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Old 01-22-2010, 06:39 PM   #1
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Unhappy post radical prostatectomy and incontinence

I had prostate surgery in Dec 2009, and it's about 6 weeks now. All seem to be fine except the problem of incontinence. It is frustarting and depressing. I am 70 and am very active (I teach at a local college). Some time I am dry for hours and then all of a sudden I seem to lose control and a constant draining. Even after going to bathroom, it just does not stop. I do kegel exercise regularly. Really need some one to tell me if there is anything else I can do. I am concerned about losing control while I am lecturing.

 
Old 01-22-2010, 08:38 PM   #2
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Re: post radical prostatectomy and incontinence

Hi, and welcome!

I had surgery less than a year ago (last April), and I'd be glad to share my experiences with you. Working through the continence recovery can be frustrating at times because for the longest time it seems like only a very tiny amount of progress, if any, is made on a daily basis. I think the reality is that time is seeming to move slowly while you feel drip, drip, drip, and so the days seem like weeks and the weeks seem like months.

The reality is that based on the re-construction that was done and the new training (Kegels) of formerly unused muscles, for most guys it takes quite a while. I'm 20+ years your junior, and it took me 11 weeks to get to "pad free."

My surgeon publishes a table of the average time for his patients to get to "pad free", and I've previously posted it on this site at this link: http://www.healthboards.com/boards/showpost.php?p=3980637&postcount=23 (I posted this while I was still in recovery.) You will see that only 45% of patients were "pad free" after 3 months....so at 6 weeks I'm sorry to say that you have a while to go just to be at the average!

From the spread of data in the table, you will also see clearly that guys will recover at widely differing rates. While the average was about 3 months, it really spreads out over the first year.

I'll encourage you to keep doing your Kegels, and in fact if you can integrate them with other exercise, I really think that helps. Do Kegels while walking up or down stairs, for example, will help you subconciously engage those muscles while using your core muscles and others.

Hang in there, I think you'll start noticing improvement soon.

 
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Old 01-23-2010, 04:50 AM   #3
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Re: post radical prostatectomy and incontinence

Dear kcon
Thank you very much for the information. The table is very useful and I suppose I will have to be a little more patient. I appreciate your encouragement. I will try to be more patient and keep working on kegels. Again, thanks

 
Old 02-27-2010, 08:49 AM   #4
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Re: post radical prostatectomy and incontinence

6 weeks isn't really that long. I had radical surgery at 54 and had incontinence for 5 months and then it gradually went away. Give it time, do those exercises. That was 6 years ago and so far everything is ok.

 
Old 02-27-2010, 12:52 PM   #5
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Re: post radical prostatectomy and incontinence

Here is an extract from my earlier post (One Man's Story).

One of my support group members told me to take incontinence pads with me when they removed the catheter. He was right! Believe me, gravity takes over when the catheter is removed. My urologist told me that there is going to be leakage, but not to get discouraged - it would improve. He also was right.

At first I had no control. If I stood up gravity took over. After about a week I was able to make it to the bathroom before my bladder was completely emptied in the pad. I was using 6 to 8 Depends, regular absorbency pads a day. These pads fit inside jocky shorts. At night I wore Depends super plus absorbency underwear changing to a second pair about 2:00AM.

Doing kegel†exercises helped. Four months out I was using 1 Poise very light pad a day and maybe another at night - the underwear no longer necessary. Now 6 months out I usually don't wear a pad at all. Occasionally if I'm going to be in a situation where a bathroom is not readily available, I'll wear a pad and carry one or 2 extras just in case. For the most part, I'm now padless.

Hang in there. Things get better.

 
Old 02-27-2010, 02:27 PM   #6
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Re: post radical prostatectomy and incontinence

Those who have told you that the incontinence will likely get better with time are probably right -- that is the case for the overwhelming majority. But on the small chance that your's does not, you should know that you do not need to live forever with incontinence. There are devices available, such as various "male slings" and the AUS that can be surgically implanted and often resolve moderate and even severe incontinence. So, give it some time -- but if it does not improve, see a urogolist with expertise in incontinence issues.

 
Old 02-28-2010, 05:27 PM   #7
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Re: post radical prostatectomy and incontinence

Thank you dmarcus48. Your comments are encouraging. I am keeping my patience and hoping that I will be normal soon. Thanks for support, means a lot.

Quote:
Originally Posted by dmarcus48 View Post
6 weeks isn't really that long. I had radical surgery at 54 and had incontinence for 5 months and then it gradually went away. Give it time, do those exercises. That was 6 years ago and so far everything is ok.

 
Old 02-28-2010, 05:31 PM   #8
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Re: post radical prostatectomy and incontinence

Thank you for your encouraging support. I suppose I have to get used to this situation and hoping that it will be normal soon. I am fine while sleeping and sitting, it's when I am walking/standing. Many thanks for support.

