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day 5 with cathetar out

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Posted 5/2/2010 7:14 PM (GMT 0)

What should I expect? Had da vinci prostatectomy 13 days ago. Gleason 7 with no indication of cancer elsewhere. Great news but wandering when I will get urine control back. Presently, have to sit on toilet since the urge is too great as my bowels interfere. Urine just rolls out of penis. When I try and force a urine flow the penis end burns. If I sneeze or cough I do feel it squirt out. All thoughts appreciated.

Posted 5/2/2010 7:32 PM (GMT 0)
Hello and welcome. As I recall, it took a couple of weeks after the catheter was out for things to start improving. Make sure you do your kegles, drink lots of water, and be patient. In three or four weeks it will all be a bad memory. I am one year from surgery and have no leaks - although I wear a pad for insurance. Everybody is diffrerent in the timing of improvments.

It would help people on this site answer your questiosn if you put your pertinent history in your signature on your control panel.

Did your surgeron mention anthing unusual in the surgery - concerning the bladder?


Keep us posted on your progress and don't hesitate to ask anything!!
Posted 5/2/2010 7:51 PM (GMT 0)
Welcome.
Based on my experience with DaVinci, you're doing fine for now. Just keep up the water consumption to reduce the risk of a urinary tract infection. Better to buy more pads than to fight the pain of a UTI.

I was at the 7+ pads a day level for almost two months. It doesn't just change, you will notice over a week or two that there will be improvements, then level off for a while, then improve a bit more.

Just get in lots of walking, which helps those muscles, and although some disagree, I think a regime of Kegels helps. Not so many that you tire the muscles (that makes it worse). I started with 1 or 2 sets of 10 a day, then pushed it up to 3. At 5 sets I had gone too far, and made things worse. 3 sets a day seems reasonable, at least for me.

I am still at a pad a day 6 months out. Some days there is very little leakage, but then there are bad days too.
Some here on the board have been virtually dry from day one. There isn't much logic to it, although some articles say if you had both sets of nerves spared it gets better sooner.
That wasn't an option for me. sad

DaVinci 10/2009, post op Gleason 4+5, positive margins
IGRT started 4/23/10
Posted 5/3/2010 12:41 AM (GMT 0)
Jed,
You said something interesting. What do you mean, your bowels interfere? Most guys have no problem with bowel control. Is that what you are saying? You may need to use an antispasm drug for your bladder if things are really uncomfortable still. Would you mind explaining what you mean? thanks
Paul
Posted 5/3/2010 1:26 AM (GMT 0)
Hi

  Had my cath. out on Mon. 26th, sounds like about the same condition, about 5-6 pads during day, 2 at nite depending on amount of liquids and activety.

  Been walking in 15min. cycles about a hour a day, and trying to get out to the store an around people, once a day, this sounds easy but the fear of losing it makes it tuff.

  I've been trying to do the kegels on a regular hourly cycles but seem to over do it and get a aching pain from the prostate area, which makes it hard to sit down without a cushion, will back off an try again later.

 Same outcome with sneezeing and coughing and bending down to pick up something, also, driving tends to simulate a good steady drip. I do take some comford, when sitting on the toilet, to be able to start and stop the stream.  lol.

 Also, I have gone back to old HW. treads trying  to find some kind of norm or average progression to compare with and found a posted, that recommended a Suzan Summers thigh Master to replace the Kegels, me always being the tool guy, ordered one from amazon [cheap].

 If you need someone to compare notes with, e-mail is in history, click on timm.  welcome, good luck.  Tim

Da vinci 4/14   3+4-7 

Posted 5/3/2010 3:01 AM (GMT 0)
Welcome jedabuck7,

Don't feel bad about having to sit to pee.  It may be a while before you feel comfortable standing to pee again.  The tip of my penis was sore for a few weeks after the catheter was removed.  Things did get better quickly for me after 4 weeks.  If you have any concerns about pain be sure to call your urologist. 

