Urodynamic Studies? Is this really neccessary for low drippage,one pad daily?

Urodynamic Study include Cystometry, Electromyelogram, Pressure Studies, Voiding Cystourethrogram, Multi-Channel Video Urodynamics, Measurement of Post-Void Residual...etc.

Urodynamic Studies? Is this really necessary if I'm not on board with the SLING procedure?

I recently posted where after almost three year DaVinci Robotic Radical prostatectomy, I find myself mildly incontinent,meaning I do not believe I have stress incontinence, no dribble during laughing, coughing,but maybe when I yawn, which is very weird. I wear One depends diaper per day..on days when I go out, but not yet tried to use regular skivvies. (bareback) I am 57 years old.

I notice when I sit down to go, it has spurts here and there that last for a few minutes after the main emptying of my bladder. When I stand up peeing, I can try to stop the flow, but not completely..some still dribbles out. Only tried it once, so i'll get back to you on that.

next week, My Urologist wants to do a Urodynamic Study,to see if I'm a candidate for a SLING procedure,and to also measure pressure. I am seriously thinking of cancelling. If my problem was having to wear three or more diapers per day,and more excessive leakage, then I would definitely consider it, but even after wearing a diaper all day when I'm out, it hardly notice any leakage or odor coming from the diaper, so.....

The uro also discussed the AUS procedure, but that is way beyond went I need at this point. I am content with what I have to deal with now, and as one fellow poster said, "Why temp fate", which I can agree with given I also have a 6.8cmx7.6cm Lymphoceal pushing inside my bladder that also has to to be drained, ( a result of the RP, and surrounding lymph node removal) and if I were to do this urostudy, I should at least wait until this mass effect on my bladder is addressed first. I'm no doctor, but it's my body, and Ill have to think about that.

I also recently posted "To Sling, or not to Sling" here on the prostate cancer boards which gives more detail to what I've been going through.

Post Edited (unhappycramper) : 10/15/2011 10:41:02 AM (GMT-6)

unhappycramper -(my dyslexia kicks in and I see it as unhappycrapper)

- I am at one pad a day - and have measured it - 30-50ml depending on physical stress and fluid intake
- once considered getting a sling - now content with my "new normal" - have to remember to let "mr. johnson and the twins" to get an airing once in a while -

-the tone of your letter sounds like the doc is trying to push something on you , you do not want, but don't want to displease....
-if you are not anxious about the leaks, the pad, the "new normal for you"... tell doc - thanks but no thanks.....

-if you were in the "worried guy" pre-sling status, I would recommend you research it further ... but from my own personal point of view, I would be more bothered with the change in stream output ( 2-1/2 minutes to void) - than my regular frequency - once every 1 to 1-1/2 hours pit stop to pee.

the old phrase -measure twice cut once - applies to many decisions in life - this included.

-I think you already know the best answer for you.

new normal hugs,
Bronson

Remember, it's your choice, to do or not to do this, it's not up to the doctor. If you are content with the mild incontinence you describe, I wouldn't be eager to have the sling done. If your condition ever worsens over time, you can always re-evaluate your situation.

David in SC

unhappyCRAPPER...funny, when I joined this site back in 2005, I should have used unhappyUNcrapper, since I first diagnosis was IBS, and constipated. That constipation was a result of a bowel obstruction and carcinoid tumor blockage in my ascending colon. So that DX changed to a rare carcinoid tumor cancer.

But when I was on the IBS boards here, I received a lot of compassionate advice that helped me,even though I never had IBS, I did change my eating habits for the better! When I had my Prostate surgery in 2009, I just kept the moniker. It may be confusing here on the Prostate boards,but wanted to keep all my med history together.

I have also received good and compassionate advice here too.

I am 57 years old. If the dribbles get more out of hand later on in my years, then I re-eval the situation, but I'll pass on any procedures and only concentrate on that fluid density mass causing pressure on my bladder....The surgeon tells me this can happen when working around lymph nodes during surgery. I have to get that drained, and who knows, this might take away some problems with urinary control,or maybe not..one step at a time. Thanks for all your replies! Have a great weekend!

Unhappycramper,

Step right over here... right next to the pee gravel... Put your toes on the edge of the concrete patio... See those orange lines on the ground? OK, let's see how far you can shoot.

Hey, you are going about it the right way. No need to rush anything. Just make sure to take data and keep track of your progress. You might find you are getting better slowly. My reams of data, graphs and charts really helped me. When the data curve of leak vs time flattened out and the forecast curve indicated I would never reach zero, that's when I decided to get the sling.

Stopping mid stream used to feel uncomfortable but not painful. I would try to stop it near the end of the process, not at the beginning.

Good luck,
Jeff

I second the comments made by Worried Guy. I am also a long term leaker with hopes that the situation will improve with time. It appears to be doing just that as my pad weight numbers continue to very slowly go down. I have heard too many stories about how the testing to evaluate the need for a sling cause an increase in incontinence levels. With my incontinence output at around 11 to 15 cc per 24 hours, I sure would hate to bring that back to 30 or 40 cc per day as I had when I was several months out from surgery.

Early on I could not stop my flow in mid-voiding. Later, I could with a lot of effort but it still spurt a bit as I tried to shut down. Now I can stop it with a moderate pelvic floor contraction. It does not hurt to stop but I do get somewhat of a burning sensation doing that. I also get a burning sensation if I try to push hard to empty my bladder of urine. I refrain from that because I really don't need a more powerful bladder muscle trying to work against my weaker pelvic floor muscle.

The evolution of internal feelings doing Kegel exercises has been interesting to me. At first I felt I was pulling up a muscle a great distance. Kind of like imagining the pelvic floor muscle in profile shaped like the letter "U." My pelvic floor exercise felt like I was taking the two upper ends of the "U" and straightening them to form a horizontal line. I felt inside like I was pulling up and then pressing the muscle against the bladder. As I progressed over months, the "U" shaped straightening process went away and now that distance from feeling the muscle to be flaccid to tight and holding against my urethra is firm and tight. For me that firm tight feeling took a very long time. I suppose it was the outcome of having a fairly sedentary life style (office job at a desk all day)

You are doing the right thing to wait and assess the situation. As Jeff requested, it would be interesting to note your pad weight to see just how much you are leaking.

Mike S.