HealingWell
Search Close Search
☰

Frequent Urination after Robotic Prostatectomy

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
12
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 6/9/2017 12:34 PM (GMT 0)
Hi All,
I am 59 years old and it has been 2 1/2 weeks since my robotic prostatectomy and the recovery is going pretty well I must say. My biggest concern at this point is that I am urinating more frequently now than I was before the surgery (which I thought would be literally impossible). For the past week I have been getting up about 6 times (about once an hour) at night to urinate which really makes it tough to get a good rest. With the catheter in place I was sleeping really well but I'll take the frequent urination without the catheter for sure.

I've read some posts along these lines and it sounds like I'm not the only one who experiences this issue. I did go to my urologist's office a couple of days ago so they could check for a urinary infection and I'm still waiting to hear back. They looked at my urine and a visible inspection did not indicate an infection so I'm still waiting on the results. It's not just at night I experience this frequency - it's all day long. For some reason I thought my frequent urination would be gone immediately after having my prostate removed but I guess it takes time.

I guess I'm just looking for anyone who has had their prostate removed recently and is experiencing the same issue. I read in one of the posts that I maybe should do my best to extend the time that I do actually urinate if possible (hold it) and that should help in time.

Any other insight would be appreciated. Good luck to all who have to go through this procedure and I hope you all recover well with no side effects in a reasonable amount of time. I feel you are my brothers. By the way, 2 of my actual older brothers had the surgery before I did so I wasn't at all surprised when the biopsy showed prostate cancer.
Posted 6/9/2017 1:47 PM (GMT 0)
How much water are you drinking in the evening? I drank lots of water during the day post surgery but I think I slowed my intake down around dinner time. I certainly don't remember getting up every hour - maybe three or four times a night.
Posted 6/9/2017 1:51 PM (GMT 0)
Try cutting down on your fluid intake after dinner and avoid caffeine or carbonated beverages.
Posted 6/9/2017 1:52 PM (GMT 0)
Hi John,
I always have some type of liquids at night but I haven't had any alcohol and won't have any for 4 weeks. Before the surgery I had about the same amount of liquids or maybe even more but didn't have to go this much. I just thought the frequency of urination would decrease and be a benefit of prostate removal but I'm I'm hoping that this is temporary which I will certainly discover in time.

Thanks
Posted 6/9/2017 1:54 PM (GMT 0)
Ya know, since I cannot drink alcohol for the 1st 4 weeks I have replaced those liquids with ginger ale and root beer which are both carbonated. I'm going to test out just water this evening and try to limit that intake as well and see what happens. I don't drink a lot of carbonated beverages so maybe those are the culprits.
Posted 6/9/2017 2:12 PM (GMT 0)
Any diuretic will make you pee more, and soda definitely fits that category. I echo others to say limit your fluid intake of any kind after a certain hour of the evening...after dinner, 7 pm or whatever. Drink plenty of water through out the day....it will help getting everything back to working condition. And remember, it is not a quick process. I had my RALP in early Feb and am 'down' to 3-4 pads in a 24-hour period. I could get by with 2-3, but it is a comfort thing. After cath removal, I was at 8-10 and they were full and got up 2-3x per night to urinate (but I did stay well hydrated...2-3 L of water a day). I also do a full regiment of Kegels, 150-180 reps/day.

I was a big coffee drinker and eliminated this for a time. I will now have a cup from time to time and will be able to hold most of it, but will see uptake in leakage around 20-30 minutes afterwards. switched to chamomile tea, which it still slightly diuretic, but, well, we've got to have our vices, no?
Posted 6/9/2017 3:14 PM (GMT 0)
I had the same experience after my RALP. I read here and my surgeon confirmed that one consequence of the foley insertion is that your bladder flattens out and loses some of its elasticity. I started seeing some improvement after 3-4 weeks, and now after 2 months it feels close to normal.

Give it some time, I think it will get better. Best wishes for your recovery.
Posted 6/9/2017 3:59 PM (GMT 0)
Thanks for your replies RealisticOptimist and Kcheves. It just may be the carbonation from the soda that is a big factor due to the fact I hardly ever drank soda prior to my surgery. I'm going to lay off any carbonation tonight and stick with water and limit that the closer I get to bed.

I think that's interesting that the bladder flattens out and loses some of its elasticity due to the Foley Catheter. I'm coming up on 3 weeks this Tuesday so maybe there is a light at the end of the tunnel. Thanks for the kind words and for your prompt replies!

