When Jim, a 64-year-old retired teacher from Glasgow, sat in his urologist's consulting room and agreed to a radical prostatectomy, he thought he had asked everything he needed to. He had enquired about the success rate. He had asked about recovery time. What he did not ask — and what nobody volunteered — was how likely he was to experience urinary leakage afterwards, how long it might last, and what practical support the NHS offered for managing it. "I came home from hospital in an incontinence pad the size of a mattress," he recalls. "Nobody had warned me. I felt blindsided." Jim's experience is not unusual. Research by Prostate Cancer UK consistently shows that men receive and retain far less information about post-surgical continence than their consultants believe they have given. If you or someone you love is facing prostate surgery, these are the eight questions that could make the difference between feeling prepared and feeling blindsided.

1. What is my realistic chance of regaining full continence — and by when?

Urinary leakage after a radical prostatectomy is not a rare complication. It is an expected outcome that affects the vast majority of men to some degree in the weeks following surgery. According to NICE guidelines on prostate cancer management, continence typically improves over the first 12 months, with most men reaching their best outcome by 12–18 months post-operatively. However, "most men improve" is not the same as "you will be dry." Ask your surgeon for figures specific to their own caseload — a reputable urologist registered with the British Association of Urological Surgeons (BAUS) should be able to share their personal continence outcomes. Surgeons who are hesitant to share this data are worth a second opinion.

2. What type of surgery is being recommended, and does it affect continence risk?

Robotic-assisted laparoscopic prostatectomy (RALP), open retropubic prostatectomy, and laparoscopic prostatectomy all carry different profiles for continence recovery. BAUS data suggests that nerve-sparing techniques, where clinically appropriate, are associated with better early continence outcomes. Ask your surgeon whether a nerve-sparing approach is possible in your case, and if not, why not. Understanding the surgical plan gives you a clearer picture of what recovery may look like — and allows you to plan accordingly rather than face surprises on the ward.

questions to ask GP prostate surgery UK infographic — Orykas UK

3. Will I see a continence nurse specialist before and after surgery?

This is the question Jim wishes he had asked. A continence nurse specialist is an NHS-registered healthcare professional with specific training in bladder and bowel dysfunction. They can teach you pelvic floor exercises before surgery — pre-operative "prehab" has strong evidence behind it for improving post-surgical recovery — and follow up with you afterwards to adjust your programme. Bladder & Bowel UK recommends that men undergoing prostatectomy begin supervised pelvic floor training at least four to six weeks before the operation. Ask your GP or surgeon to refer you explicitly. Do not assume this referral will happen automatically; in many NHS trusts, it requires a proactive request.

4. How do I perform pelvic floor exercises correctly — and who will check my technique?

Pelvic floor exercises are frequently mentioned and rarely taught properly. A leaflet handed to you in an outpatient clinic is not equivalent to supervised instruction. Research published in the British Journal of Urology International shows that men who receive biofeedback-assisted pelvic floor training recover continence significantly faster than those who follow written instructions alone. Ask specifically for a referral to a physiotherapist with pelvic health experience, or enquire whether your NHS trust has a dedicated pelvic floor clinic. If in doubt, NHS 111 can help you locate services in your area, or you can search via the Chartered Society of Physiotherapy's directory.

5. What symptoms should prompt me to contact the NHS — and when?

Post-surgical leakage is normal. Certain other symptoms are not. Ask your surgical team to be explicit about the red flags: signs of urinary tract infection, sudden changes in urine colour or smell, inability to urinate at all, or leakage that worsens rather than improves after the first few weeks. Your GP should receive a discharge summary, but it is worth confirming this — and confirming that your GP knows to expect it. For out-of-hours concerns, NHS 111 is the appropriate first point of contact rather than attending A&E for non-emergency bladder concerns.

6. What practical aids are available on the NHS, and what will I need to source myself?

The NHS does provide some continence products through community nursing teams and GP referrals, but provision varies significantly by region. Ask your GP or continence nurse specialist exactly what your local NHS trust provides, in what quantities, and how long the prescription lasts. In many cases, what is supplied — typically disposable pads — is sufficient for the acute post-operative phase but impractical for longer-term management. Washable, reusable incontinence underwear is not typically provided on the NHS, but it represents a far more cost-effective and dignified long-term solution. Understanding what you will and will not receive allows you to plan your own provisions without panic-buying in the first days after discharge.

7. Are there medications or procedures that can help if leakage persists?

For men whose leakage does not resolve adequately within 12 months, there are established clinical pathways. NICE-approved options include duloxetine for stress urinary incontinence, urethral bulking agents, male slings, and, for more significant leakage, the artificial urinary sphincter — a device with strong long-term outcome data from BAUS member centres. Ask your surgeon at what point they would consider referring you on to a specialist continence service, and what that pathway looks like. Knowing that options exist — that leakage is not simply something to be endured indefinitely — is itself valuable. Too many men suffer in silence because they believe nothing more can be done.

