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

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
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.

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 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.

@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.

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

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.

FWIW, I've researched the AUS, the Sling, Pro Act as well as the Clamp (yuck!) and variations of the catheter. None of which is my cup of tea. Pretty much resigned myself to changing Depends six times a day and Kegel's as my two forms of daily exercise.

I had prostate cancer radiation 5 years ago. Yes incontance was really out of control. My body was pretty traumatized by it. 2 years later, I had my Gall Bladder removed, which REALLY MESSES up #1 and #2.. My Urologist told me I had a spastic bladder. That is, the bladder runs amok, sending out urgent messages that you have to pee.

I got some meds to lessen the urges and leakage. Kegel exercises are important. I happened to find a Suzzane Summers thigh master (there are also knock-offs of thigh master which work just as well. I feel that focuses more precisely on strengthening muscles that control the bladder.

Stress and anxiety still really trigger me to have urges again. I practise belly breathing all the time now. You breathe in slowly, extending your belly, then breathe out. Every step, breath in, wait, breath out (with mouth open) wait. Each step should be 4 seconds. If that's too hard, make it a short count to start. '

Another important part is focusing on your body. When you feel the urge, wait as long as you can. Whenever I sit or lie down for a while - as soon as I stand, I have the urge to go. I grid my loins, reinforcing my mind I do not have to pee when I stand up.

There is also a condition called 'latchkey incontanense'. That is, if I am not near a bathroom and mentally engaged, I don't feel the urge. When I start home, the urge becomes strong, fumbling with the key in the door, I start leaking, by the time I hit the toilet, I've lost control. This has all gradually improved over time.

I don't want to bumb you out, but this has been a several-year process for me to improve. Everyone reacts differently. At first, I wet the bed fairly often, had to use a mattress cover, and wear a diaper. At first, it was totally uncontrollable (stop drinking liquids 3-4 hours before sleep. Then eventually, I would dream I was urinating, and then question myself (in the dream) if I was asleep or awake.

Ask your Doctor if he can give you a list of accurate websites for information on health, diet, etc. These days, there is so much 'fake news' out there. It's hard to decide which sites are best.

Hope this helpful for some.

@jeffmarc I would very much love to just use a pad, but I just like the extra insurance that a brief gives me, for those times when the pad gets too full/wet and starts to leak a bit. Without a brief, that's going to show on my pants. As for peeing in a restroom, I just pull the front of the brief down enough to reach my penis, and then I pee as usual.