Why do men leak urine after having the prostate removed for prostate cancer?

if you can place all your winnings on one toss of the dice and lose and then not whisper a word about your loses and then start over.......kipling

After the prostate is removed the male depends almost exclusively on the external sphincter for the control of urine. The male’s body has  to “relearn” how to control continence. How much one will leak, how long one will leak, and to  what degree one leaks, cannot be predicted. The fear of incontinence along with the fear of impotence are primary factors in the “Decision.” These two factors often are more important to the male than concerns about the “best thing to do to cure the cancer.” Prostate cancer is unique in this way.

Dirty little secret: I don’t think doing Kegels have anything to do with the return of continence. Don’t get me wrong… they don’t hurt anything. I think continence starts with the prostatectomy being performed well, and then…luck. Why it is that I can remove a prostate the exact same way in one patient (and he is dry day one after removing the catheter) and then a another patient takes weeks to regain continence?


From “The Decision.”

your anatomy inside is now like a girl's.....

A discussion of post-prostatectomy incontinence from Walsh’s book. This is very good.

“The well wear a crown that only the sick can see.”


11 Replies to “Why do men leak urine after having the prostate removed for prostate cancer?”

  1. Dr. McHugh,
    i have heard great feed back and have enjoyed your approach to a great explanation about prostate cancer.

    Matt Gasque
    Greenlight Laser


  2. Lies. You DO NOT tell here in all these posts that YOU, the PROSTATE SURGEON remove the (INTERNAL) BLADDER NECK SPHINCTER along with the prostate and THAT IS WHY men are INCONTINENT after prostatectomy.
    You DON’T EVEN SHOW IT IN YOUR SILLY DIAGRAM; you only show the (EXTERNAL)secondary sphincter. Why lie about it? Sure seems like a cover-up to me. But than again were would prostate surgeons income come from if they did not do prostate surgeries. NOW WE GET TO THE TRUTH MAYBE? I’ve lived it, experienced and even here the truth is NOT SHOWN and it’s kept from all of us!


    1. Truth is: I had a prostatectomy, I agreed and approved a prostatectomy, thereafter I drip/flood urine out all the time, complained to Dr. ” what’s this happening and why”, then I discovered (no help from the Dr) I was born with a main pee control valve called ‘bladder neck sphincter’, aka ‘proximal sphincter, ‘ smooth muscle sphincter’, I also learned it was under autonomic nervous system control and that it is always shut tight, and it’s before the prostate.I learned I had a secondary sphincter that is not ever closed tight and not supposed to be, and it was under voluntary nervous system control, and it is after the prostate. It is the one that is most always (99% of the time) talked about relating to prosate surgery. Kegel exercise and such.
      I then asked the Dr/Surgron “why is my bladder neck sphincter not closing after the catheter was removed and how long before it closes back up” . Dr. only then tells me “you don’t have one after my surgery”
      Now thats cheating! I did not approve any such removal of my bladder neck sphincter. NOT NO WAY NOT NO HOW! .That’s wrong to withhold the truth and cover up what is really done. A Dr/Surgeon can not be allowed to cover up the facts about what you take out when they talk to patients about doing surgery before it happens. That’s is when the patient needs ALL the facts. TheTruth. Patient should be told “Prostatectomy with bladderneck sphincter-ectomy Mr patient so all you guys will leak pee all the time because we cut oout the smooth muscle on the bladder that is your main pee control valve and keeps pee held tightly inside your bladder without you ever knowing or feeling it do so! SOME men get SOME control by the secondary sphincter if it can magically do more work than it was designed to do.
      That secondary sphincter, once your main sphincter is cut out of you, will actually be your “squirt valve” just like a squirt gun. Kind of exactly what it used to do, you squeeze that muscle and stuff (semen) would squirt out of you. If you squeeze your Kegel exercise muscle your secondary sphincter will now squirt out pee for you. This is how you go pee now too. You can pee out at any time. If you orgasm you will squirt pee out because it is your squirt valve now.
      You either drip pee all the time, OR if you secondary sphincter works somewhat you will squirt pee any time your body moves in such a way as to tighten your stomach, diaphragm, exert such as lift, or move your penis around with that same muscle (like you used too), or orgasms.
      Now Mr Patient would like to hire me to operate on you, now that you have heard what we will do for you when we remove your prostate? I have lived it since July 20, 2010. I am a truth advocate. I am against any Dr. with holding the truth from prostate cancer patients. I paid to get ALL the truth from the Dr/Surgeon. This is not his income vehicle. Well turns out yep it sure is.
      Now why would he not tell all us guys the truth!? Oh, I see why. Duh, I am stupid and slow.


      1. Please understand my comments and real life situation have nothing to do with Dr. JM here. Never seen him nor talked to him.
        However, I would like to know if I can help him and how he is doing post prostatectomy now? lol I am not a doc.


      2. I am the Jim above. Now another 3years & 3months passed since prostatectomy & a not authorized bladder neck sphincterectomy.
        Everything I said is the truth, not an opinion. my wife didnt like my limp penis nor my limp penis dripping & squirting pee inside her and all her resultant UTI’s. So had a artificial urinary sphincter implant January 2014. Now I have stress incontinence but I no longer have PFNFR incontinence. (Pee For No F’in Reason). Still have some pee go into wife’s vagina if we can get un-erect penis to flop into her vagina.
        None of this truth of surgery outcomes was told to us PRIOR to surgery. Future? Can you say artificial penile implant for imitation erections and wear pads forever. Oh but look at what the terrible lying prostatectomy surgeon provides. Income to more medical people. I now provide to all these new Surgeons, healthcare workers, hospitals, was it $6,000 to AMI for the implanted sphincter device


  3. hi: I had prostate cancer in 2001 had it removed 2yr. later I got bladder cancer I just started having drip problem. is there any of stop the drip it is getting worse. I can’t take long walks or stand to long it runs faster is there any thing I can do to stop the problem?


  4. I am more horny now than before my prostae is gone f in cancer no hard ons no sperm pills didn’t t help I will find a way to get it together in the mean time I drip like a faucet still horny


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