Most men describe leakage after prostatectomy in one word: bad. Or better. Or still there.
Those words are honest. But they make it almost impossible to see progress, and progress is what keeps you going.
Researchers and pelvic health specialists use a number instead. Once you understand that number, your recovery starts to look very different.
The Number: Grams of Leakage in One Hour
The standard tool is the 1-hour pad test. You wear a pre-weighed pad, drink some water, then go through everyday movements: walking, stairs, standing up from a chair, lifting, coughing. Afterward the pad is weighed again. One gram is about one milliliter of urine.
A 2025 study of 182 men after prostatectomy sorted leakage like this: [1]
| 1-hour leakage | What it usually feels like |
|---|---|
| 2 grams or less | Considered continent |
| 2 to 10 grams | Mild: a few drops, often with coughs or lifting |
| 11 to 50 grams | Moderate: you need a pad you can count on |
| 50 grams or more | Severe: heavy pads or adult briefs |
What the Research Found About Heavy Leakage
Here is the finding that surprises most men. In that study, the men who started rehab with the heaviest leakage made the biggest gains. [1]
- Men in the severe group started at an average of about 131 grams per hour.
- About six months after the catheter came out, they averaged about 24 grams.
- At their first rehab visit, only 8% of them were out of adult briefs. By the last visit, 77% were.
- Their total pads and briefs per day dropped from about 3.5 to 1.5.
That is roughly an 80% drop in leakage. Many were not completely dry yet. But going from soaking through briefs to a light pad is a different life.
In fact, the starting leakage number was the strongest predictor of how much a man improved. Age and body weight were not.
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Why Pad Counts Can Fool You
The same research team noticed something important. Pad counts and actual leakage often did not match. [2]
Two men leaking the same few grams might use one pad a day or four. Some men who tested as dry still wore a pad for peace of mind. That means “I’m still on three pads” may not mean what you think it means.
This is why tracking only pads, or only “wet or dry,” can make you feel stuck when you are actually improving.
Five Things Worth Tracking Instead
- How much you leak, not just whether you leak
- What you wear: briefs, pads, liners or nothing
- When you leak: coughing, standing up, lifting, a golf swing, late-afternoon fatigue
- How many products you use per day
- What you are back to doing that you had stopped
Check these every one to two weeks. A month later, the trend is usually clearer than your day-to-day feelings.
An Honest Note This was an observational study without an untreated comparison group, so it cannot prove rehab alone caused every gram of improvement. Some recovery comes with healing and time. But it is strong evidence that heavy early leakage is not a reason to give up. Pelvic floor training remains the first-line treatment recommended by the American Urological Association. [3]
Start With Your Real Number
In the Month 1 Class, we cover the first 30 days after catheter removal: how to activate the right muscles, how to protect yourself during coughs and lifts, and how to track your progress so you can actually see it. Live, online, and capped at 8 men at the same stage.