Prostate Cancer Incontinence: What products do you use? Tips?

I chose not to get the AUS due to complications (Urethral stricture). I couldn’t be more pleased with a $39 incontinence clamp. Does not hurt when sitting on hard surfaces as many AUS users have reported. Can do anything while wearing it. Seldom remember it’s even there. No chance of malfunctioning necessitating surgical replacement like an AUS. I recommend giving it a try before committing to an AUS. After trying several, I settled on the Weisner Clamp bought on Amazon).

PS: That the clamp can only be worn 2 hours a day is a myth. I’ve worn the Weisner clamp 16-20 hours a day for 3 years with no ill effects. I Don’t clamp too tight for 100% effectiveness. Most leaking occurs at night when clamp is off. I use one pad a day. (Tena maximum protection is the best pad IMO) I Change location of clamp with every void.

@tuckerp See below for my comment on an incontinence clamp.

@tico14
I know a few people that have put in the AUS. It has worked quite well for all of them.

Proact Doesn’t work if you’ve had radiation. Same problem with the sling it is not very effective if you’ve had radiation.

Using a Weisner Clamp every couple of days is no big deal as long as you take it off after two hours or reposition it. Sure beats changing pads, six times a day. That really prevents you from doing much traveling or going to long-term events.

I will put on a clamp when I go to the gym. Do the same when I go dancing with my wife. I just make sure I don’t put it on for more than two hours.

I’m seeing a doctor next month about getting an AUS installed. I’m almost 78 and even though I don’t change pads even three times a day if I’m really active a pad only last a couple of hours. I’ve been to a few seminars where doctors talk about the AUS and it has been very successful. I think you should review the options again.

If you have not had radiation and don’t Think you’ll ever have it then ProACT Is a really good option. A doctor at one of the recent seminars said that he put them on many patients, And then found out that it doesn’t work well if you’ve had radiation. The patients that didn’t have radiation have been very pleased with it. The problem with radiation is it hardens the urethra and as a result ProACT Can’t squeeze hard enough to reduce leakage.

@lsk1000 thank you for your post. Had prostate removed 6 weeks ago and the leaking is horrible. Was thinking about the same clamp and was concerned about how it worked. Read a lot of reviews about it leaking and being uncomfortable. How is wearing it under jeans? Is it very noticeable or uncomfortable.

Here is how I use a clamp.:
- despite all the caveats about not wearing it more than two hours straight I have been wearing it 16-20 hours a day.
- take it off at night, which is a time when leaking is minimal.
- not over-tightening the clamp. I don’t aim for 100% effectiveness. I’m content to let some leaking and needing only one Tena Maximum Protection pad a day. Tightness can be tested by voiding with the clamp on. If you push and nothing dribbles out it’s probably too tight. Experiment.
- Insure the high spot on the bottom of the clamp is centered on the urethra.
- Change the position/location of the clamp with every void. Do frequent visual checks to see any irregularities in appearance..
- On the off chance there is some chaffing I use a skin cream.
- IMPORTANT: Try different brands to see which fits best. Ill-fitting clamps can be ineffective and irritating. After trying 5 brands, I use Weisner.

I would certainly try this before getting an AUS or a Sling. I would opt for a surgical fix after using a clamp. No restrictions on activity. Can be worn with anything, shorts, jeans, bathing suits.

FYI: I’ve heard an AUS is not recommended if there was radiation. You may eventually need salvage radiation if PSA rises so I wouldn’t rush into surgery right way. Discus this with your doctor. And as for the non- surgical alternatives to a clamp, wet pads and briefs are gross, and external catheters require wearing a piss filled bag tied to your leg and the equipment can and will malfunction (turn over in bed the wrong way) leaving a mess.

@lsk1000
Actually, the AUS is one device you can use if you’ve had radiation. I’ve watched two seminars at least, from urologists that specialize in incontinence, and they specifically said that the AUS is what they use when somebody’s had radiation, and none of the other devices work.

Interesting. I heard radiation can cause inflexible scar tissue that is more difficult for the cuff to squeeze. And in my case a urethral stricture would require surgery to fix the stricture which can fail right away or if it failed down the road it would necessitate removing the AUS, salvage surgery to the urethra and re-implantation of the AUS is even possible. Fortunately I like the clamp so I’m not haunted by this decision.

ChapGPT on AUS for what it's worth:
Effects of Radiation
Radiation (such as after prostate cancer treatment) can cause:
Tissue scarring and fibrosis around the urethra
Reduced blood supply to tissues
Weakened tissue healing ability
These changes mean:
The urethra is more fragile, making it harder to safely place the cuff that controls urine flow.
There’s a higher risk of complications, such as erosion (the cuff wearing through the urethra) or infection.
Healing after surgery may be slower or less complete.
📉 Risk Comparison
Studies show that:
Men without prior radiation have good success rates (80–90% dryness with low complication rates).
Men with prior radiation can still benefit from an AUS, but have:
Higher revision rates (more reoperations)
More frequent erosions or infections
Slightly lower long-term continence rates

@lsk1000
That’s why the urologist requires a cystoscopy to make sure that it will work properly.

More AI answers

For men with incontinence after prostate radiation, the artificial urinary sphincter (AUS) is often the most effective device for moderate to severe leakage, as it is specifically recommended for post-radiation cases. An AUS is an implanted, three-part device that controls urine flow, while less invasive options like penile clamps can provide temporary external management. For mild cases, some clinicians may consider other surgical options, but radiation often makes an AUS the preferred choice due to previous tissue changes.

The great AI Debate. Thanks for opposing pov which I think is more up to date considering the advent of the transcorporal artificial urinary sphincter cuff placement which lower risk of do-overs ampnd and increases success rate.

@gabfab37

You are very early in your recovery - please do not be discouraged.

Many patients need up to a year to regain full continence. PT and Kegel's exercises help a lot and speed up recovery. Please also check with your urologist if it is OK to use this device so early after surgery. Your body needs to adjust to "new normal".

Recovery is not only about increasing strength of a sphincter - your brain and autonomous nervous system also need to be re-trained to recognize when leaking is happening and to automatically squeeze pelvic muscles and a sphincter.

Did you ever actually measure how much do you leak in milliliters ? It will help you see the trend over time. Number of pads is not a good measure since it is so individual and even doctors make that mistake (asking "how many pads do you use" ).