Bladder Control

It's still early days, so waiting a little longer might be okay. It takes a long time for the body to heal. Some guys are dry by this point, but others take months (sadly a few never). I'd be inclined to give it a couple of more weeks.

But if it's still a concern to you, a call to your surgeon is always in order.

Andrew

Sean, probably obvious, but are you doing your Kegels? And are you sure you are doing them correctly? There is biofeedback that can help you be sure they are done correctly, if the issue continues.

As others have noted, its way early to be concerned. I would give it some more time before allowing yourself to be upset right now. Focus on healing, hopefully the rest will come.

Seankc said...
I have been lax re Kegels. It is entirely my fault, but I was doing them wrong. I just found out that I should be "feeling" them through my butt, whereas I've been doing them through my pelvic area.

Thank you so much for feed back.
Sean

Sean,
I see you have about the same size prostate as I did. I had more trouble than most, but less than a few. At my 6 week visit, I was expressing much concern with my level of incontinence. Dry while sleeping, mostly dry sitting, but standing it pretty much came out most all the time. Sure, I could stop it with a Kegel, but I could not Kegel all day, and even if I could that was miserable. The doc and his PA ( or nurse practitioner? can't remember) reassured me, saying that guys with large prostates often were much slower to recover, and yet just as likely to finally become continent as the guys with smaller prostates. Just takes longer. One way they explained it: the bladders of the huge prostate guys gave us a dam to work against for many years, and our bladder was well trained to push against the dam. Now that "muscle bound" bladder still wants to push hard, but there not only is no prostate to fight back, but the remaining sphincter is not used to carrying the main load. So it can take a while to re-train everything.

How are you at night? Since I was dry at night from the get go, they encouraged me by saying the single strongest predictor of final continence, even if it takes a long time, is being dry at night early on.

A final point: they pointed out that sometimes the anastomosis , the place where the urethra is sewn back together, sometimes falls down into the remaining sphincter, the muscle that clamps off urine flow, that squeezes the urethra(the tube urine flows through), when we Kegel. Of course, the place where the urethra is joined (sewn/sutured) back together forms a scar, like any other cut. A scar can be tough hardened tissue for weeks or months. If that is the case, even very strong sphincters will not be strong enough to keep that scar compressed all day long, or maybe even way less than all day. If that is the case, there is nothing to do about it except wait for healing. That is a luck of the draw thing. Thy try to keep the scar away from the sphincter, but there is only so much room, and when we stand up with a full bladder, it tends to fall towards, or into, the sphincter.

In my case, I had a pretty wet 1st months, and I was very concerned and unhappy about it. Though still hoping. Between maybe 6 months and a year I was much better, even when walking, but still not great. After about 1 year, I was pad free ever since, now at 2.5 years, except when I feel like I need some backup just in case. But most days I wear no pads and have only 1 remaining problem. Several times a day I get some sort of contraction or spasm (bladder?) when it really wants to push urine out involuntarily. Usually, I can get this Kegeled off, but I must be gun fighter fast. Occasionally a few drops escape, but not enough to show through past under wear for over a year now. But that 1st 6 months seemed pretty hopeless. Still, I have continued to very slowly improve even after 18+ months.

You are about 4+ weeks? Even if you are having a real bad time and really wet, there is just no way to know at this time. You might be good to go in a few more weeks, or months, or more. Your large (ex)prostate will probably slow down your recovery, but does not decrease you odds of full recovery. Good luck, may you improve steadily and rapidly!

Post Edited (BillyBob@388) : 8/30/2016 7:21:06 PM (GMT-6)

Hi Seankc,

It is still a little early to worry about it - even though it seems like forever. Odds are very good you will be fine in 3 months.
There are plenty of studies that show continence rates over time. Here are some round, post-surgery numbers for you.
At the end of 3 months, 2/3 of guys will be dry.
At the end of 1 year, 2/3 of the remaining guys will be dry.
Of the ~10% who are still leaking after one year about half will require follow-up surgery, usually a sling or AUS. (I was one of the "lucky" 5% that had surgery.)

In the meantime, do your kegels, wear your pee pads, and use this as an excuse to have your wife and kids do all the heavy lifting around the house. It is Good For Men's Prostate Health. You read it here. ;-)

Jeff in NY and worried no more

I had surgery last April and I was leaking over 700 grams a day (they had me measure it). What worked for me was riding a bike while wearing pads. This put a lot of pressure on the lower pelvic muscles. Once I started riding about 60 miles a week my flow stopped.

I am on hormonal and S. Radiation. Leaking is slowly coming back which is normal during radiation. Hoping full control comes back once radiation ends.

Seankc said...
Hi BillyBob,

Thank you for the post and all the thoughts you put together here! As with everybody else on this site you have been so generous in sharing.

I have been wet at night too so we will just have to see. I have faith in God that with time it will all be ok. 4 weeks feels like forever when you have just had surgery!

Once again, thank you!

You are very welcome. But being wet at night by no means guarantees a bad outcome, it's just if you were dry it would be a really good sign for you. Many are not dry at night yet end up dry.

And don't forget! If you are among the really unlucky, and in the small 2-5% that, even with the best surgeons and aggressive rehab are just not dry enough at say 18 months, in that worst case scenario there is always surgery, which can fix the vast majority of those wet guys! For a long time I was planning on having that surgery, I was just so slow I figured I would need it and was looking forward to it. But so far, I am not volunteering for it. My lack of dryness is so slight, I'm not sure it is worth having more surgery. So, I am not, yet.

Sean,
No need for concern. Around the same time after my surgery, it seemed that I was seeing good improvement. I recall stating that to my doctor, and he replied "you will have good and bad days". He was absolutely right. Are you seeing a Physical Therapist? P.T. was great help in making sure the kegels were done correctly, and at each visit there were additional combinations added to the exercises. I am now 5 months out and been 99% dry for couple of months. Do the kegels, and walk. I have not tried bike riding, but must work for some. My bet is you will be fine soon. Your faith is the best asset you have, stay strong. In my prayers.
Mack

Hey there, its early days... I leaked like a sieve at times for months after surgery, 2.5 years later I get a few dribbles but thats about it. I remember at 2 months melting down thinking my life was over, how could I go to work leaking like this and so on? Recovery from leaking is not a linear improvement, you really will have good and bad days and weeks. Keep working on kegals and walking.

At the 4 week mark I tried walking around the block with a full depends on, 6 houses away it was full, my pants were wet. uhgggg. Today its 4-6 mile hikes and nary a drop. You will get better, just keep remembering it takes time. Also avoid things that irritate your bladder and drink lots of water to stay hydrated.

Stay positive

Sean,
By the way, I am the famous/infamous nutjob who measured his pee leakage every day for over a year. I plotted it with forecast ( exponential, 2nd and 3rd order polynomial) curves and presented that to my Uro. When the forecast indicated I would never be continent I started preparing for the next surgery.

I recommend taking data periodically by weighing your pee pads. You might not think you are improving but the data will show the truth.

Good luck.
Jeff