Urinary control usually improves significantly during the first year after robotic prostate surgery, but recovery varies from person to person. Published continence rates can differ because some studies define continence as using no pads, while others allow one small security pad.
Your age, urinary function before surgery, anatomy, pelvic floor rehabilitation and surgical technique can all influence recovery.
What Does Continence Mean After Robotic Prostate Surgery?
Continence means being able to control your urine after surgery, but studies define it differently. Some require you to use no pads, while others count you as continent if you use one small security pad a day.
This can make continence rates look quite different between studies. So, when you hear a percentage, ask how the study or surgeon defines “continent” before comparing the figure with other results.
What Do Published Continence Rates Show Overall?
A 2024 analysis of 193,618 patients undergoing open, laparoscopic or robot-assisted radical prostatectomy compared continence definitions and recovery rates. Within the robot-assisted reports, mean continence rates were approximately 42% at one month, 65% at three months, 79% at six months and 86% at 12 months.
| Time after robot-assisted prostatectomy | Mean reported continence rate |
| 1 month | 42% |
| 3 months | 65% |
| 6 months | 79% |
| 12 months | 86% |
These figures come from hundreds of studies using different continence definitions, with “no pad” being the most common. Around two in five patients were continent at one month, two in three by three months and more than four in five by one year. Your recovery may differ, but it’s common for urinary control to keep improving for several months after surgery.
What Do UK Continence Data Show?
A contemporary UK multicentre study also illustrates how the definition of continence changes the reported result. In the 26-centre subset with surgical-approach data, 96% of procedures were robot-assisted. At 12 months, 65% of respondents were completely pad-free, while 42% reported being both leak-free and pad-free. Fewer than one in ten used more than one pad per day.
| UK patient-reported measure | Before surgery | 12 months after surgery |
| Completely pad-free | 97% | 65% |
| Leak-free and pad-free | 77% | 42% |
| Moderate or big problem with leakage | 1.9% | 9.7% |
| More than 1 pad per day | Not applicable as a postoperative comparison | Fewer than 10% |
At 12 months, 65% of men were pad-free, while 42% were both leak-free and pad-free. Fewer than one in ten needed more than one pad a day. These findings also show why the definition used matters when interpreting continence outcomes.
Evidence Note
Continence rates after radical prostatectomy depend heavily on how continence is defined. A 2024 analysis of 193,618 patients across open, laparoscopic and robot-assisted prostatectomy found that ‘no pad’ was the most frequently used definition, appearing in 53.3% of reports. A further 19.3% used a ‘security pad’ definition, while other reports used absence of leakage or did not clearly describe their criteria.
This variation helps explain why reputable studies can report substantially different 12-month continence rates without necessarily contradicting each other. When comparing results, check whether continence means absolutely no pads, no leakage or zero to one security pad per day.
What Happens Immediately After the Catheter Is Removed?
After your catheter is removed following robotic prostatectomy, some urine leakage is very common. You may leak when you cough, sneeze, stand up or move suddenly, but early leakage does not determine your final level of bladder control.
Leakage soon after catheter removal varies between patients and should not be treated as a definitive prediction of your long-term bladder control. The large literature analysis reported a mean robot-assisted continence rate of around 42% at one month. Individual centres can report different outcomes; for example, Cambridge University Hospitals advises patients that around 90% of men are dry by one year in its own postoperative pathway.
What Are the Continence Rates at Six Months?
The same large analysis reported a mean robot-assisted continence rate of around 79% at six months. Your own result may be higher or lower depending on how continence is defined and on patient and surgical factors.
These figures vary because studies use different definitions and include different patients and surgical techniques. If you still have some leakage at six months, you may continue to improve over the rest of your first year.
What Are the Continence Rates at Around Three Months?
The 2024 evidence analysis reported a mean continence rate of around 65% at three months for robot-assisted prostatectomy. Individual studies and centres may report higher or lower figures because their patients, techniques and definitions of continence differ.
If you still need pads at three months, do not assume your recovery is finished. Many men continue to improve between three and 12 months, so a steady reduction in leakage is a positive sign.
What Are the Continence Rates at 12 Months?
At 12 months, the large literature analysis reported a mean robot-assisted continence rate of 86%. In contrast, the contemporary UK patient-reported study found that 65% were completely pad-free and 42% were both leak-free and pad-free. The difference illustrates how patient populations and continence definitions can substantially change the reported percentage.
Your recovery can still vary based on your age, pre-surgery urinary function and surgical technique. If you still have leakage at one year, further improvement may still be possible, and your specialist can discuss treatment options.