8. How will this affect my quality of life, and where can I find peer support?

This is the question men are most reluctant to ask and surgeons are most reluctant to raise. Urinary leakage after prostate surgery has a measurable impact on mental health, relationships, and daily activities. Prostate Cancer UK's research shows that many men withdraw socially, reduce physical activity, and experience depression as a direct result of unmanaged post-surgical leakage — none of which is inevitable with the right support. Ask your GP about referral to a clinical psychologist if you are struggling. Ask about local support groups. Prostate Cancer UK runs a Specialist Nurse helpline (0800 074 8383) and an online community where men in exactly this situation share practical advice. You are not the first person to face this, and you should not face it alone.

Why most British men do not ask these questions

Cultural factors play a significant role. British men — particularly those of Jim's generation — are socialised to minimise health concerns, defer to medical authority, and avoid discussing anything that touches on continence or sexual function. Consulting room appointments are short. The anxiety of a cancer diagnosis narrows focus onto survival rather than quality of life. And many men simply do not know what they do not know.

If you are accompanying a partner, father, or friend to a pre-operative appointment, you can help by printing this list and asking the questions on their behalf. Bring a notebook. GPs and surgeons are, on the whole, pleased when patients arrive prepared — it makes consultations more productive for everyone.

Managing leakage day-to-day: practical options that work

For the weeks and months after prostate surgery, reliable, comfortable protection is not a luxury — it is a practical necessity for maintaining confidence and continuing normal life. Disposable pads are the most commonly issued option, but many men find them bulky, warm, and environmentally wasteful over the course of a recovery that may extend to 12 months or more.

Orykas UK specialises in washable incontinence underwear designed specifically for men, made from bamboo fibre and certified to OEKO-TEX Standard 100 — meaning the materials have been independently tested and verified as free from harmful substances. The range includes:

Men's Washable Incontinence Boxer — the flagship option for men with moderate to significant leakage post-surgery, with a discreet integrated absorbent panel that sits flush against the body.
3 Pack Men's Light Leak Boxer Briefs — ideal for men in the later stages of recovery managing residual light leakage or post-void dribble.
3 Pack Ultra Absorbent Men's Incontinence Briefs — higher-capacity protection for the early post-operative weeks or for men managing ongoing stress incontinence.

All Orykas washable boxer briefs are machine-washable at 40°C and are designed to last two to three years with normal use — making them considerably more economical than disposable alternatives over the course of a recovery. Because bamboo fibre is naturally temperature-regulating and breathable, many men find them significantly more comfortable during physical activity and overnight than traditional incontinence products.

A note on VAT relief: If your incontinence is a chronic condition — as post-prostatectomy leakage lasting beyond the acute phase may qualify — you may be entitled to purchase washable incontinence products VAT-free under HMRC's disability products scheme. Orykas UK can provide the relevant documentation. Speak to your GP or continence nurse specialist to confirm your eligibility.

Related Orykas UK Advice

Frequently asked questions

How long does urinary leakage typically last after a prostatectomy?

Most men experience significant improvement within three to six months of surgery, with the majority reaching their best continence outcome by 12–18 months. A small proportion of men — particularly those who had pre-existing bladder issues or whose surgery involved more extensive nerve removal — may experience longer-term leakage. If you are concerned about your rate of improvement, speak to your GP or ask for a referral to a continence nurse specialist.

Can I start pelvic floor exercises before my surgery?

Yes — and NICE and Bladder & Bowel UK both recommend it. Pre-operative pelvic floor training, ideally supervised by a pelvic health physiotherapist, is associated with faster continence recovery after radical prostatectomy. Ask your GP or surgical team for a referral as soon as your operation date is confirmed.

Is urinary leakage after prostate surgery covered by the NHS?

Continence support — including specialist nurse assessments, physiotherapy, and in some cases disposable products — is available through the NHS. The extent of provision varies by trust. Ask your GP to refer you to your local continence service, and ask your surgical team to include continence support as part of your post-operative care plan.

Are washable incontinence boxer briefs hygienic and effective enough for post-surgical use?

Yes. Washable incontinence underwear made from certified materials and washed at 40°C meets standard hygiene requirements. Many men find them significantly more comfortable and dignified than disposable products for day-to-day wear, particularly as leakage reduces and they move to lighter protection. They are not typically appropriate as the sole protection in the immediate post-operative days when leakage is heaviest, but are excellent for transition and long-term use.

What is the VAT relief scheme for incontinence products, and do I qualify?

HMRC's disability products relief allows certain goods — including washable incontinence underwear — to be sold without VAT to individuals with a chronic disability or long-term health condition that affects normal physical function. Urinary incontinence resulting from prostate surgery may qualify, particularly once it has persisted beyond the acute recovery phase. Speak to your GP, who can confirm whether your condition meets the qualifying criteria.

Sources and further reading: NHS (nhs.uk) — Prostate cancer treatment and recovery; NICE (nice.org.uk) — Prostate cancer: diagnosis and management (NG131); Prostate Cancer UK (prostatecanceruk.org) — Living with and after prostate cancer; British Association of Urological Surgeons (baus.org.uk) — Patient information on radical prostatectomy; Bladder & Bowel UK (bladderandbowel.org) — Pelvic floor advice for men. This article is intended for general information purposes only and does not constitute medical advice. Always consult your GP or specialist regarding your individual circumstances.

8 Questions to Ask Your GP Before Prostate Surgery — and Why Most British Men Don't