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Issue with Incontinence After Radical Prostectomy

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Posted 8/4/2011 10:55 PM (GMT 0)

My husband had open prostate surgery on 7/19/11 and had the catheter removed on Tuesday, 8/2/11.  He has been doing his kegels as instructed.  He has a problem with incontinence.  He has not been able to produce a stream.  His bladder empties when he gets out of a chair and has a lot of dribbles as well.  Is this normal this soon after surgery or is this something we need to bring to the attention of the doctor?   

Posted 8/4/2011 11:25 PM (GMT 0)
First off welcome, sorry you have to be here but since you have this disease in your family you have found a great source of information.


Sounds normal to me, quite honestly the post surgery results and progress is all over the map. Just because he's leaking quite a bit now does not mean he will continue to have issues later. The trauma to his urinary tract from surgery is major, everyone progresses at a different rate and from a different starting place. A couple of suggestions

1. Don't overdo the Kegels, too many is IMO worse than not enough, the muscles tire easily and too many will do no good at all. I did 3 sets of 10 spaced throughout the day.

2. Don't get discouraged, many men take from 6 months to a year to get control back.

3. Once he gets feeling better don't let him overdo it, the desire is to get back to normal as fast as possible. Damage can be done by overdoing it.

He's still way early in his recovery, progress may be slow but it will happen.
Best of luck
Posted 8/4/2011 11:27 PM (GMT 0)
Thanks for your quick reply. I am sure your response will give him some peace of mind. I know it is a bit early but we were afraid that something might be wrong.
Posted 8/4/2011 11:35 PM (GMT 0)
Hello JG
like Dave says it's very early days for your hubby, it takes time to heal and for things to start to work again, every one is different and so are the surgeons so it will depend on a few things. One thing we all have in common though is that we loose a sphincter muscle below the prostate, this is one that women don'y have, it is a mans first line of defence and what is usually the strongest one. So we have to get used to using the lower one which is part of the pelvic floor muscle group, that is why kegels are important. for me I started by being dry at night then it was gradual progress measured by numbers of pads per day, no feelings at first would go to loo and drain out sometimes not much other times a lot would surprise me, then after about 10 -12 weeks dry as a potato chip, as long as not having a few drinks all bets are off.
It will take time to retrain and to heal only a small percentage have to have further treatment so don't panic just yet, I went to see a continence nurse prior to surgery and it was well worth it.
good luck
Ausboy
Posted 8/4/2011 11:43 PM (GMT 0)
Thanks for responding. We were just surprised by the fact that he is not able to stand up and urinate. It just empties into the pad before he gets a chance to get to the toilet. Everytime he gets out of a chair, the pad gets soaked. He has been doing his kegels but not sure if he is doing too many.
Posted 8/4/2011 11:58 PM (GMT 0)
Just an FYI, your husband's case will be different,

At a day or two out I felt like I had to pee all the time, it would dribble when I wasn't trying, and wouldn't when I tried. I just kept trying to hold it when I felt it drip, and got up a lot to try, soon I was able to hold a few ounces, still felt weird when trying to pee.

Nights got dry first, at 3.5 weeks out I went to Jeep Safari in Moab, I was down to 1pad/day. May 3 marked one week without pads, surgery was March 1.

My bet (and sincere hope) is you will see slow progress with sudden milestones.
Best
Dave in Durango CO
Posted 8/4/2011 11:59 PM (GMT 0)
Your husband is still very early in the healing process. I had open surgery as well and incontinence was a problem when standing up for a couple of weeks. I would stand up and walk very quickly to the bathroom hoping to have some left when I got there. But, it got better pretty fast after that. See my post in reply to Aframe2 for more.
Posted 8/5/2011 12:02 AM (GMT 0)
It varies a lot with different people, but I remember being able to stop the stream the day I got off the table when the catheter was removed. It took several months for the leaking to stop completely. I would say keep kegleing and wait a couple of months before panicing
Posted 8/5/2011 12:12 AM (GMT 0)
Thanks to all for your replies.
Posted 8/5/2011 12:22 AM (GMT 0)
 I had my date with Davinci on June 8th and on the 15 my catheter was removed. I did my Kegels as told by my URO and and still leaked like crazy. On Saturday July 1st I was going to the lake with my wife and friends and decided I wasn't going to wear any pads that day and to my surprise I stayed dry (except when I jumped in the lake) all that day and every day since. I still have an occasional stress drip or two specially when I pass gas, which I now do sitting on the toilet. I think what I am trying to say your husband will know when he can stay dry and you just have to put your mind to the fact you can stay dry. I still do the Kegels and this afternoon was the first time I passed some gas and didn't drip. Keep in touch, good luck with your husbandsrecovery and do not be afraid to ask any questions here as there are no silly or stupid questions in this forum.

