The short answer: Some leaking is common in the weeks after TURP or HoLEP, and radiotherapy can irritate the bladder for a while, but for most men things improve with time. How long it takes varies from man to man, so pelvic floor exercises and a clear line to your healthcare team matter more than any single date.
The three treatments, in a line each
- TURP (transurethral resection of the prostate) is an operation to reduce the size of the prostate, done when it has grown too large and is causing problems when you pee.
- HoLEP (holmium laser enucleation of the prostate) uses a laser to remove enlarged prostate tissue.
- Prostate radiotherapy is a treatment for prostate cancer. It can also irritate the bladder along the way.
So TURP and HoLEP treat an enlarged prostate, and radiotherapy treats cancer. Different reasons, same question afterwards: how long will the leaks last?
Leaks after TURP
You will have a catheter for a short time after the operation. The NHS says you might not be able to control when you pee once it is removed, and you might need to pee often for a few days, sometimes with burning. It says these things should get better as you recover.
Most people are back to their usual activities around 2 to 4 weeks afterwards, though it can take up to 6 weeks to fully heal.
Lasting problems are uncommon. Newcastle Hospitals says losing control of the bladder is rare after TURP, happening in less than 2% of men, and that it can be temporary or permanent. It also notes that overactive bladder symptoms, such as urgency, may take 3 months to settle.
Leaks after HoLEP
The University Hospitals Sussex leaflet on HoLEP says up to 1 in 10 men might have temporary leakage after surgery. It is common to leak a little when sneezing, coughing or lifting in the first 3 months, while the pelvic floor muscles recover. It usually gets better over time.
The same leaflet puts the risk of long term leakage at around 1 to 2%.
Leaks after prostate radiotherapy
Radiotherapy can irritate the lining of the bladder and the urethra, and cause swelling in the prostate. Prostate Cancer UK says urinary problems tend to start midway through treatment and may begin to improve several weeks after it finishes, but that this is different for everyone.
The usual problems are needing to go often, including at night, and a sudden urge to go. When the bladder muscle squeezes without warning, urine can be pushed out before you are ready. Prostate Cancer UK says incontinence after prostate radiotherapy is rare.
Its guide to urinary problems says leaking is more likely if you have had a TURP in the past, and that some men have symptoms for several months.
That is about as precise as the reputable UK sources get. If your leaks are not settling, ask your radiotherapy team what to expect in your case. They know your treatment.
Pelvic floor exercises
The NHS advises starting pelvic floor exercises as soon as you can after TURP, to help you regain control of your bladder. The Sussex leaflet calls them essential after HoLEP and suggests long and short squeezes, 8 repetitions, 3 times a day, with the Squeezy app to guide you.
After radiotherapy, Prostate Cancer UK suggests asking your medical team about pelvic floor exercises.
We have written more on how to do them in our guide to pelvic floor exercises after prostate surgery, and on what is going on underneath in why bladder leaks happen after prostate cancer treatment.
What to wear while you recover
In the early days, while leaks may still be more than light, use what your hospital team or continence nurse suggests. There is no prize for switching early.
As things settle into drips, dribbles and the odd leak when you cough or lift, washable leakproof underwear starts to make sense. It looks like ordinary pants, which after a few weeks of hospital kit is no small thing.
When to see a GP
Contact your GP or hospital team if leaks are getting worse rather than better, or are still more than light after the recovery time you were given.
The HoLEP leaflet says to contact your GP or go to A&E if you have severe bleeding, cannot pass urine or feel unwell.
If you want to talk it through, Prostate Cancer UK has specialist nurses on 0800 074 8383.
Getting on with your day
Frank's Pants are for light leaks. Once yours are at that stage:
- The Active is made for the last drop and post pee dribbles.
- The Everyday suits small leaks on and off through the day, like the odd one when you cough or lift.
- The Ultra comes with three washable pads that clip in, so you can swap a fresh one in on long days.
If your leaks are heavier than that, stick with the products your healthcare team recommends and talk to them or your local continence service.
Your first pair is covered by Frank's Word, our 60 day guarantee. If it does not keep you dry and comfortable, you get your money back.
Frequently asked questions
How long do bladder leaks last after TURP?
The NHS says losing control after the catheter comes out should get better as you recover, and most people are back to their usual activities in 2 to 4 weeks. Recovery varies, so ask your team what to expect in your case.
Is leaking after HoLEP normal?
Some leaking is common. One NHS trust leaflet says up to 1 in 10 men have temporary leakage, often when sneezing, coughing or lifting in the first 3 months, and that it usually gets better over time.
Does prostate radiotherapy cause leaks?
It can, but leaking is less common than needing to go often or urgently. Prostate Cancer UK says it is more likely if you have had a TURP in the past.
When can I switch to washable leakproof pants?
Once your leaks are light, drips and dribbles rather than heavier leaks. Until then, follow the advice of your hospital team or continence nurse.
This article is general information, not medical advice. Always follow the guidance of your GP or healthcare team.