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Bladder volume after surgery?

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Posted 4/5/2013 6:44 AM (GMT 0)
Is bladder volume less after surgery?
Doc did not mention there were any bladder issues after surgery.
It seems I can't hold it any longer than 4 hours at night and even less during the day.
Went to bed at 10:30 and awoke at 2:30 with strong bladder pain from fullness. I also have some blood in urine that drips out after going.
This has been going on since cath removal.
I'm not leaking which is good, but if this is my new normal...I don't know. :-(
4 hours of sleep is wearing me down. I hope it gets better...
Posted 4/5/2013 8:02 AM (GMT 0)
I don't know if it is any less, but I experienced the same situation as you. However I was waking every hour with a need to pee.  Of course I was and still am leaking. It has gotten better over the past seven weeks, however I think the stitches have been causing some irritation and spasms which seems to make me want to go to the bathroom when I don't really have to go.  Hoping when the stitches are gone that I can get better control.
Posted 4/5/2013 9:51 AM (GMT 0)
James -Sorry your sleep is disturbed.
However your surgery was VERY recent. It will probably be several months before you settle into a pattern you can call a "New Normal" and it will get better.

I think you will though find that you have alter what you drink, how much you drink and when you drink it. I try to drink nothing after 8pm and make sure that the last things I drink are mild (eg green tea, no alcohol, nothing carbonated, no caffeine etc)
Also if you do have to get up you may have to trick your body into thinking it has not (really) woken up, so don't turn the light on, may be even feel your way to/from the bathroom with your eyes shut as well. Our bathroom is right by our bedroom, but if you have to go upstairs or downstairs or take a long walk to pee, then maybe consider getting a suitable bottle you can have by the bed so you don't even need to get up to pee (my dad did that).

Alf
(I'm not a good example of bladder function though as I think that I have always had to pee frequently since I was a little kid.)
Posted 4/5/2013 12:15 PM (GMT 0)
I used to wake up about every other hour during the night to pee. That lasted for several months post-op. Then it started to change to 2-3 times. Now it is only once a night, about normal for me before surgery.
In my case, my doctor said my prostate was about double a normal prostate and it was pushing against the bladder for many years. He said it would take me longer than the average guy for my bladder to relax. I guess that is why I still use 3 pads a day, almost 9 months later.

Hopefully you won't take as long to get back to "normal".

Bill from Florida
Posted 4/5/2013 1:15 PM (GMT 0)
Yep. No drink after 8 or 9 for me. I have been doing that for years.

How long do the stitches take to go away?
Could this be the reason I'm dripping blood after urinating?
Hopefully, all that I'm experiencing with bladder fullness and urgency is because of the stitches.

After going back to bed at 3:00am this morning, I did manage to sleep to 8:47am. Almost 6 hours!
Posted 4/5/2013 1:26 PM (GMT 0)
Sparky,

You are dry, that's great. I went through the same thing with the nighttime urgency and you have all new plumbing that will take awhile for you to get use to the differences in feeling the bladder and the new seldom before used sphincter. The first 6 months I found myself during the day needing to do every 2 hours as I drink a lot of water all day long. Now 20 months past surgery I can control the urgency so much better and most nights I can go all night with our waking to pee and the most is once a night if I drink much before going to bed. The blood after urinating will go away soon and if it doesn't talk to the doc. The only time I leak at all now is when I pass gas sitting or standing with a near full bladder, but even that has gotten better with time. I was told that the same pelvic muscles that controls the urethra sphincter controls the anus one too so it takes work to open one and not the other.

Posted 4/5/2013 1:40 PM (GMT 0)
I think it took me 6 months before I could go all night without and that is if I didn't drink liquids after say 7:00 pm. I seldom get up any more just to simply pee. Sometimes I wake up after 5 hours and have a hard time falling asleep again so I go ahead and take a piss but I don't get up because I have to.
Posted 4/5/2013 1:59 PM (GMT 0)
I had a large prostate and had cancer in the apex which required my surgeon to cut close to the sphincter to try to get it all. As a result I am recovering continence s-l-o-w-l-y. Coming up on nine months after surgery (and three months after ART IMRT) I am down to one pad a day and still improving albeit slowly.

