Continence: timing of phasing out pads is important and a challenge

My URO said words to the extent that he wanted me off pads by our next 3 month visit. He said it a way that made me think I had a choice in the matter??

Well, low and behold, a few days later was a Saturday. I went without a pad that day and every day since...

Guess I had been on the pads for about three months and was down to 2 a day...

I laughed when I read the JHU take home message about continence.  It was very close, in some cases identical, to the language on the printed material my husband was given by his surgeon's team when he went home and then again when he went into have the cath taken out.  His surgeon, by the way, came out of the urologic oncology pipeline from JHU (he was the head of Urologic Oncology at the Bayview Campus and an Assistant Professor before he left to become chair of the Dept. of Urology for the medical school and cancer center where we live) .   Did you also get the part of the message about activity level with the words to the effect you had surgery, you are not sick.  Don't act like you are sick.

It has been 5 months since my husband's surgery.  Everyone truly is different.  He never wore the depends type underwear and only wore the guards for like 2 weeks before going down to the shields.  He quit wearing shields routinely by the time he went into for his first post op exam/PSA.   At this point he has very occasional stress incontinence which is unpredictable as to when he will have it - sometimes a certain physical activity might trigger a slight drip, other times that same activity is not at all problematic.  Right now it seems like serious coughing jags may create a little drip.  What he found however was when he would have a little drip and put on a shield afterwards, the shield was completely dry when he went to take it off several hours later.  He was literally just having that momentary mini squirt, so he quit even putting on a shield in those situations as he was wasting product.    What he did notice however early on in the continence routine was that late in the day - which is something his hand out mentioned, was more difficult for leaking as the muscle would begin to tire and that it when he tended to need to put on a shield during the period he was training himself to discontinue using them.   Don't get discouraged if you are doing well for much of the day but by very late in the afternoon or early evening, you have a slight set back during your continence training.

good luck. 

im a little confused about terminology. When you guys say pads, do you mean the guards or the depends mens underwear/diaper?
I've always referred to the Depends Mens Briefs as pads, and the small thing that fits in your regular Hanes briefs, as a guard. And I think there is a smaller one called a shield.

Whats what on the terminology?

I've been down to leaking about .6=.7 ounces in a 24 hour period, but today was not that good, .6 oz in about 6 hours. Complier told me not to expect it to be linear, so I wont worry. Until tomorrow

Hey Men !

for Steve N Dallas.

On pads for about 3 months, then dry. I love the quote, "Nobody can go back and start a new beginning, but anyone can start today and make a new ending." That's a positive thought I intend to remember.

for Goodlife.

8 months until pad free.

It's good to learn of the tremendous variation among mens' experiences with getting to continence (or not). I somehow picked up the notion squirting and leaking and dribbling might last 1-2 weeks. I guess that's possible, but unlikely. Something in the order of 3-8 months sounds more realistic to me now. My new rule is not to go anywhere without 2-3 fresh clean unopened pads in my pocket as backups.

Yesterday I was walking a client's dog and discovered the pad I was wearing was soaked. I put on a fresh dry one, but an hour later the new one was soaked through too. Ouch. Made the discovery those handy-dandy black poop bags pro dog walkers (a sideline of mine) always keep in their pocket are perfect for disposing of spent/used wet pads. I put them in public trash cans. Maybe not quite as hygenic a good practice as keeping them until disposal in the trash can when I get home, but I feel like I've discovered a practical new "off-label" use for doggy poop bags: no poop, just the soaked pad. Publicly acceptable to walk around with a doggy poop bag (with unknown contents). Good!

for Lovif.

Guards for 2 weeks, then Shields, then you quit Shields by first post op exam. Stress related occasional drip. Some occasional drip late in the day. The muscles involved get tired.

"Don't get discouraged." Thank you, Lovif. I was feeling more than a little discouraged yesterday. First leaking a lot during the day's errands. Then waking up in the middle of the night last night to a soaked pad, soaked diaper, soaked sheet, soaked under pad. Thank heavens for the big black 30 gallon heavy-duty trash bad I had wrapped around the mattress, providing a good barrier against my mattress getting soaked. Sometimes I'm real thirsty on going to sleep and drink 1-2 glasses of water on retiring. Not doing that any more!

for TDNJam.