Can Continence Continue Improving After One Year?
Some men may continue to improve after the first year, although recovery generally slows. Long-term studies are not completely consistent: some cohorts report further gains beyond 12 months, while others find that urinary continence becomes relatively stable after the first year.
Your specialist can reassess the type and severity of leakage and discuss further rehabilitation or, in selected men with persistent stress incontinence, options such as a male sling or artificial urinary sphincter.
Why Do Different Studies Report Such Different Numbers?
The operation hasn’t suddenly become more or less successful; the measurement may simply differ. When you compare figures, check how continence was defined, when it was measured and how many patients were followed up. This helps you understand what the result really means.
| Example 12-month definition | Conventional robotic surgery | Retzius-sparing robotic surgery |
| 0–1 pad per day | 94% | 95% |
| No pad or only a security pad | 85% | 92% |
| Strictly no pads | 61% | 85% |
These figures come from a single comparative study and should not be treated as universal expected outcomes. This is why stricter “no pad” definitions usually produce lower continence rates than definitions that allow one security pad.
Is Robotic Surgery Better for Continence Than Open or Laparoscopic Surgery?
Robot-assisted surgery may be associated with faster early continence recovery in some comparisons, but this advantage does not consistently persist at longer follow-up. A meta-analysis of randomised trials comparing robotic with conventional laparoscopic prostatectomy found better continence at three and six months with robotic surgery but no significant difference at 12 months. A recent systematic review comparing robot-assisted with open radical prostatectomy found better urinary continence recovery at three months with robotic surgery, but further studies with longer follow-up are needed to establish whether this advantage persists.
Your recovery also depends on factors such as your anatomy, pre-surgery urinary function and your surgeon’s technique and experience.
Does the Surgical Technique Affect Continence Recovery?
Techniques that preserve or reconstruct structures involved in continence may influence recovery. In comparative studies, Retzius-sparing RARP has been associated with better continence recovery than conventional RARP, although results vary according to follow-up time and how continence is defined. Separately, a longer pre-operative membranous urethral length has been associated with better continence recovery.
Your surgeon must also balance continence preservation with complete cancer removal. The best technique for you depends on your anatomy, cancer location and surgical circumstances.
What Other Factors Influence Continence Recovery?
Several factors can affect how quickly you regain urinary control after robotic prostate surgery. Your recovery usually depends on a combination of your health, anatomy and surgical care.
- Baseline urinary function: Your bladder control and urinary symptoms before surgery can influence postoperative recovery.
- Membranous urethral length: A longer urethral segment measured on pre-operative MRI has been associated with a greater probability of continence recovery.
- Age and urinary symptoms: Older age and more severe urinary symptoms before surgery have been associated with a greater risk of postoperative incontinence. Higher BMI and larger prostate volume have also been associated with poorer early continence outcomes in some analyses.
- Surgical factors: Technique, preservation of continence-related structures and surgeon experience may also contribute.
These factors vary between individuals, so your recovery may not follow the same timeline as someone else’s. Your surgical team can give you more personalised guidance.
Does Age Affect Your Chance of Regaining Continence?
Yes. Age can influence how quickly you regain urinary control after robotic prostate surgery, with studies suggesting that older men may have a slightly higher risk of ongoing leakage.
However, age alone does not determine your outcome. Urinary symptoms before surgery and anatomical factors, including membranous urethral length, are also associated with continence recovery.
How Important Are Pelvic Floor Exercises?
Pelvic floor muscle exercises are commonly used as part of rehabilitation after radical prostatectomy. Evidence suggests that structured pelvic floor training can help accelerate continence recovery during the earlier postoperative months, although it does not guarantee that everyone will become continent sooner.
Your team may teach the exercises before surgery and advise when to restart them after catheter removal. Correct technique is important, so specialist pelvic-floor or continence support can be useful if you are unsure whether you are performing them properly.
Myth vs Fact
| Myth | Fact |
| Everyone should be dry as soon as the catheter is removed. | Leakage is common initially and continence usually improves gradually over the following months. |
| An 86% continence rate means 86% of men never leak. | Not necessarily. Study definitions vary and may include no pads, a security pad or other criteria. |
| A lower reported continence rate means the surgery was performed badly. | Not automatically. Patient characteristics, follow-up, case complexity and the definition of continence can all change reported rates. |
| Robotic surgery guarantees better bladder control than open surgery. | No. Continence is influenced by many patient, anatomical and surgical factors, and the robotic platform alone cannot guarantee recovery. |
| There is nothing you can do if leakage persists. | Specialist continence assessment, pelvic-floor rehabilitation and, for selected persistent stress incontinence, surgical treatments are available. |
When Should Persistent Leakage Be Assessed?