As for sleeping through the night, it's impossible to tell. My bladder capacity is about half what it was before surgery but it is still better than my dog's. She will reliably wake me up to let her out before I would wake up myself because I have to pee. While she is outside sniffing the bushes I relieve myself and then we both go happily back to our respective beds.
Posted 4/5/2013 2:05 PM (GMT 0)
So Peter, you relieve yourself on the same bushes? smhair

BTW my dog can hold it 10 to 12 hours maybe your dog has a prostate problem? Time for a DRE?

Post Edited (Water Guy) : 4/5/2013 8:18:40 AM (GMT-6)

Posted 4/5/2013 2:07 PM (GMT 0)
That's another process to work on. The bladder is a stupid organ and it needs time to remember it's own capabilities. Perfectly normal to have to work your way back to what was normal. I saw quick improvement in this, perhaps 4-6 weeks before I felt it was normal again.
Posted 4/5/2013 2:11 PM (GMT 0)
iSpark,

For me bladder capacity is greatly diminished. I used to normally just go once, maybe twice a day - producing a large volume. Now when I think I am full I probably can't even fill a eighth to a quarter cup.

I am also not so sure I am as continent as I think I am because I cut down so much on liquids and use the restroom 6+ times or so a day. When I reach my quarter cup maximum I start to drip. In fact the last couple of days I think I am getting worse, not better (It's only been a week post catheter though)

For me the difficult part is not knowing when I need to use the restroom.  I seem to have lost the feeling in my bladder etc that tells me when I am full. I have to rely on the drips to tell me (and they are not a reliable indicator). Internally I feel totally different. I can't understand what my body is telling me. For example, when emptying my bladder my abdomen aches; I feel that I am dripping, but I'm not - or vice versa; I think I am having small bladder spasms for no reason, etc.  I think it is these types or lack of sensations which have thrown me off the most as a result of the surgery. Even BM sensations are different now.

I was thinking of returning all the large incontinence pads I bought and just use mini-pads. But now I'm not so sure I should do so - as I am a little worse than before.  Maybe it has just been a couple of bad days - only itme will tell.

I'm with you about getting up at night to use the restroom. Once I'm up, I'm up for a few more hours which makes the next day miserable for me and everyone else. I have to be much more careful about drinking anything at night etc. This has been quite the lifestyle change for me. My wife has no sympathy...she just says 'welcome to a women's world'.

 

Posted 4/5/2013 2:59 PM (GMT 0)
Water Guy,

I am sure that my dog gets lonely out there sniffing the bushes in the 4:12 am darkness every morning but I can't join her this time of year, it's too cold and Mr. Unreliable would disappear completely and I would be unable to pee on anything but myself.

My dog's bladder capacity is OK, I think. She does have congestive heart failure (she takes a lot of the same drugs as my dad, actually) and the diuretic makes her thirsty. I don't think she has prostate issues.

Mr Anxious,

Maddening isn't it that we can't get more sympathy from our wives. Why can't they understand that their incontinence is comical whereas ours is tragic? I will never understand women.
Posted 4/5/2013 3:03 PM (GMT 0)
Hi Spark,

Even though my incontinence was over at about 3 weeks, I also had reduced bladder capacity for a few months.  My surgeon explained that while we are on the catheter our bladders are flat and do not fill at all.  Depending on how long you are on the catheter and what your bladder capacity was before surgery, it takes a while to stretch the bladder out.  For me it was quite a while before I was sleeping through the night without having to get to go.  Four hours was about my limit for about 4 months and then got better.  Being a former teacher, I used to have an iron bladder that could hold it most the day.  As far as blood, that too is similar to what I had.  I took stool softeners for months because if I had to bear down at all, I would get blood in the urine and I would wonder what was wrong now.  Doctor said very normal and that too improved over time.  You're on the early end to recovery and none of this is anything to worry about--easy for me to say now!  You will be fine and giving newbies advice before you know it.  Best wishes! 

