Total Incontinence After Prostatectomy

Garry: You are not alone. I had robotic laproscopic prostate surgery March 2, and catheter removed March 8. As with you, I fell fine and recoveery from surgerory was quick. However, since that time I have had pretty much total urinary incontinence (not bowel - which seems fine). It is a little over two months and I am using about 3 or 4 pads a day. Night time is prretty much dry as I lie down and my pad is more or less dry in the morning. Same goes for sitting. But when I stand up after lying or sitting for a period, I have no ability to hold my urine. I have consulted with my surgeon, a respected and capable uroligist, who said to come back at three months, and that we would discuss treatments.Of the 105 opeerations done by him on the robot, he says I am the only one to have aalmost complete urinary incontinence.A google review says that this is a long term issue, and I continue to "kegel", and will undertake a more rigorous schedule. Let's stay in touch. Ron 

Gerry: I had zippo control. However, I am doing my kegels like crazy and have noticed a strengthening of my muscle as I do them, as well as a slight ability to control my steam after I have voided in the morning, and then lie down and wait 1/2 hour and walk to the john holding in my muscle. At that point, i can slightly control my slight stream. Not much of an improvement, but at least some slight change. I will continue to kegel and see if the situation improves. I am thinking this is  long term process.  Ron V.

Ron:  Congratulations on progress and keeping me posted.  Unfortunately, I have trouble with incredible complexity of this website and I could never read all of your last message.  You are welcome to email me directly at [email protected].  I had 60-day phone discussion with doc this past week and he now acknowledges I'm doing less well than average.  He agrees it's OK to try Kegel exercises, which he hadn't been enthusiastic about before.  But he still thinks it's really just time that solves the problem.  If no progress by July, they'll have me in for a look-see.  Best regards.  GerryE

Hey Guys,

My husband had the robotic laproscopic prostatectomy on Aug. 22nd. He is doing well. We were told to do the Kegels ahead of time. He did them a number of times everyday for a month. But we also know a few guys that did NOT do the exercise ahead of time....and are having problems. Also I was told age is also a factor with the recovery time. Where did you have your surgery at? We had ours done at the City of Hope with Dr. Tim Wilson, who has done over 1,000 of this procedures.
Do you know if they spared your nerves during the surgery? Our Dr. said that sometimes the nerves take time to recover from surgery even if they are not damaged. Good Luck to you.
Kay

Hi Brian,

I did a lot of research on all 3 types of surgery. My husband and I picked the robotic laproscopic prostatectomy.

The open surgery has a lot of draw backs: more blood loss, longer surgery time, cutting through all of the muscles and tissues, the surgeons vision is not as clear due to the blood in the surgery site, maginfication is not as good as the robotic (which is magnified by 16x), under anesthesia longer, recovery time is longer from the surgery, cathether is in longer, and also recovery time of continence and potency.

The laproscopic seemed better but it still had a few draw backs that I saw. First of all it does NOT move in the same direction as you would move your hand. For instance if you turn right, the instrument moves the opposite(to the left). Some surgeons don't do laproscopic surgery because they can't compensate doing things opposite of the way the instruments move. It does NOT magnify as much as the robotic. The surgeon has to sit in an awkward position during the whole surgery. It does NOT compensate for any surgeons temors or sudden movements.

The robotic laproscopic surgery has less blood loss, mimimal invasive (5 small holes), magnifies the surgical field by 16x, the panoramic camera that can turn 360, in color, 3 dimensional viewing, instruments are made to move in the direction the surgeon moves, the computer adjusts for and surgeon tremors or sudden movements, shorter recovery time, cathether is out sooner (5-7days), continence is returned sooner, nerve sparing surgery can be done with more precision in a bloodless field. Look at the City of Hope web site and it will tell you about the procedure in more details.
Or look: www.davinciprostatectomy.com
www.intusurg.com

I also found out that it is VERY IMPORTANT to find a surgeon who does a LOT of whatever surgery you decide to have. Don't be afraid to ask the doctor how many he does a week or a month. Also ask what his outcomes of the surgery (continency & potency). All GOOD surgeons would give you the results. It should be up in the 90%. It might not be right away. The City of Hope gives a 50% of their patients are continent after one month, 75% after 3-6 months, and up in the 90's% after a year. The Dr. we saw did 8-10 of these surgeries a week. He has done over 1,000 of these procedures. He started by doing the open procedures, then the laproscopic and now the robotic laproscopic.