Some leakage is common during the first few months after robotic prostate surgery and should generally improve gradually. If you continue to have significant leakage, see little improvement or find it affecting daily life, speak to your prostate team.
They can check whether the problem is stress incontinence or another urinary issue and recommend appropriate treatment. Persistent bothersome leakage can often be managed with specialist continence support and, when needed, further treatment.
UK Guidance Note
NICE recommends ensuring that people with prostate cancer who develop troublesome urinary symptoms after treatment have access to specialist continence services for assessment, diagnosis and conservative treatment. This may include coping strategies, pelvic-floor muscle re-education, bladder retraining and appropriate medication.
NICE also recommends referral to a specialist surgeon when stress incontinence remains intractable, so that an artificial urinary sphincter can be considered. You do not need to wait for an exact 12-month milestone before discussing significant or troublesome leakage with your prostate team.
What Should You Ask Your Surgeon About Continence Rates?
Ask your surgeon how they define ‘continence’, for example, whether it means being completely pad-free or using one small security pad. It is also useful to ask about recovery at three, six and 12 months rather than focusing on one percentage.
You can also discuss how your age, urinary function, anatomy and planned surgical technique may affect your recovery. Finally, ask what pelvic floor or continence support is available if your recovery takes longer than expected.
Key Takeaways
- Continence generally improves substantially during the first year after robot-assisted radical prostatectomy, but there is no single recovery percentage that applies to every patient.
- A large 2024 evidence analysis reported average RARP continence rates of 42% at one month, 65% at three months, 79% at six months and 86% at 12 months.
- Continence percentages depend heavily on whether a study defines recovery as no pads, no leakage or allowing one security pad.
- Contemporary UK patient-reported data found that at 12 months 65% were pad-free while 42% were both pad-free and leak-free, illustrating why definitions matter.
- Age, baseline urinary symptoms and anatomy, particularly membranous urethral length, can influence recovery, while surgical technique and surgeon experience may also contribute.
- Pelvic-floor muscle exercises can help accelerate continence recovery during the earlier months after surgery.
- Persistent bothersome leakage should be assessed; NICE recommends access to specialist continence services after prostate-cancer treatment.
Frequently Asked Questions
1. What are the continence rates after robotic prostate surgery?
Urinary control usually improves steadily after robotic prostate surgery, with published rates of around 42% at one month, 65% at three months, 79% at six months and 86% at 12 months. Your recovery may differ depending on factors such as your age, urinary function and surgical technique.
2. Is urinary leakage normal after robotic prostate surgery?
Yes, some urine leakage is very common after your catheter is removed following robotic prostate surgery. You may leak when you cough, sneeze, stand or move suddenly, but this does not necessarily predict your long-term continence.
3. What is the continence rate three months after robotic prostate surgery?
Studies report continence rates of around 65% at three months, although some robotic surgery studies report higher rates. If you still need pads at this stage, your bladder control can continue to improve over the following months.
4. What is the continence rate six months after robotic prostate surgery?
Around 79% of men are reported to be continent at six months in large analyses, although individual studies can report different figures. Your recovery may continue to improve between six and 12 months after surgery.
5. What is the continence rate 12 months after robotic prostate surgery?
Published studies report continence rates ranging from around 65% to over 90% at 12 months, depending on how continence is defined. Most men experience significant improvement in urinary control during the first year.
6. Can your continence improve after one year?
Yes, your urinary control can continue to improve after the first year, although recovery usually becomes slower. If you still have significant leakage, your specialist can discuss options such as pelvic floor therapy, a male sling or an artificial urinary sphincter.
7. Does age affect continence recovery after robotic prostate surgery?
Yes, older men may have a slightly higher risk of ongoing urinary leakage after surgery. However, your age is only one factor. Urinary symptoms before surgery and anatomical factors, including membranous urethral length, can also influence recovery.
8. Do pelvic floor exercises improve continence after prostate surgery?
Pelvic floor exercises can help strengthen the muscles that control your urine and are an important part of recovery. Your healthcare team may recommend starting or restarting these exercises at an appropriate stage after surgery.
9. Does robotic surgery provide better continence than other prostate surgery?
Robotic surgery may help some men regain urinary control faster, particularly during the early months of recovery. However, research has not shown that it always provides better long-term continence than open or laparoscopic surgery.