Posted 4/5/2013 4:02 PM (GMT 0)
iSpark,

I have a similar experience to you.  Part of my needing to go often is, I think, my preocccupation with not leaking.  The other is my bladder is smaller due to my surgery, but I had a fairly large capacity bladder before.

Night time isnt so bad, as I return to sleep easily.  Its work that is challenging.  I often have to excuse my self during meetings much more frequently than others.  I just returned from a long business trip and the flight was a challenge.  But, no big deal - a smaller bladder is modest price to pay for being on the other side.

Pat

 

Posted 4/5/2013 4:15 PM (GMT 0)
ispark - just remember you have been through a major trauma and your body is readjusting to the "new normal". Some days (and nights) I can hold more fluid in my bladder while others days (etc) it seems I have to pee every half hour - let alone 4 hours.
-your muscles are still week so the triggers you ignored before surgery are more sensitive so you are triggered into peeing more... I personally feel there is some truth to having to stretch the bladder back into shape ( since it has a new realigned sphincter attached to it) by trying to hold back... but do not decrease your normal fluid intake - or you will dehydrate yourself and get sick.
-be patient - even stressing out about peeing can bring on stress incontinence.
-have a urinal bottle by the bed so you can pee and go - if needed - you don't have to lose sleep - just bits of it ...
- I have been trying a new (to me) Serotonin supplement and have been able to have longer sleep segments ( I also have sleep apnea and use a CPAP machine) ... so am peeing less at night than usual.
-take care
- relax
-avoid coffee or a nightcap before bed...
-allow your body to heal...

Bronson
Posted 4/5/2013 4:27 PM (GMT 0)
Thanks guys.
I know I'm still really early from surgery, but the 4 hour max thing is getting me.

I may have to try that pee bottle by the bed.
It sure would beat getting up and then being wide awake for an hour or so.

When they took the cath out, I asked should I try and hold the urine in until I had a urgent need to go, the doc said with a emphatic no, do not try and post pone voiding or until the urge is intense.
Posted 4/5/2013 4:44 PM (GMT 0)
For a young man such as yourself, it will be at least 6 mos before you will feel like the old you and the new normal will be pretty much the same as the old normal. You might try to create a really new normal, by avoiding the anxiety trap that ensnares so many pca patients and be, in fact, patient. This is not to say you need some stoic warrior mode. Share experiences, but don't dwell [live} in them. Exercise, eat well and thrive…...
Posted 4/5/2013 5:15 PM (GMT 0)
While you had the catheter, your bladder was empty for one or two weeks. As mentioned, when cut out the prostate, they are real close to the bladder neck, which could change volume slightly, and even change the shape a little. And after cutting out the prostate, there is some extra room, and the bladder may hang a little lower.

Combine all these variables and yes, you will be different after surgery.

I have consciously worked to retrain my bladder. Each night, after getting the urge, I would work to hold it longer. After a few nights of bladder stretching, I could tell the difference. Now, unless I had excessive fluids in the evening, or iced tea with nutrasweet, I rarely get up in the night. I can usually make it until 7.

It will get better.
Posted 4/6/2013 1:58 PM (GMT 0)
I'm 3 years out, and I still notice diminished capacity. I usually have to get up once per night, but no more than once. When traveling by plane, I always request an aisle seat so I have easy access to the bathroom. I'd say that during the day, I cannot go more than 2.5 hours without peeing, and that is without drinking very much. I drink quite a bit of iced green tea during the day, so I usually hit the bathroom about every 1.5 hours.

Paul
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