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bowel problems: pinching off?

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Posted 6/5/2008 9:31 PM (GMT 0)
OK, this is something I've been wondering about for some time now.

I have noticed that since my robotic prostatectomy, that when I have a bowel movement, I have a slightly more difficult time "pinching off" the, erm, you know.

This is just a slight problem, and all it really amounts to for me is that a) I end up spending more time completing the movement, and b) it requires more clean-up (toilet paper, etc.) afterward.

Is this a side effect from my surgery? Do others have this? Sometimes I wonder if my anal sphincter is larger or weaker because the prostate is gone...?

If this is a silly question (or silly conclusions), just let me know and go back to your regular programming...!

Thanks in advance! scool eyes
Posted 6/6/2008 12:18 AM (GMT 0)
There is no such thing as a silly question on this forum. As a matter of fact, I'm experiencing the same change in eliminating as you do. I have not mentioned it to any one because I did not consider it a big problem, but I know that my body is not quite the same as is was before the operation. Just one of those things that some of us have to learn to live with I guess.
All the best to you in your future.

Magaboo
Posted 6/6/2008 12:38 AM (GMT 0)
I've never seen a silly question on this forum. Like Mugaboo says there are no such things here. I'm thinking that as you've been sliced 'n' diced and had an empty space created where previously organs were. maybe things are rearranging themselves :-)
Bill
Posted 6/6/2008 12:54 AM (GMT 0)
I found the key for me was to have more solid bowel movements. Instead of "pinching a loaf" as we used to say as kids, I prefer to adjust my diet so I'm a step below constipated but one above one long "loaf," if that makes any sense. Sort of like more solid waste... so I don't have to pinch. Makes clean-up quicker. If you are taking a multi-vitamin or iron tablets, that would help.

I can't believe I just wrote this.
Posted 6/6/2008 4:24 AM (GMT 0)

After my da vinci surgery on 4/8/08, my rectum hurt which it never had before surgery.  At my first check up on 5/22, I told my doc about it and he said that pain down there was common.  As of a couple of days ago, everything in that catagory is back to "normal" with no more pain.

Maybe you'll get back to normal after a couple of weeks.

Posted 6/6/2008 5:03 AM (GMT 0)

CT said...
After my da vinci surgery on 4/8/08, my rectum hurt which it never had before surgery. At my first check up on 5/22, I told my doc about it and he said that pain down there was common. As of a couple of days ago, everything in that catagory is back to "normal" with no more pain.

Maybe you'll get back to normal after a couple of weeks.


Doubtful... my surgery was almost two years ago!
Posted 6/6/2008 3:44 PM (GMT 0)
Have you tried adding fiber to your diet? Try drinking a glass of Metimucial a day it will help to regulate you. It works for both diarrehea and constipation. Give it about 4 days to kick in. A couple of years ago my husband had a problem such as this (nothing to do with PCa didn't have it than) he was scoped from top to bottom at the hospital and they found nothing, they told him to go home and drink Metimucial and that finally helped him. I think the powder from is better than the pills.
Posted 6/7/2008 3:02 AM (GMT 0)
I'm not sure how fiber would help... I am not having overly soft (or overly hard) stools.... they seem just right (if there can be such a thing). Without being graphic, I can only expel them approximately 95%, and then I'm trying to get the rest out or pinch off or whatever, or wait until gravity kicks in (usually this is what it takes).
Posted 6/8/2008 3:32 PM (GMT 0)

Strictly,

I know exactly what you are talking about! I'm almost 5 years past my radical and still have this problem and if anything its gotten worse. It feels almost like there was an internal hernia of my bowel pushed into the spot my prostate used to be. Presurgery my B.M. used to come right down and out and I had control of it the whole way, now it seems to push into this area which makes it much harder to "Pinch or push it out" Its like instead of coming right down, it turns and goes into there where it changes the shape of my B.M. making it much harder to expel.  I never heard anyone talk about this subject here and I'm so glad you brought it up! I thought it was just me and never told the Dr. about it either. Maybe its much more common that we know:"???

Thanks,

Your friend,

Pete 

Posted 6/9/2008 4:03 AM (GMT 0)

Three months out, my BMs have also returned to the same as they were before surgery.

Pete: if you ask your doc for a DRE, he/she should be able to tell whether you have a kink in your rectum. And I thought DREs were behind us -- pun intended :-)

Posted 6/9/2008 1:50 PM (GMT 0)
Have you gentlemen seen a doctor about your condition?

