden, dramatic increase in leakage after initial improvement

• Leakage that isn’t improving over time or is significantly affecting your quality of life

Persistent urinary incontinence doesn’t mean you’ve failed. There are additional treatment options that may help, and discussing your concerns with your healthcare team is an important part of recovery.

The Bottom Line

Urinary leakage after prostatectomy is one of the most common parts of recovery—and for many men, it gradually improves over time.

Recovery isn’t always a straight line. Some days will be better than others, and the pace of improvement varies from person to person.

The most important things you can do are:

• Give your body time to heal.

• Learn proper pelvic floor muscle technique.

• Stay active within your recovery guidelines.

• Maintain healthy bladder and bowel habits.

• Reach out to your healthcare team if you have concerns or feel your recovery isn’t progressing as expected.

Remember, you’re not alone. Many men experience urinary leakage after prostate surgery, and with time, practice, and appropriate guidance, bladder control often improves significantly.

Please see my courses section on my website thepelvicplatform.podia.com to find a pre and post prostatectomy educational module series to help someone navigate and prepare for what is to come.

Disclaimer: This article is intended for educational purposes only and is not a substitute for individualized medical advice, diagnosis, or treatment. Recovery after prostate surgery varies from person to person. Always follow the recommendations of your surgeon and healthcare team regarding your specific situation.