10. When should persistent urine leakage be assessed?
Some leakage is common during the first few months after robotic prostate surgery and should generally improve gradually. If you have significant ongoing leakage, little improvement or symptoms that affect your daily life, speak to your prostate team for assessment and treatment options.
Final Thoughts: Understanding Continence After Robotic Prostate Surgery
Urinary leakage is a common part of recovery after robotic prostate surgery, but your bladder control will often improve gradually over the following weeks and months. Published continence rates can vary considerably because studies use different definitions, so you should look beyond a single percentage when considering what your recovery may look like.
Your age, urinary function before surgery, anatomy, pelvic floor rehabilitation, surgical technique and your surgeon’s experience can all influence your recovery. If you are considering robotic prostate surgery in London and would like specialist advice, you can contact our team to discuss your options and arrange a consultation tailored to your individual needs.
References:
- Moretti, T.B.C., Magna, L.A. and Reis, L.O. (2024) ‘Continence criteria of 193,618 patients after open, laparoscopic, and robot-assisted radical prostatectomy’, BJU International, 134(1), pp. 13–21. Available at: https://pubmed.ncbi.nlm.nih.gov/37713071/
- Bridge, J. et al. (2024) ‘Urinary and Sexual Impact of Robotic Radical Prostatectomy: Reporting of Patient-reported Outcome Measures in the First Year after Radical Prostatectomy in a Contemporary Multicentre Cohort in the United Kingdom’, European Urology Open Science, 64, pp. 11–21. Available at: https://pubmed.ncbi.nlm.nih.gov/38812920/
- Kadono, Y. et al. (2023) ‘Comparison of postoperative urinary continence and incontinence types between conventional and Retzius-sparing robot-assisted radical prostatectomy’, Neurourology and Urodynamics, 42(6), pp. 1411–1420. Available at: https://pubmed.ncbi.nlm.nih.gov/37096807/
- Mac Curtain, B.M. et al. (2024) ‘Membranous urethral length and urinary incontinence following robot-assisted radical prostatectomy: a systematic review and meta-analysis’, BJU International, 133(6), pp. 646–655. Available at: https://pubmed.ncbi.nlm.nih.gov/37667431/
- Zeng, Y. and Wang, J. (2024) ‘Pelvic Floor Muscle Exercises can Effectively Improve Urinary Incontinence after Radical Prostatectomy: Systematic Review and Meta-Analysis Based on Randomised Controlled Trials’, Archivos Españoles de Urología, 77(6), pp. 658–665. Available at: https://pubmed.ncbi.nlm.nih.gov/39104234/
- Haney, C.M. et al. (2023) ‘Robot-assisted Versus Conventional Laparoscopic Radical Prostatectomy: A Systematic Review and Meta-analysis of Randomised Controlled Trials’, European Urology Focus, 9(6), pp. 930–937. Available at: https://pubmed.ncbi.nlm.nih.gov/37353415/
- National Institute for Health and Care Excellence (2019, updated 2021) Prostate cancer: diagnosis and management. NICE guideline NG131. Available at: https://www.nice.org.uk/guidance/ng131
- Cambridge University Hospitals NHS Foundation Trust (2024) Robotic radical prostatectomy: pre- and post-operative information. Approved 10 May 2024. Available at: https://www.cuh.nhs.uk/patient-information/robotic-radical-prostatectomy/
- Huang, H. and Cai, K. (2025) ‘Prognostic factors for urinary incontinence after robot-assisted radical prostatectomy: a systematic review and meta-analysis’, Journal of Robotic Surgery, 19(1), 628. Available at: https://pubmed.ncbi.nlm.nih.gov/40987992/
- Rinaldi, M. et al. (2024) ‘A matched-analysis on short-term and long-term (up to 5 years of follow-up) urinary incontinence outcomes after robot-assisted radical prostatectomy with and without anterior and posterior reconstruction: data on 1358 patients’, International Urology and Nephrology, 56(1), pp. 121–127. Available at: https://pubmed.ncbi.nlm.nih.gov/37648873/
- Suartz, C.V. et al. (2026) ‘Comparative functional, perioperative and oncological outcomes of robot-assisted and open radical prostatectomy: a systematic review and meta-analysis’, International Urology and Nephrology, online ahead of print. Available at: https://pubmed.ncbi.nlm.nih.gov/42230439/
- Trieu, D. et al. (2021) ‘Surgeon case volume and continence recovery following radical prostatectomy: a systematic review’, ANZ Journal of Surgery, 91(4), pp. 521–529. Available at: https://pubmed.ncbi.nlm.nih.gov/33319438/