22 days post-op - incontinence frustrations

Don't give up on the Kegels, I did Kegel exercises every 15 minutes a day while I was out of work after the operation, eventually things started to tighten up, you have to have patience. When I started to drip less and less I would put woman's thin pads, which I cut in half and put them in my underware sideways to prevent me from wetting my pants. When i started to drive I would squirt when I was stepping into my car, I told my Urologist and he told me to mentally tighten my muscle when I stepped into the car in order to retrain the muscle, it actually worked. I don't know if this is any help to you, but keep working it and you should start to see positive results.

InTheShop said...
Welcome to HW.

The other thing you need is time. 22 days isn't that long and you likely just need more time to heal.

Hang in there, it gets better as your body heals.
Andrew

That. It is almost impossible to predict how much time you will need, mainly time from the surgery but also even from the catheter. Not only is 22 days nothing in this game, your only a few days past the catheter removal. I suspect that all related muscles get really lazy while the catheter is in and maybe even have time to atrophy just like a leg muscle in a cast for weeks. Plus the bladder and most everything else is probably inflamed and irritable and prone to spasm. Plus the bladder itself shrinks (more atrophy?) while a catheter is in place, though probably not by much in just 3 weeks.

Finally, you mention "a pucker in the anastomosis at the bladder neck". They make an effort to place the anastomosis far enough away from the sphincter(the one you are trying to strengthen with Kegels) that it won't fall down into the sphincter. But since there is little room to work in there, and you are steep head down(trendelenburg position) for most of the surgery which encourages everything to fall away from the sphincter towards the head, there may be a problem. When you have a full bladder and especially if you stand up, that healing anastomosis may fall right down into the sphincter. And while it is swollen and stitches are dissolving and scar tissue is healing, even a very strong sphincter muscle may not be able to squeeze the urethral anastomosis hard enough to close it. Or if you can it takes so much effort that the muscle quickly fatigues. If this is the case, nothing but time is going to take care of that, and that all depends on how long it takes for your anast. to heal enough to be easy to close. Though it will probably help to have stronger muscles.

A lucky few(IMO) are dry from the time the catheter is removed, or within a week or two. Most of us take some months to be mostly dry, seems to me. Probably a much smaller % are like me. I took most of a year(even with biofeedback/electrostimulation training at about 3 months) to get mostly dry, and am still slowly improving at 2 years. Maybe 3% or so will never get dry enough and may need additional surgery to fix it.

I'm sorry you are having to go through this, it sucks for sure, most of us can relate. Keep Kegeling, but don't overdo it. Remember how if you are trying to build muscle by lifting weights or running, most don't recommend going to exhaustion every day. That might also apply to Kegels, but I don't know for sure. And hang in there, it almost certainly will get better either in weeks or months. (Though he was upfront about the ED, I don't feel like my surgeon adequately prepared me for the likelihood of incontinence that could well last weeks or even a lot longer, and I bet most don't)
Bill in mS

Post Edited (BillyBob@388) : 1/8/2016 10:00:08 AM (GMT-7)

I am about the same point in my post-cath journey. Mine came out three days ago and I'm having problems, especially when getting up from a chair. It's also no fun to get out of bed two or three times a night.

I've benefited a lot from the suggestions in this thread. I especially appreciated Big Mac's suggestion (which I remember from a previous thread) of inserting a pad into Depends type underwear. I did that for the first couple of days and nights. Today, I've improved a bit so I got brave and put a pad inside of some tight-fitting lycra boxer briefs. They are the kind that have 7-8 inch inseams, so they extend quite far down my leg, just above my knee. Compared to the Depends briefs, they are both snugger and longer (and washable, if it comes to that). I figured they would help hold the pad in place and would catch any stray drips. So far, that seems to work for me.

My doctor is also a big believer in Kegels. He told me to to do two sets a day of 8-10 exercises per set. I'm doing that, plus Kegeling like crazy every time I stand up. (But he also said you can over-do Kegels, so don't go overboard).

I've also benefited from the guys in this forum who counsel patience. I accept that recovery won't be a straight-line improvement. There will be good days and bad days. I agree that incontinence is frustrating and uncomfortable. In a few months, I'm hoping to be able to look back on this period and joke about it (but it's too soon right now).
_____________________
Age 59
Biopsy on 10/29/2015 showed Gleason 3+4=7, positive 6 out of 12 cores
RALP on 12/23/2015
Cancer was contained, surgical margins were free of tumor. No detected Extraprostatic extension; no Seminal Vesicle or Lymph-Vascular invasion identified. Woo hoo!
Final Gleason 3+4=7, Stage T2c

TS, you're getting the idea. Also, never trust a fart.

It took me a couple of months before I was willing to go without a depends guard in my shorts, and I still put one in for unusual situations. Or when I'm wearing pants that will show even a small spot.

Hey Allen, definitely a good day bad type thing. Fatigue is a huge factor. I had my surgery in Mid- December and I try to look at my progress in weekly chunks rather then daily. Last week I finally made it to underwear and the thin depends pads and as someone here suggested I use 2 pads side by side; overlapping a little towards the top and more so towards the bottom, so it covers more surface are for the penis moving around. I only use 3 to 4 thin pads a day now and have not been leaking much but today I was outside loading my truck with branches and working for about 3 hours and I leaked more then I have in weeks, so just the fatigue and extra physical work got the flow going a bit and I had my first little wet spot in my underwear. I'm a little discouraged but now I've confirmed to myself that any extended physical work will probably require the heavier depends pad for a while, same as long rides just to be careful with any full bladder/urgency issues because when that bladder is full it wants to get out. Just another hurdle to get over, but again as long as I have some overall weekly progress I am happy...Good luck, Jim

My clothing habits have changed dramatically. I purchase nothing but dark pants or jogging pants to cover the occasional accident. Take a bath EVERY day because you may not smell the urine but others do. Dogs love to stick their nose in your crotch cause they smell the leaking piss.

Good luck. This is the new normal.

This is a good time to revisit this post.

Last week was about 8 weeks post-op. I was excited to be using the Depends Shield for the first time. Last Saturday, I decided to experiment, and used the same pad Saturday and Sunday - it was still dry when I tossed it out. On Monday, I caught a cold, and by Tuesday I was coughing... back to the thick pads. I just couldn't hold it in while coughing.

So the lesson here is don't get cocky (so to speak), and always be prepared to take a step back.

Tony

I would like to share my experience. My catheter was removed 1 week after the surgery. My nights were dried since the catheter was removed. Initially, I used about 5 pads per day and I remember it was dripping as I was getting out of the shower. I started walking 2 miles every day in the gym and did kegels as I was working out. That helped a lot with my incontinence. Initially, my mornings were relatively dry and I started dripping in the afternoon and it got worse at night. It has gotten a lot better now and it is 6 weeks after the surgery and I am using one pad per day. I stopped kegels a few days ago and it dripped pretty badly. When I restarted kegels ago, it is much improved.
I would to share my experience how I used pads. Every time I go to rest room, I fold 6-section of toilet issue into a mini pad and put it on top of the pad and I change the mini pad every time I go to the toilet. That way, my pad is always dry and I don’t need to change the pad in the public rest room.

PSA increased from 4 to 5
DX on 1//7/16 Age 60.
Gleason 4+4=8
CT Scan and Bone Scan Negative
Robotic Surgery on 2/16/16
Post Surgery Pathologic Stage pT2c; pathology report negative.