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For some men, the first symptom of prostate cancer is bladder problems.  On the other hand, prostate cancer surgery can cause urinary incontinence.  The bladder and the prostate are intimately related. Understanding their relationship and possible implications of both prostate cancer itself and any treatment for it is essential for all men, especially if you’ve been diagnosed with the disease.Your prostate and bladder are neighboursBoth the prostate and the bladder lie in your pelvis.  The prostate is a cone-shaped organ about the size of a golf ball.  It lies just below your bladder.  When you urinate, urine passes from your bladder to your penis via a tube called your urethra.  Your urethra passes through the middle of your prostate.  Given this relationship its easy to see how any enlargement or swelling of your prostate can impact your bladder function.Prostate cancerProstate cancer can cause problems such as difficulty starting to urinate, a weak stream, blood-stained urine, difficulty completely emptying your bladder or leakage of urine after you’ve finished urinating. These can all occur when your prostate has changed in a way that is putting pressure on your urethra or bladder.  However, it’s important to realise that urinary symptoms caused by the prostate don’t only occur with cancer.  It most often occurs as a result of benign prostatic hyperplasia (BPH).  This is a non-cancerous enlargement of the prostate that is very common as men age, with over half of men in their 50s have BPH.  It is important for any man who develops urinary symptoms to see their doctor to rule out prostate cancer.Treatment for prostate cancerProstate cancer surgery can have side effects, including bladder symptoms.  During the surgery, either your urethra itself or the nerves and soft tissues around the urethra and bladder may be damaged.  Some of these include those listed above that may occur as symptoms of prostate cancer and are associated with different degrees of incontinence.  Rarely men lose all control over urination. The likelihood of this happening during prostate surgery depends on a number of factors such as the prostate cancer surgery you are having, previous surgeries and your general health, all of which you’ll need to discuss with your surgeon.  Radiation therapy can also cause changes in your bladder function including incontinence.  Again this is due to damage to nerves and soft tissues around the pelvis and bladder.Improving outcomesUrinary incontinence after treatment for prostate cancer is significant because of the impact it has on day to day life, relationships with others and difficulty with self-care.  Fortunately as your body heals your urinary function will often improve, with most men noticing great improvement within 12 months.  Additional steps such as pelvic floor physiotherapy, lifestyle changes and medication can all help with this process or improve your bladder function if things aren’t quite where you want them to be.