Keep healing,

Dan 

Posted 5/3/2010 3:25 AM (GMT 0)
 The thing that seems to be a constant is the vast variability in the duration and degree of incontinence that is experienced after this surgery. Some guys are dry early on, some run like a faucet for quite a while and a few poor souls have to live with it for a long time with little relief. The most important thing I can tell you is to expect it to last a while and be fairly heavy for a time. I think I must have suffered from temporary deafness when my surgeon mentioned incontinence prior to surgery because the degree of it that I experienced took me by suprise. I am now 12 weeks out from surgery and was using (and soaking) about 12 to 14 pads per day worn inside of a Depends for about the first 8 weeks. I was thinking that no improvement was in sight. Then one day I got up with a full bladder, held a strong Kegel contraction to make it to the BR and slowly relaxed it and the urine suprisingly stayed in the bladder. about from that time on the leakage has decreased to about 3 or 4 pads per day and is now down to one or two "guard pads" per day worn inside of briefs. I agree that Kegels do seem to help. Execise in general is important but get plenty of rest too; you just went through major surgery. I find that when I get tired the incontinence worsens again temporarily.  As for the burning at the tip of the penis, that may be from irritation from the recent catheter, or from the urine being too concentrated and irritating. Do not try to dehydrate yourself to slow down the incontinence, (been there, done that.) It just make you feel each little squirt more acutely. If it persists, though, have your Dr check a urine to make sure you do not have an infection. I took a lot of comfort from advise here on this forum to try to be patient and that it would get better and that is true.    
Posted 5/3/2010 6:36 AM (GMT 0)
My Da Vinci was April 7.  My catheter was removed April 19.  The first 5 days were heavy leaking and some discomfort from catherter irritation.  It is now 13 days since catherter removal.  I use 1 pad for the entire day and starting this week NO pads at night.  I believe I am ahead of the curve.  I have documented my "pee leakage" and I leak about 0.50 ml/hour during the day.  I hope to be leak free pad free in 2 weeks.  We will see

Rick

Posted 5/3/2010 12:19 PM (GMT 0)
You will most likely see a huge first improvement during NIGHTS. Your body slows down and you don't produce as much urine plus gravity lessens the pressure on your bladder. After that everyone seems a tad different with some guys in control right after the catheter came out. Personally I quit the male pads about a month out and used a couple of female light day pads for a few weeks and now at less then three months out I occasionally wear a pad if I know I may be quite a distance / time away from a toilet but around home / locally I'm wearing zero pads with an occasional sneeze leak but certainly no reason to wear a bulky, very uncomfortable pad.....Catheters! I had my DiVinci robotic prostatectomy 2/10/10 and the penile catheter came out the following day before I went home. The Foley pubic catheter came out ten days later and three days longer then planned since my very enlarged prostate required extra time to re-attach the urethra / bladder connection. Whole procedure took four hours and for me it took a month to get my digestive / colon back to normal with gas and constipation.

74 years old / Gleason 3+4=7 / 2 of 12 cores positive at 30% and 70%. Margins clear and nerves spared. Five week PSA undetectable.
Posted 5/3/2010 5:48 PM (GMT 0)
I think the urologists may sometimes become inured to the incontinence. I say that because when I went to get my catheter out they made no provision in the office for the inevitable leakage. I remember asking for a towel or something and the look of surprise from the PA at the request. Naturally it did not go as planned and the catheter stuck. I ended up removing it myself a couple of days later in the shower.
Posted 5/3/2010 11:24 PM (GMT 0)
You are still in the early healing process. The key for you is to drink plenty of water, avoid coffee, alcohol, spicy foods, and acidic fruits. Do your Kegels regularly and wait for things to get better. We have had some on this board who were dry right after catheter removal and other who took a long time to get there. I was dry at night few days after the catheter was removed but used 2 pads per day for a while then 1 pad and finally dry after 4-5 months. Be patient.
Posted 5/4/2010 12:44 PM (GMT 0)
This subject is very dear to me. I had my surgery on October 26th, 2009 & it is now a little past 6 months post surgery. My surgeon gave me the statistics that 98% of men are dry within a year after surgery. Through my own desire to believe that the return of continence was no big deal, I became very depressed after the catheter was removed because I was going through 8 to 10 pads a day 2 weeks after the catheter was removed. I read a lot of posts on this forum from guys that were dry almost immediately after the catheter was removed & felt that I was doomed to a life of constant leaking. I don't believe these results were typical as I read a lot from guys who have major incontinemce problems. Perhaps the surgeons minimize these potential problems so that you are not afraid of surgery. Even with my problems, I do not regret surgery. I tried Kegels & physcial therapy for 6 weeks. My leaking was the worst when I walked. I would go through a pad in 45 minutes of walking. Finally, at about 5 months post surgery there was an almost overnight improvement to 3 pads a day & last week I had a 1 pad day. Most days it is 2 to 3 pads though. If I play golf I now go through about 3 pads for 18 holes.

