VED causing increased incontinence (?); any similar stories

[edit 3/14/2012-- I have since collected 3 months of data and have found no obvious correlation between "normal" VED use and increased incontinence. I still think it's possible that I may have been a little "overzealous" one time with the VED, but it was also at the same time I noted signs of a UTI. Bladder infections are well-documented as causing increased bladder sensitivity and control problems, so I've chalked this problem up to the UTI. As of 3/14/12, I'm on biofeedback and am at ~3 pads a day.

***** I'm leaving the rest of this unedited, in case anyone might find anything useful in it*****]



I wanted to see if any others have experienced this or have possibly correlated the two issues... Sorry... long thread.

The Summary: Looking for anyone who may have experienced increased incontinence after using the VED.

Now for the whole story:

By one week after catheter removal (maybe even within 3 days after), I was at 1-2 pads per day. Approx. 2 weeks after catheter removal, I started on 5mg Cialis and VED (Osbon manual). All through this time and prior to surgery I was doing kegels... and was also aware that overdoing them can cause extra stress on the sphincter, so I'm fairly sure I was not overdoing them. I was only using the VED every couple of days, as well (not daily).

Approx 2 weeks later, I noticed that my pad usage started to climb (4....5...6 pads per day). I also had signs of a UTI (same pains/itchiness I have had many times before). I happened to have had some levaquin on hand from just before my surgery and started taking those over a weekend, until I could get to the URO. A nurse squeezed me in the next Tues and did a culture and set me up with Cipro. My symptoms AND my pad usage started to go down. Within 3-4 days, I was down to 3-4 pads/day. I got the results back from the culture-- negative. No growth. I'm a biologist... plenty of background in microbiology, so I decided this was very possibly the result of excess levaquin in my urine sample killing off the bacteria before it could be cultured (just a hypothesis). All I know is that my UTI symptoms got better and pad use went down.

NOW... the last 2 weeks since:

My pad usage has started to climb again-- to the point where I'm frequently just constantly dribbling into the pad. My flow at the toilet is low and FREQUENT. Like MANY of you, I'm best when lying down. Sitting restricts the flow, but once I stand up, I'll get a rush. Before all this, I could easily tell a flow was starting when it began to enter the penis, and I could stop it (or slow it) with a kegel.

Looking back over the last couple weeks, I realized that while I was dealing with the UTI symptoms, I ALSO stopped using the VED. After my pad usage was down to 3-4/d, I started using the VED again (maybe every 2-3 days). I started feeling so much better, that I decided it was time to start getting serious about daily VED usage. I used it last Sun and Mon. On Tues and today, my pad usage is up to 6-8/d. I'm also completely LOADING the pads (with occasional leakage/underwear/pants changes), whereas before, I was changing pads with spotting and a little weight to them. (Interestingly enough, I am still able to get 8-9 hours of sleep with no leakage and no longer getting up in the middle of the night to pee. (Controlling fluid intake in the evenings).

Soooooo (if you've made it this far) ;) ..... my theory:

The TIMM Medical (Osbon maker) rep said, "Don't worry about how much pumping you do... you really can't damage it (me, not the pump ) ... just stop pumping before it hurts. If it hurts, release a little air... then try further."

I noticed in the first couple of uses, it was pulling up scrotal tissue, which they warn about, so I fixed that. I'm pretty confident I'm using it the right way. BUT, I also happen to be kind of "thick", if you know what I mean. The base of the VED up to 2 inches or so (when fully vacuumed) is fully sealed by the thickness of my penis-- more so than by being simply sealed against my pubic skin. This is WITH the gray insert added; without the insert, I pull in scrotal tissue. When fully vacuumed (and without any pain), I'm about the length I was before surgery, although of course, much thicker than with a "natural" erection, just because of how the VED works.

Now, with my increased incontinence after 2 days in a row of using the VED, I'm now wondering if the VED is causing stress to the external urinary sphincter. I'm VERY familiar with the anatomy and physiology involved here (again... biologist), so I'm left thinking this is one of the last plausible reasons.

I have searched high and low (on this forum and via google) and haven't found a single discussion of this. I was wondering if anyone else encountered this, particularly during the first several months of recovery.

Right now, I've stopped using it for a while. My next scheduled URO followup is in a couple weeks. Was going to wait and see if my incontinence starts to get better while not using the VED.

