Men recovering from prostate cancer often face the challenge of urinary incontinence, a common side effect of treatment. According to Nathaniel Coddington, MD, a functional reconstructive urologist with AdventHealth Medical Group Urology at DTC, options for managing this condition have expanded.
“There is an increasing array of options for treating urinary incontinence,” said Dr. Coddington. “We’re better at helping men regain their quality of life than ever before.”
Dr. Coddington explained that up to 20% of men who undergo prostate cancer treatment experience persistent bladder leakage. For some, this means minor leakage during activity, while a smaller group may encounter more severe symptoms that affect social and physical activities and can lead to depression or weight gain.
“They can’t go out and be social, they can’t exercise, and they often struggle with depression and weight gain,” Dr. Coddington said. “That kind of severe case is rare, but it can be devastating.”
Historically, the main solution for severe incontinence was the artificial urinary sphincter—a surgically implanted device requiring manual operation to urinate. While effective, some patients found it cumbersome.
Today’s alternatives include the ProACT system, which involves implanting two adjustable silicone balloons near the bladder neck. These balloons are connected to ports under the skin and can be adjusted by a physician as needed.
“ProACT is going to make a lot of men a lot happier,” Dr. Coddington said.
He encouraged patients facing these issues after prostate cancer surgery not to lose hope: “When you see a urologist to discuss options, be aware there are new developments in this field,” he said. “Oncologists work to give you quantity of life, and we give quality of life.”
Early detection remains key in managing prostate cancer outcomes; it is the second-leading cause of cancer death among men in the United States. The five-year survival rate for cases detected early stands at 99.8%, according to CDC data.
Screening begins with a PSA blood test; improvements in biomarker testing now help distinguish aggressive cancers from those less likely to require intervention.
“We’ve come a long way,” said Dr. Coddington. “We’re much better at treating men who need to be treated and not treating those who don’t.”
Guidelines suggest average-risk individuals begin screening discussions at age 50; those at higher risk—such as Black men or those with family history—should consider starting at age 45 or earlier if multiple relatives were diagnosed young.
AdventHealth Orlando has been serving patients since its founding in 1908 and continues as both a care provider and training hospital under President Terry Shaw (https://www.adventhealth.com/hospital/adventhealth-orlando).
Dr. Coddington specializes in various reconstructive procedures related to urinary function following prostate cancer treatment.