As far as I can remember, here is the progress on pads. The first week post catheter removal, I leaked all the time. I had to wear an adult diaper to bed & it was soaked each morning. After about 10 days, I was able to wear a Depends Guard at night. When I came out of the shower in the morning, I had to keep a piece of tissue over my penis to prevent leakage & had to wrap it around the head of the penis when putting on my underwear to prevent leaking all over my underwear. After 2 weeks of this, I went to my surgeon & he gave me a prescription for a clamp. I would use the clamp for a couple of hours some days to help with the leakage. I found that if I drove somewhere for more than 5 minutes, that I would leak uncontrollably when I tried to get out of my car. Sometimes, it would overflow the pad & I would wet my pants badly. After another couple of weeks, I asked the Dr. for a prescription for physical therapy. I went twice a week for 6 weeks for biofeedback physical therapy which helped me be able to Kegel better but saw no improvement. Around the 15th of January, I stopped the pyscial therapy with still no improvement. about the first of March, I started being able to go through the night with very little leaking. Almost magically, about the first of April, my usuage of pads went from 5 to 8 pads a day down to 3 to 4 pads. Since April 1, I have not worn a pad overnight, just a couple of kleenexes down in my underwear. A couple of days, it has been 1 pad but most days it is 2 to 3 unless I do a lot of heavy physical work. I have lost an additional 15 lbs for a total of 36 since surgery & I do walk a lot.

I guess my message is that you probably will get better even though it can be very frustrating waiting for this to happen, Also, every man is indeed different. 2 monhs ago, I was anticiapatinmg the need for an artificial sphincter. Today I am thinking of getting the sling but I will wait till at least a year post surgery to see if I improve & think I will probably be able to avoid the sling also. I just wish I knew how common my problems are & I would not have been so depressed as I would have had reason to be optimistic. AZpeaks was the first man to give me hope when he called me after I posted on this forum. I have talked to others who have helped me to grasp the realities & possibilities of my situation. As far as ED goes, I was very lucky, getting my firsr erection 18 days after surgery. It was without Viagra & not anything like the old days, but with Viagra, it's actually pretty good. You & all of us, will never be able to forget about PCa. Now I'm worring about PSA if you read my most recent post. The point is, that we can get through this with the help of family, friends, doctors, & all the great people on this forum!
Posted 5/4/2010 7:13 PM (GMT 0)

Thanks so much for all the responses. It really helps to have so many people trying to get me through this.

After reading the responses I feel i may be having some type of reaction to my new antibiotic along with bowel spasms.

When I went back to have my catheter out my middle incision (above my bellybutton) was not healing and Doc suscribed cephalexin 500mg 4 times a day. Everytime I go to the bathroom I have this short bout of diahreaa then urine rolls out the end of my penis. If I try and force a stream it burns. I have seen a small stream twice and can feel hard stream when I sneeze or cough.

Go to Dr tomorrow and will let you know what happens. Butthole hurts to sit on especially with pads but after hearing so many worse experiences I hate to complain.

Thanks,

JED   

Posted 5/4/2010 7:37 PM (GMT 0)
You need the "doughnut" cushion for any hard chair you have - get a foam one from Walgreens or Wal Mart. Keeps the weight off the perineal area. I grew to love mine after a bout with the 'roids, some rectal surgery, and now PCa.

Also, I hope they have you on a fairly gentle stool softener (some of them are pretty brutal). I use one that used to be called Surfak - most pharmacists know it, or Docusate Calcium 240mg for the content. I had a lot of issues with any stress at all in a BM - had brutal bladder spasms at the same time for weeks.

Ask the urologist about any burning - it may be normal because of the urethra sutures, or may be the start of a urinary tract infection (no, just because you are on antibiotics doesn't mean they cover the UTI as well - they gave me a whole different scheme of meds for that).
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