 
Old 02-28-2010, 05:33 PM   #9
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Re: post radical prostatectomy and incontinence

Thank you for support and advice. I get frustrated at times but I am getting better in being patience. Many thanks for your support.

Quote:
Originally Posted by medved View Post
Those who have told you that the incontinence will likely get better with time are probably right -- that is the case for the overwhelming majority. But on the small chance that your's does not, you should know that you do not need to live forever with incontinence. There are devices available, such as various "male slings" and the AUS that can be surgically implanted and often resolve moderate and even severe incontinence. So, give it some time -- but if it does not improve, see a urogolist with expertise in incontinence issues.

 
Old 02-28-2010, 05:33 PM   #10
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Re: post radical prostatectomy and incontinence

Sometimes, it's just good to know you're not the only one. I know people who never had any incontinence, and some (a minority) who've had problems for awhile.

Last edited by dmarcus48; 02-28-2010 at 05:35 PM.

 
Old 04-29-2010, 10:02 AM   #11
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Re: post radical prostatectomy and incontinence

KCON, about two weeks ago I was diagnosed with prostate cancer (I just turned 60), stage T1C. My Gleason was 3+3 = 6 on the right side with 2 of 8 specimens showing cancer, and 3+3 = 6 on the left side with 5 of 6 showing cancer. My prostate was enlarged to 419mm and a bone scan and CAT scan last week showed no cancer spread (which was a relief). From what I've read, I'm leaning towards a radical prostatectomy (I had hernia surgery years ago, so robotics is out due to scar tissue). My big concern is becoming impotent. I now have the early stages of ED (I don't know if it's because of the cancer and enlarged prostate). I was wondering if you have data on how serious the risk of impotense is versus age group. Thanks in advance for any advice.

 
Old 05-14-2010, 01:45 PM   #12
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Wink Re: post radical prostatectomy and incontinence

It has been 5 months since my surgery and I feel that I am 90% there! I went for physical therapy, getting to do keggel right way and several other pelvic floor exercises. The PT was terrific in explaining these exercises. Helped me tremendously. So, for those with incontinence problem, I feel that these pelvic floor exercises can complement keggel exercises as long as one does it correctly.

 
Old 06-07-2010, 07:42 AM   #13
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Smile Re: post radical prostatectomy and incontinence

Hi Kcon: I just had my robotic surgery on 4/12/2010, so it is 8 weeks since surgery and 7 weeks since catheter was removed. My original gleason was 3+4 and stage T1C. After surgery I was 4+3 , and stage 3 with a positive margin. Psa test 5 weeks after surgery was <.1. I am 61 years old, I go to the gym2-3 days a week, run approx 2-3 miles, want to do a 5k this summer, and lift weights.

My incontinence is getting better every day, 1 pad a day. coughing and sneezing is still a probelm unless I react quick and do a kegel while coughing.

I have 2 concerns: I urinate so many more times than I ever did, does this improve over time??

Sexual function is non-existent right now. Even though I do not get an erection I have brought myself to orgasm, (dry) but also I did urinate alittle during an orgasm. Is that normal?" It could be very embarrasing with my partner.

Hope you are doing well and look forward to your response.

 
Old 06-07-2010, 08:24 AM   #14
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Re: post radical prostatectomy and incontinence

as far as the frequency of urination yes it will get much better, you're doing great at this point. I was using pads for 5 months, but I'm not as active as you due to foot problems.

As far as sex goes, it all depends. As for myself, not really, but for others...?

 
Old 06-08-2010, 11:28 AM   #15
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Re: post radical prostatectomy and incontinence

wow, you are doing so great . It took me a long time. As to urination, I also had 'urge' to go more frequently, but I tried to control, doing kegel exercises. That helped me. It took me a while but now I am able to control the urge like I did before surgery. As to sexual function, I am not thinking (71 yr old!), if it happens, fine, if not...

Keep it up...I wish I recovered as afst as you did

Quote:
Originally Posted by Teddy Bear 6649 View Post
Hi Kcon: I just had my robotic surgery on 4/12/2010, so it is 8 weeks since surgery and 7 weeks since catheter was removed. My original gleason was 3+4 and stage T1C. After surgery I was 4+3 , and stage 3 with a positive margin. Psa test 5 weeks after surgery was <.1. I am 61 years old, I go to the gym2-3 days a week, run approx 2-3 miles, want to do a 5k this summer, and lift weights.

My incontinence is getting better every day, 1 pad a day. coughing and sneezing is still a probelm unless I react quick and do a kegel while coughing.

I have 2 concerns: I urinate so many more times than I ever did, does this improve over time??

Sexual function is non-existent right now. Even though I do not get an erection I have brought myself to orgasm, (dry) but also I did urinate alittle during an orgasm. Is that normal?" It could be very embarrasing with my partner.

Hope you are doing well and look forward to your response.

 
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