Incontinence

Hello to all on the forum. I have enjoyed the wisdom and the information avaliable here and I guess that I just desire some re -assurance about post op incontinence. For brief background I was followed closely by my urologist for elevated PSA`s (gradually rising to 5.8) with 3 suspicicious biopsy`s followed by one in Dec. 09 that revealled Gleason 6 adenocarcinoma in several locations. My father died in 2000 from an unusually aggressive form of prostate Ca. I am 54 years old. I decided on surgery and was initially scheduled to undergo Robotic RP last month but due to the unexpected death of my son in late Dec 09 we put the surgery off until last week (surgery was on 2-8-10.) The surgery went OK except the Doc said I had more bleeding than he anticipated and that he had to cauterize multiple areas and he said that that made him unsure if he was able to spare the nerves from injury. Post op path looks encouraging with clear margins and no signs of tumor in the seminal vesicles. I tolerated the cath OK and had it removed 3 days ago. I expected some incontinence but it has been total since then with any activity other than sitting still. I am unable to accumulate any urine to speak of in the bladder; it just constantly empties. I have been using about 6 to 8 pads per day. I have been doing the exercises religously and am watching what I drink. This is definitely the hardest part to deal with. I`m giving thought to buying some hose clamps (not really..) I am scheduled to return to work in 3 days and work closely with clients and am concerned about how to keep from smelling like a urinal. I change pads often and try hard to maintain hygeine. If anything it seems like it is getting worse since I have been leaking even while sitting at times today. I know it is really early but any feedback would be appreciated. Are there any tips to control odor also? Thanks much in advance.

Hi Floyd,

You are VERY early in the recovery process and most of us will leak in varying degrees for at least 2-3 month. Some reported complete continence soon after surgery, but those are the exceptions, not the norm. You will have to be patient a little longer, do as much walking as you can comfortably handle and keep doing your kegels. I'm sure that in a few more weeks you will notice a big improvement.

Wishing you a quick and complete recovery.

Magaboo

Floyd,

I leaked like crazy for 2 1/2 months and then slowly began to see improvement. At 4 months I was pad free. It will get better, just takes more time than we like. Sorry to hear about your son.

Robert

Floyd,
I had the same immediate flooding experience (7+ pads a day/ 1 at night for security), age 56, DaVinci 10/2009), and am improving slowly, but improving (these days 2 a day, still the night security pad). The following is my opinion from that experience, and I am not a doctor, so take my comments as just mine.
1) watch not how much you drink, but what you drink. Too little fluid will cause as much trouble (urinary infections, urine so dense it irritates on its own). Water is king. Some will disagree, but I see that anything carbonated or heavily acidic opens the floodgates. So no beer, no coke, no sparkling water, no orange juice, even a small glass of champagne at new years blew right through. For me, any of those is bad. I've cut myself back to one cup of coffee a day, and that may be too much, but I'm not willing to go to decaf. Vitamin C comes from other, less agressive juices.
2) avoid heavily acidic foods - dill pickles and mustard on a sandwich cause me a bad afternoon.
3) the real "male guard" pads have some odor control properties (Depends, Walgreens Certainty). The only comment I have heard was someone who commented on an antiseptic smell (yes, that was me they noticed).
4) Don't wait for "full" pads - that almost guarantees a big spill. Change when you can rather than when you must. I will get argument on the board that this encourages wasting money, but I've wasted more on less important things in my previous life.
5) Get single packet wet wipes or equivalent, and use them frequently. Even a purell wipe is ok if you don't have any skin irritations, and used judiciously.
6) Avoid sudden moves or stretches.
7) Do the Kegels, at least 3 sets of 10 over the day (too many in one session stresses the muscles, so don't go for quantity)
8) Walk, walk, and walk some more. It is the only exercise they allowed me.

And don't stress. Worry and stress make it worse. I can say that now, and you can't do much about it, but worry and stress make it worse.

Welcome.

Thank you to all; the suggestions and sharing of your experiences help immeasurably. Patience is not one of my virtues. I tend to be the type that is impatient to "fix" a problem when faced with it and am finding it a little hard to relax with this. It helps greatly to know that you are not alone with the effects of this surgery. I have had major surgery in the past but this one effects you more in the way that you view yourself as a man than any that I could conceive.

RJohn, thanks also for the words of condolence. Early in December I thought that finding out that you had cancer was monumental but it later assumed relatively little importance in comparison.