I know that a lot of the hospitals now do the laproscopic and the robotic laproscopic surgery. We talked to a lot of different men who had prostate surgery done. Good Luck.
Kay

Hi motopedlr,

Sorry to hear about your cancer. Good Luck!! There is hope. Just ask lots of questions. It will make you feel better with the more information that you have. Remember no question is stupid. I went with my husband to all of his appointments. I had a BIG binder with all the info I collected. I wrote all my questions and his questions before the appointments. I left spaces for the Dr.'s answers. This way we didn't forget to ask questions that was important to us. By writing the questions down before our appointment....we didn't forget to ask the Dr. Hey, as far as the Kegels, one of the guys(who had the surgery before my husband) we talked to told my husband to do them as if training for a marathon. They all regained continence anywhere from 12-30 days after surgery. I'm talking about not having to wear a pad. I've heard they had a few Oops(minor leaks) with coughing, sneezing, and laughing. But those get better with time.

Yes, I think it makes a difference. But I just recently read that erections are not instant like when a guy gets excited, after the surgery. It takes stimulation to the penis itself. The City of Hope gives their patients Viagra as soon as the cathether comes out to increase the blood flow to the area to help things to heal faster. Two days after the cathether came out we had sex with No erection, but he had was able to have an orgasm. That was 8 days after surgery. At about 3 weeks we had an erection. It did take some working but both partners have to be willing to work at it and adapt, because it is different. I told my husband we would just have to keep practicing until we get it right. The Levitra(Viagra) works, but causes him to have head aches and his heart races. So, we are going to try without the Levitra for a while, or switch back to the Viagra. Our health plan changed the Meds. from Viagra to the Levitra. I don't remember the Viagra causes the same problems. I will be calling the Dr. to check on this. You can write to me at [email protected] for more details on things. By the way how old are you? From what I heard, age and health before surgery also makes a difference on the recovery.

He had his surgery on August 22nd. He is 43 years old and is physically active, because he is a hay farmer. He also coaches sports for our local High School.

Flopsie:
Thanks for the encouraging post. I had a radical prostatectomy on 10/18/05 with catheter out on 10/25/05. So far almost total incontinence. Nighttime is fine, or sitting if I concentrate on squeezing.

These are your words that give some hope: "For the first 3 months he had no bladder control, did his excersizes faithfully. Then he started having less and less leakage."

I am almost 63. How old was your hubby when he had the surgery done?

And great news about the PSA! That is the main event, as they say.

Derek

Hi Derek, my hubby was 56 when he had his surgery, we are now 11 months post-op and total bladder control. BobIn Az, you are correct, every one is different, but in time, I think we will all be free of the depends and such.

My thoughts and prayers are with each and everyone of you.

Hello Everyone,

I need your help. My husband, a very young 70, has just been diagnosed with prostate cancer.  In July he began having problems with bladder dysfunction and that's when the diagnosis was made. He has been self-catherizing since then. What we'd like to know is what  procedures, RP, robotic laproscopic surgery or a weaning off the catheter with hormones and then IMRT radiation, others with the same type of problems have chosen and the outcome.  Thanks

Sharzey

Philpa -- I think your husband's situation needs a real pro to sort it through. The pre-existing urological conditions seem a bit beyond what most are going through going into a decision about prostate cancer treatment. If he were my best friend, I'd urge him to consult with at least 2 or 3 of the very best surgeons you can connect to. Based on everything I have seen and heard, your consulting docs should include one or two who are very experienced with the robotic, laparascopic procedure, since it has many advantages over traditional surgery when it comes to surgical precision and to various aspects of healing (based on my views of various data).
best of luck to your husband and to you. James