Post Edited (NoMoProstate) : 3/14/2012 8:59:27 PM (GMT-6)

I think your theory has some merit on the surface. I have never used a pump so I have no first hand experience to compare with, but if the pump can draw urine out of the urethra, perhaps it could cause extensive strain further up, thus increasing your number of pads. Sounds logical, and like all things PC, sure it would vary from guy to guy depending on all his circumstances. Have you ran your idea on your doctor or surgeon? Would be interested in what he/she would say. Be worth a shot.

Doesn't hurt to think outside the box like you are doing. Please followup on this subject, would love to know what becomes of this idea.

Good luck, and don't hurt yourself with the pump!

david in sc

I started using a VED about 6 weeks after surgery and have used it fairly regularly ever since, now about 3 1/2 years. Have never had any incontinence issues. Obviously I empty a full bladder before I start pumping, but otherwise I don't void ~ and never had any problem.

I did leak a few drops of urine at orgasm once or twice in the first month, but since then completely dry.

So in my case, no correlation between incontinence and pump use.

Purgatory said...
Have you ran your idea on your doctor or surgeon? Would be interested in what he/she would say. Be worth a shot.

Doesn't hurt to think outside the box like you are doing. Please followup on this subject, would love to know what becomes of this idea.

Good luck, and don't hurt yourself with the pump!

david in sc

Thanks, David. I'm went in for the "UTI that may not have been a UTI, due to the negative culture"... it was a nurse visit only, due to unavailable URO at short notice. My next appt is Feb 15. I'm a compulsive experimenter (like I said... biologist) ;) so as long as I'm not having pain, or it's not tooooo unmanageable, I'm going to ride out this theory for a bit and not use the VED at all. I've been recording pad usage daily for several weeks, since this all started. What I WASN'T recording was VED usage (until I came up with this notion a couple days ago).

I will DEFINITELY follow up here and with what my doc says, as this progresses. Since I couldn't find anything on the forum, maybe it'll help someone later.

Piano said...
I started using a VED about 6 weeks after surgery and have used it fairly regularly ever since, now about 3 1/2 years. Have never had any incontinence issues. Obviously I empty a full bladder before I start pumping, but otherwise I don't void ~ and never had any problem.

I did leak a few drops of urine at orgasm once or twice in the first month, but since then completely dry.

So in my case, no correlation between incontinence and pump use.

Thanks for the feedback. When I came in at 2 wks post-catheter and told him I was at 1-2 pads, he said sounds like it's time! Maybe it wasn't. :/

NoMoProstate said...
SO, I am serious now about more aerobic exercise to see if I can get off the HBP meds.

I can report that despite my frustration with not getting as much weight off as I'd like to, exercise on a more regular basis since PCa diagnosis has allowed me to shave one BP med off, (well, need to confirm that shortly, but so far looking good at all the checks as it's been reduced and finally eliminated.) Poundage-wise I've only gone down 5% or so, but I'm fitter. Now if I could just lose the other 20%...

I'm still on HCTZ, and it will probably be the last one I get off, if I ever get off all of them, despite the urinary effect, because it's not only cheapest, it's also the most effective for me - I've tried to go off it once before, and that was a miserable failure. I pay more attention to getting adequate hydration & potassium so we don't have to relive (could well have been "not live," I've gathered) the reason we tried going off it (potassium crash and trip to the ER.)

I don't drink soda much, have had perhaps 3 liters total in the 4+ months since surgery. I do drink coffee, and having tried getting off of it in recent memory, I did not bother to try going off of it for this. I know exactly how little use I was even long after the withdrawal symptoms abated, and I had no desire to go there again. I've pared down a bit to half a pot of half-caf, and there I'll stay. I accept that serious drinking (alcohol) will have an unpleasant price at this point for more reasons than it used to, but had largely cut down to the 1-2 drink on any night I'm drinking at all level before this for other reasons, and remain there. Drinking alcohol at all is sporadic with me - coffee is a daily deal. Despite all this, I'm mostly 1-pad a day, less if I don't walk - but walking is exercise is a good thing, other than the dribbling.

I have not used a VED, seem to have some action without one, but at various points I have had "partial erection leakage" (and at other times ejaculating urine) even when I had voided ahead of time. Since I was also having the endless dribbles at the toilet, I got ultrasounded at my 3 month, but no significant bladder retention was seen. Those are gradually improving with time, but not in a steady or unidirectional fashion.

I'm mildly amused with the folks that are bothered with getting up in the night - the week I had the catheter in was the only week I've stayed in bed all night in years (and at that I was up past the 2 liter mark on my bag some mornings.)