Terry the Water Guy.

Posted 8/5/2011 12:24 AM (GMT 0)
good luck on your husband's healing process, its so early in the game right now, and incontinence issues vary so much, patient to patient.

david in sc
Posted 8/5/2011 2:17 AM (GMT 0)
jg, your husband is still in his early steps on the road to recovery. It seems like all of us who have had surgery have had different experiences with regaining control. I had a stretch after surgery where I felt I was making no progress at all for a while and then there was an occasional day that was a little bit better than the day before. And of course, sometimes there was a day that was worse than the day before. Try to avoid getting discouraged but when it happens, remember that all of us here have also been down that road and somehow get the strength to keep going on the journey. The two of you can do it, too.
Posted 8/5/2011 3:13 PM (GMT 0)
Thanks all.
Posted 8/17/2011 1:12 AM (GMT 0)
jg welcome to the forum. You have picked a good site with lots of knowledge, experience and support on offer.

Sorry to hear about your husband's post op problems. Since I have been on this forum the one thing I have noticed is that many of us respond differently to treatment. Hang in there and try not to get too despondent, it's early days yet. 

Posted 8/17/2011 1:26 AM (GMT 0)
It has now been 2 weeks since the cath was removed and there has been a little improvement on the incontinence issue. He has had some improvement in the mornings but not in the evenings or overnight. I had read that the overnight incontinence improved first.

My husband received his path report today from his prostatectomy on the MD Anderson website. One thing I am confused about is the Perineural Invasion as well as the 3rd component of his Gleason score being Tertiary 5. He is a Gleason 7 (4+3) and now with a tertiary of 5. The surgical margins were negative, seminal vesicles negative, lymph nodes negative, organ confined, and vas deferens negative. There was also High Grade PIN listed. Should we be concerned about the tertiary 5, PIN and the Perineural Invasion since it was organ confined? We don't have a doctor's appt until 8/25.

Thanks in advance for everyone's help.
Posted 8/24/2011 9:15 PM (GMT 0)
Hi Folks, kinda new here. Just had catheter taken out today. I had know idea what to expect. All your postings are really going to help both me and my wife. I feel like I need to order a truckload of pads. I was at the grocery store and the clerk said "how are you?" I pathetically grinned as the stream trickled. Fun times ahead!
Posted 8/24/2011 9:57 PM (GMT 0)
Hi Sparkit

Welcome to the club no man wants membership to, but at least you found us. Staying dry will come eventually just do not get frustrated and give it time. Sounds like you have been secretly viewing our blog and postings so you have enough information to be dangerous now and I see no need to rehash my experiences. BTW your posting humor at the grocery store shows promise that you will fit right in with most of us crazies in here. Keep us informed and ask as many questions you need. There are no stupid questions in here just beware you may get some crazy answers. yeah

BTW good luck with your recovery.

Terry the Crazy water guy

Posted 8/24/2011 10:10 PM (GMT 0)
Sparkit, welcome to the club. The leaking will pass as the days go by and you do your exercises. My first improvement was at night. I still have the occasional drip with a sudden move or heavy lifting. This should make the up coming bowling season a bid interesting.
I think it was almost a week before I made my first steam. I was so proud! So relax some and carry extra pads( Manty sheilds) where ever you go for a while,and just worry about spill over.
Posted 8/24/2011 10:11 PM (GMT 0)
Sparkit, welcome to the club. The leaking will pass as the days go by and you do your exercises. My first improvement was at night. I still have the occasional drip with a sudden move or heavy lifting. This should make the up coming bowling season a bid interesting.
I think it was almost a week before I made my first steam. I was so proud! So relax some and carry extra pads( Manty shields) where ever you go for a while,and just worry about spill over.
Posted 8/24/2011 10:51 PM (GMT 0)
Gents: Thanks for "warm" welcome. Humor is definetly going to be a requirement to get through all this. I am considering swimming as my exercise as there is an excuse for a wet suit. What respectable bowler hasn't spilled his beer on himself. "Darn, I spilled my beer in my lap."
Posted 8/24/2011 10:56 PM (GMT 0)
 

OK everybody Sparkit has passed his membership test and should be given his membership card to the crazies chapter of HW. skull

Sparky start your own thread now so we can all meet you in the forum, you can list me as your sponsor too. yeah   

Terry

Post Edited (The Water Guy) : 8/24/2011 5:01:26 PM (GMT-6)

Posted 8/24/2011 11:27 PM (GMT 0)
We were concerned as well but it has been 3 weeks since the catheter removal and much has improved. I am sure it will get better.
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