What Cialis Does and Does Not Do for Post-Surgery Incontinence
Cialis (tadalafil) is not a treatment for urinary incontinence after prostate surgery. It is a medication for erectile dysfunction that works by relaxing blood vessels. While some men notice improved urinary symptoms when taking Cialis for other reasons, the improvement is usually modest and happens in only some patients — it is not a reliable way to treat leakage.
The incontinence that follows prostate surgery happens because the surgery affects the muscles and nerves that control urine flow. Cialis does not repair those structures or restore their function. If your doctor has prescribed Cialis, it is for erectile dysfunction, not for incontinence, even if you notice a small benefit to leakage.
Many men confuse the two issues because they can happen at the same time after prostate surgery. Understanding what each medication actually does will help you talk clearly with your doctor about which problem you want to address first.
Key Takeaways
- Cialis is designed to treat erectile dysfunction, not incontinence, and should not be counted on to reduce urinary leakage.
- A small number of men report slight improvement in urinary symptoms while taking Cialis, but this is not a proven or reliable effect.
- Post-surgery incontinence comes from damage to the muscles and nerves that hold urine, which Cialis does not repair.
- Treatments that actually target incontinence include pelvic floor exercises, medications like mirabegron, and in some cases, surgical procedures.
- Talk to your urologist about which problem — erectile dysfunction or incontinence — is most bothersome to you, so you can prioritize treatment.
Why Incontinence Happens After Prostate Surgery
Prostate surgery — whether for cancer, benign enlargement, or other conditions — can damage the external urethral sphincter, the muscle that you consciously control to stop the flow of urine. The surgery can also affect nerves that signal when the bladder is full or when to release. The result is leakage that ranges from a few drops with coughing or exercise to constant dripping.
Most men regain continence within weeks or months as swelling goes down and nerves heal. Some men have lasting incontinence that improves slowly over a year or more. A smaller group has persistent leakage that does not resolve on its own.
Because the problem is structural — damaged muscle and nerve pathways — a medication that improves blood flow to the penis does not address the root cause. Cialis cannot rebuild the sphincter or restore nerve signals.
What the Research Actually Shows About Cialis and Incontinence
A few small studies have looked at whether phosphodiesterase-5 inhibitors (the drug class that includes Cialis) might help urinary symptoms. Some found a slight reduction in urgency or frequency in men who took these drugs for erectile dysfunction, but the effect was weak and did not happen in all patients.
No large, well-designed study has shown that Cialis reliably reduces incontinence after prostate surgery. The men who did report improvement may have been improving naturally over time, or the improvement may have been too small to measure reliably. The bottom line: Cialis is not a proven treatment for post-surgery incontinence.
If you are taking Cialis and notice your leakage is less, that is worth mentioning to your urologist — but do not stop other treatments or delay seeking proven options because of it.
Treatments That Actually Target Post-Surgery Incontinence
Pelvic floor exercises (Kegel exercises) are the first-line treatment. These exercises strengthen the external sphincter muscle and can reduce leakage significantly, especially if you do them consistently. A pelvic floor physical therapist can teach you the correct technique, which many men get wrong on their own.
Medications that may help include mirabegron (Myrbetriq), which relaxes the bladder muscle and reduces urgency, and in some cases, anticholinergic drugs. These work differently than Cialis and are chosen specifically for incontinence.
Absorbent products — pads, briefs, or protective underwear — manage leakage while you wait for recovery or while pursuing other treatments. Many men find these allow them to stay active and social without fear.
Surgical options exist for men with persistent moderate to severe incontinence. These include the male sling (a mesh support under the urethra) and the artificial urinary sphincter (a surgically implanted device). These are considered when conservative treatments have not worked after a reasonable period.
Questions to Ask Your Urologist
Before assuming Cialis might help your incontinence, have a clear conversation with your urologist about your goals. Ask: "Am I taking Cialis for erectile dysfunction or for incontinence?" If it is for erectile dysfunction, ask separately what the plan is for the leakage — whether it is expected to improve on its own, or whether you should start pelvic floor exercises or another treatment now.
Ask how long after surgery you should wait before pursuing more aggressive treatment. Most urologists recommend waiting at least 6 to 12 months for natural recovery, but if you have severe leakage or it is affecting your quality of life, earlier intervention may be reasonable.
If you are not currently seeing a urologist, ask your primary care doctor for a referral. Incontinence after prostate surgery is common enough that urologists have clear protocols for managing it, and they can rule out other causes like infection or bladder dysfunction.
When to Seek Care for Worsening Incontinence
Contact your doctor if incontinence is getting worse rather than better months after surgery, if you develop pain with urination, if you cannot empty your bladder fully, or if leakage is so severe it is keeping you from work or social activities. These changes can signal a complication that needs attention.
You do not need to wait for a scheduled appointment if you develop sudden inability to urinate, severe pain, or signs of infection (fever, burning, cloudy urine). Go to an urgent care or emergency department.
Frequently Asked Questions
If Cialis helps a little bit with my leakage, should I keep taking it?
If your doctor prescribed Cialis for erectile dysfunction and you happen to notice less leakage, there is no harm in continuing it for its intended purpose. But do not rely on it as your incontinence treatment. Talk to your urologist about starting pelvic floor exercises or other proven options at the same time.
Can I take Cialis and a medication for incontinence together?
Many men take both without problems, but you must tell your doctor about all medications you are on. Some combinations require dose adjustments or monitoring. Your urologist or pharmacist can confirm it is safe for you.
How long should I wait after prostate surgery before trying other treatments for incontinence?
Most urologists recommend waiting 3 to 6 months for natural recovery before starting aggressive treatment, but pelvic floor exercises can begin as soon as the catheter is removed. If incontinence is severe or affecting your life, do not wait — ask your doctor about starting physical therapy or other options sooner.
Is incontinence after prostate surgery permanent?
No. Most men regain continence within months. Some take longer — up to a year or more. A small percentage have lasting incontinence, but even then, treatments exist to manage it effectively.
What is the most effective treatment for post-surgery incontinence?
Pelvic floor exercises work for many men and should be the starting point. If those do not work after several months, your urologist can discuss medications or, if needed, surgical options. The best treatment depends on how severe your leakage is and how long it has been since surgery.