I'm nine months post surgery and have mimicked the earlier suggestions between too much and too little fibre. A well formed soft loaf is much better all the way around. It causes less pain and less mess.

Up until about a month ago I had some bleeding during bowl movements. At times enough to need a pad. This luckily has stopped. My bowel movement however can still be painful, but no where near as bad as the first six months. I suspect one of the following and have an appointment with a specialist to check them out.

1. Simple haemorrhoids. The semi hard/soft loafs have taken care of this for the most part.
2. Anal fissure. I think this is where the major amount of bleeding and pain came from. It feels like a sharp knife has been inserted after a bowl movement. This can be caused by loose stools for an extended period of time. I've had one of these before and it required surgery to fix. A literal pain in the but.
3. Diverticulitis. This is basically a small sac that forms near a week part of the bowel wall and can happen near where the prostate was removed. This is normally painless but can cause bleeding.
Posted 6/9/2008 2:43 PM (GMT 0)

It seems very possible that one of the vagaries of PCa is the problem shown in this thread...many PCa survivors have this problem...me included.  Very difficult to describe but you just know something is not right for after all the straining...etc you never feel completely voided.  Its as if it has a mind of its own and will do its do when it gets good and ready.  In my case as much as an hour later I still feel an inadequate response to what was just a normal action before my surgery.  But, as the old saw says, "half a loaf is better than no loaf at all."  I am hoping for better days ahead...Good luck to all you fellow sufferers...I remain just

 

Salty

Posted 6/9/2008 9:01 PM (GMT 0)
I will be bringing this question to my urologist's attention next month, at my 2 year appointment.
Posted 7/2/2012 10:38 PM (GMT 0)
FWIW: I stumbled across this forum while searching for answers to the same issue: bowel problems post-robotic prostatectomy. I'm 3 years out from my da vinci surgery and all is going pretty well. The main issues are:
1. Constipation / Bowel elimination issues. Hard stools that seem to "back up" once they reach the rectal area.
2. Occasional incontinence due to cough, sneeze or romantic thoughts when my cute wife smiles at me. ;)
3. Discomfort from sitting long periods
4. post-coital discomfort on left-side which is where nerve bundle was removed.

But since we're on the subject of bowel issues; here's my situation: I've had some constipation pre-op but since my surgery....it's gotten worse. Docs have done rectal ultrasounds to make sure there's no other issues...everything
"normal". Even went to a GI Specialist for more exams (scopes, etc.) said everything looked "normal" with exception of signs of scarring. They seem to think that the scarring can affect bowel functions from robotic surgery. All that's been recommended is taking fiber supplements .... I've been using corn dextrin (like Benefiber) and that helps. I also take Senna tablets 3X every 10 days or so...they help. But I have to say that my rear-end feels packed when I awaken and only after 3rd cup of coffee do I get "relief". Stools are hard as hell.

Can't help but think the surgery has caused this issue to become more pronounced. I eat a good diet of fiber, I jog and am not overweight. It's a pain in the ____ as it's been 3 years out and still having issues.
Read where might ask doc about "Pelvic Floor Studies" and see if rectal muscles are either hypo or hyper-tonic?
Anyone with similar issues or ideas about relief...please post/reply. Thanks:

PSA was 3.6
Gleason: 7
T2c
left side bundle removed
full-function returned... :-)
slight cough incontinence confused
constipation mad
Posted 7/3/2012 12:25 AM (GMT 0)
one thing I have mentioned in previous postings that (as one writer put it) things are settling in ( and have settled in after two years) and occasionally there is pain / pressure in the rectum due to stool filling in the re-aligned rectum due to the removal of the prostate.
-with some, there is no filling in of the gap by the rectum so nothing seems different - but with me ( and I expect others) that some stool can make it difficult to pinch off (new phrase to me!)
- Billy Mac once said that comic Billy Connelly had a phrase - "never trust a fart" - and that could be part of it too - with all the slicing and dicing down there - communication may not be the same as before.

-do have it checked out by the doctor at your next physical - to me, it is just part of the "new normal" that I have to live with.

-take care,
Bronson
Posted 7/3/2012 2:09 AM (GMT 0)
Not sure of exactly what some terms Mean here. Pinching off isn't in my vocabulary.

But, I can say that my bowel habits are different. I used to be an every 2 or 3 day guy. Now I have a constitutional every morning. I tend to smear my undershorts frequently. That trusting a fart comment is true.