I laughed out loud at, "I guess my bladder never got the message" (an expectation of a short period of incontinence, then dryness). You are still using a pad 2 years after surgery. All bets are off if a sneezing attack. "As much as I don't like it, I have come to accept it and hope one day my bladder will get the message."

All best wishes and good luck to you. Hopefully some day your bladder will read the memo, and comply. And meanwhile, your great sense of humor will carry the day.

for Pratoman.

Hey there!

". . . about terminology."

My understanding is the Depends diaper like briefs are generally called "diapers." Reading from the package they come in the labeling says, somewhat confusingly, Depend for Men Underwear -- Maximum Absorption." These are the throw-away, one-use, Depends diapers. Dry cotton personal conventional underwear like Haynes and others make are "briefs." Not to be confused with "boxers."

The small, light, gray color, folded in thirds, gray outer wrap, thingees are labeled "Depend for Men Guards -- Maximum Absorbency for Larger Surges." I'm pretty confident these are widely called "pads." The thinner, less absorbent thingees sold as Depends "Shields" are also called "pads." So two levels of absorbency. Heavy leakers like myself (this moment) stock up on Guards. When I advance to little drips I'll switch to Shields.

You wrote, "Complier told me not to expect it [progress] to be linear, so I won't worry. Until tomorrow."

Hang in there, Pratoman.

for Worried Guy.

Again, I'm reduced/expanded to laughing out loud. Thank you, Worried Guy, for this,

"If they told you there was a 1 in 9 chance you will still have wet plants at the end of the year, and a 50% chance of ED at 2 years, you wouldn't get in the car!" Actually, a 1 in 9 chance of wet pants at year-end sounds pretty good odds. You didn't mean to say a 1 in 9 chance of dry pants at the end of the year, did you? That to me sounds more like a good reason not to get in the car for the drive to the hospital.

In my case, I knowingly tuned out most of the discussion about ED and incontinence Side Effects pre-surgery, although I did strongly urge my surgeon to go for nerve-sparing (which he did) while at the same time getting all the cancer, and having negative margins. I knew if it came to a choice between either nerve sparring OR getting all the cancer, of course I'd want him to get all the cancer. Thankfully, the surgery path report was fantastic, couldn't have been better, he did the nerve-sparing, AND he got all the cancer. I'm not complaining. That said, I do feel somewhat unprepared for the reality of my heavy leaking so far -- six days out from the catheter coming out. I'm thinking more modest-size meals may make a difference here; if I go back for seconds, that feels to me a trigger for more flow, thinking back to pre-surgery. What all the good intentions in the world never accomplished, my present incontinence is in the process of accomplishing -- eating significantly less, overall.

I sort of remember multiple times reading that side effects from open surgery (RRP) are often worse in a 70 or 70+ year old man than for a younger guy. That being part of the argument in favor of radiation over surgery for someone my age (70). Can't say I wasn't warned. And I'm ecstatic I opted for surgery. "One and done."

It's definitely healing and nourishing for me to post here. I don't feel so alone or isolated knowing I've got lots of company in the post-surgery leaking and dribbling and squirting department! And my discovery I can use a black dog walker's poop collection bag to put my soiled soaked pads in when I'm out and about, offering instant utter respectability, that's a bit I can use in my planned stand up routine. Made me laugh the instant I thought of it a few days ago.

Bill Positive

It was all about confidence and heat for me. The Australian summer could spell havoc for a few droplets on one's undies and there is nothing more off putting than smelling of urine in a social setting.

So, I diligently weighed my pads every day and when the weight remained constant for a month on say 5g, I went solo (no pads).

[In hindsight, I think I overdid the precautionary part a bit]
.

Bill. If it continues, ask your surgeon about biofeedback. My surgeon does it if a patient is not mostly continent at 6 weeks. Gedman , one of the veteran posters , has done it and it worked for him, maybe he will weigh in.

As far as a scale - I have a scale I bought from my local weight watchers branch (I'm a lifetime member), that weighs my pads in tents of an ounce. You can also use a postage scale, does the same thing, you can probably pick one up at staples, or order it on amazon.

I think when this is over for me, I won't be weighing my food on that scale anymore, I'll have to buy a new WW scale LOL