post prostatectomy incontinence
I am 16 month postop and my psa has been zero, for which I am grateful. But urinary incontinence has been a persistent, big problem. I use 3-4 pads per day, and a uro workup shows I drip about 500 cc a day, which is a lot. I tried biofeedback, but stopped because I didn't believe it would help. I do the Kegels. They help a little. I tried refraining from alcohol and caffeine, but that had no affect. I guess I'm one of the unlucky ones. I now try to schedule my activities around the times when my bladder is likely to be pretty empty. I take a long walk before breakfast. I go to the gym before lunch, and I try to avoid activities that involve standing or walking after a meal.
I was offered 2 possible surgical interventions: the sling (which I may not be eligible for; they have to do a urodynamic test to find out); or the gold standard, a hydraulic pump implant that squeezes the urethra closed. When you need to void, you squeeze a ball that has been implanted into the scrotum. That releases the hydraulic pressure so you can empty the bladder. After a brief interval, it squeezes the urethra once again. A third option, not yet approved, is autologous stem cell implants, introduced by an Austrian urologist. They take a biopsy of muscle tissue from your arm, culture it for 6 to 8 weeks using a proprietary method, which produces the stem cells, then they combine the cells with a collagen medium, and inject the cells into the urethra. The treatment is most effective in women. In postop men the overall success rate is poor presumably because of scar tissue that interfers with the treatment, but in men who have no scar tissue, it works well.
Has anybody out there had any of these treatments? Can you tell me what the outcome feels like on a day to day basis?