No pain or discomfort, just different than pre-surgery. But so is the ED and moments of incontinence. But, I am alive and enjoying the good life.
Posted 7/3/2012 4:01 AM (GMT 0)

Hey Guys, I wasn't looking for this topic but once I started reading it is apparent this is a common issue post robotic surgery. With me it feels like there is a void where my prostate used to be and it is difficult for me to get started. I am thankful to be alive but there are many things I was not prepared for even with this forum. What an adventure! VIEW IMAGE

Posted 7/3/2012 4:25 AM (GMT 0)
Decided to weigh in on this one after much thought. I think you pose a legitmate question, in our PC world, many strange things happen to us, and they can vary greatly from person to person. If you were post RT or SRT (radiation), I could offer a possible explanation, because radiation can do many strange things down there, and sometimes it can take years to manifest.

I am approaching 4 years post open surgery, and almost 2 years post having my bladder disconnected and bypassed, by using a piece of my digestive system. Having said that, I have had zero b.m. related issues or problems, other than a slight increase in urgency post my salvage radiation. I tended to run on the loose side most of my adult life, and if anything, with everything I have been through in the past 4 years, it's actually improved things. Most of my b.m. depend on what I have eaten, how much pain I am feeling at the moment (I suffer from severe chronic pain post radiation), and things like that.

I am on a steady diet of codene based meds and synthetic meds, which typically consitpate people. I have zero consitpation, not really ever had much of that in my life. For me, if there is a constipating effect from the meds, it actually helps me from being loose as more typical for me by nature.

I don't think your uro can help you as much with what you describe, but if it continues to be a problem for you, I would see if you could get referred to a good internal med type doctor, who might have better suggestions.

Hope you find an answer soon, as if it were me, that would be a very annoying problem to deal with. I too, was not familiar with the term "pinching off", it did make me laugh what I figured out what was meant. Personally, I am not on that much of a friendship level with my turds, so I just flush, and don't try to get to know them that well.

David in SC
Posted 7/26/2012 9:07 AM (GMT 0)

Chas0311 said...
FWIW: I stumbled across this forum while searching for answers to the same issue: bowel problems post-robotic prostatectomy. I'm 3 years out from my da vinci surgery and all is going pretty well. The main issues are:
1. Constipation / Bowel elimination issues. Hard stools that seem to "back up" once they reach the rectal area.
2. Occasional incontinence due to cough, sneeze or romantic thoughts when my cute wife smiles at me. ;)
3. Discomfort from sitting long periods
4. post-coital discomfort on left-side which is where nerve bundle was removed.

But since we're on the subject of bowel issues; here's my situation: I've had some constipation pre-op but since my surgery....it's gotten worse. Docs have done rectal ultrasounds to make sure there's no other issues...everything
"normal". Even went to a GI Specialist for more exams (scopes, etc.) said everything looked "normal" with exception of signs of scarring. They seem to think that the scarring can affect bowel functions from robotic surgery. All that's been recommended is taking fiber supplements .... I've been using corn dextrin (like Benefiber) and that helps. I also take Senna tablets 3X every 10 days or so...they help. But I have to say that my rear-end feels packed when I awaken and only after 3rd cup of coffee do I get "relief". Stools are hard as hell.

Can't help but think the surgery has caused this issue to become more pronounced. I eat a good diet of fiber, I jog and am not overweight. It's a pain in the ____ as it's been 3 years out and still having issues.
Read where might ask doc about "Pelvic Floor Studies" and see if rectal muscles are either hypo or hyper-tonic?
Anyone with similar issues or ideas about relief...please post/reply. Thanks:

PSA was 3.6
Gleason: 7
T2c
left side bundle removed
full-function returned... :-)
slight cough incontinence confused

Chas,
I am now 2 years post op.

I have had very similar symptoms to you +
Late in the day my stream is fragmented ..... Sometimes I close it down and sit .... As good friend and doctor says "all sophisticated of mature age shutdown to urinate.... Which solves the problem.
I think this stream disturbance is due to 'poo' impinging on the urethra! The disturbing rectal dysfunction persists BUT is 99% better if I take 1 sort of 'heaped' teaspoon of Metamucil every night. I wake every morning somewhat 'full of .... it' but it absolutely worthwhile for relative comfort for the rest of the day

I THINK THIS PROBLEM IS PROBABLY UNDER-REPORTED!

Otherwise I am totally continent ..... Took ~ 6 months before I had the confidence to discard pads. On about 2 occasions I have leaked after too many beers followed by an excellent Irish whiskey!

I am as 'potent' as my 66 yr old wife wants me to be!

Cheers from Australia!


constipation mad

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