For those of you who have been recovering for some time now, have you noticed that you urinate a lot less now that your prostate is gone? Before the surgery I was up many times at night to urinate so I am hopeful that this will decrease over time. I just thought it would be immediate.
Posted 6/9/2017 4:23 PM (GMT 0)
I'm 3 months post-op and I experienced somewhat the same as you write about. Not quite so bad, but still very frustrating.
I agree on the advice not to drink more than you need for toothbrushing after dinner, and I heard from my uro and physiotherapist that the problem most of all comes from the nerves in and around the bladder. Many nerves in the whole area have been damaged or reorganized and it takes some time for them to learn to sense correctly again. I remembered a strong feel of having to go, but when I went, there wasn't that much.

I believed it had to do with bladder size which I thought in some way was reduced during op and chath-time, but maybe "false nerve signals" are more to blame.
And nerves TAKE TIME to heal.

It probably also is a good idea to try not to go the first time you feel the need. My physio says: When you feel the urge, stop, kegel for 20 seconds, breathe deeply a couple of times and try to move on without thinking too much about urine smile
This technique can sometimes make you "forget" the urge for 5-10-15 minutes.

Also remember that abdominal pressure creates a feeling of having to pee. That's why stopping up and relaxing you stomach muscles might lessen the pressure and the feeling.

Good luck. It will no doubt get better!
Posted 6/9/2017 4:26 PM (GMT 0)
That is an interesting point about the Foley effect on the bladder. Another consideration is the possibility of developing urge incontinence. The way I understood this affecting recovery from RALP was this: Trying to avoid leakage may cause emptying more frequently, which in turn reduces capacity and heightens awareness of the need to go. The answer is holding just a bit longer to retrain the urge and get the bladder stretched back to pre-op capacity.

ETA: Looks like Martin P posted while I was typing and explained it better.
Posted 6/9/2017 4:29 PM (GMT 0)
Hey Bessebo,

I had my surgery about six months ago and, yes, I had the same experience. After the cath came out it seemed as if the amount of urine I could hold was way down from pre-surgery. I was peeing very frequently and when I would pee there wouldn't be all that much there despite feeling like I really needed to go. It makes sense that your bladder at that point is not used to getting full since it had been draining immediately through the cath, and plus, there was some irritation of the whole areas' nerves from the surgery and cath, not to mention, the sphincter that is left is experiencing more load than before. For me, it got a little better each week until I no longer noticed it any more. At six months now I'm back to being able to hold a good amount of urine, as much as I remember from before, and the bonus is, my stream is much stronger than pre-surgery.

As others have said, try to avoid drinking much after 8 pm to cut down on the having to get up at night.

Hang in there.
Posted 6/9/2017 5:10 PM (GMT 0)
Hey schoolpsych,MartinP, and Explorer59,
Thanks for that info. It makes complete sense and now I know that it isn't only me who has experienced this phenomenon. Also, thanks for the tips on when I feel the urge to go.

Tonight I'm going to limit the carbonated beverages and try to limit the water after 8PM. Hopefully I see some improvement and start to get some more sleep! smile
Posted 6/14/2017 1:22 AM (GMT 0)
Hi just had divinci on march 8th have been almost incontince free. Cut out all coffee and pop and lemonade at least that's what I had to do love my coffee but about 2 hrs after drinking 1/2 cup start losing control. The other thing I recommend is walking I have almost walked 200 miles since march 15th. Good Luck you will get there.

Psa 20. Gleason 9 61yr old.
Posted 6/14/2017 1:54 AM (GMT 0)
Well, guys, let me check in from almost 2 1/2 years post RALP. I rarely am up at night..maybe once during a night no more than twice a week. One contrary thing I've learned is that I can hold it better when I work at keeping hydrated (yes, with WATER). I can tell when I'm dehydrated...and I find that's when I seem to need to pee the most...and only squeeze out a little bit at a time. (More concentrated urine means more irritation to the bladder?)

It gets better, guys. But, give it a few months, not a few weeks. Seriously.
Posted 6/14/2017 12:56 PM (GMT 0)
SkyPilot56 and halbert,
Thanks for the info. I will definitely give it a few months, not weeks. I just was a little concerned that increased urination may indicate a problem. I did get my urine checked last week and no infection was found. They also noticed that I was not retaining any urine in my bladder so that is not an issue either.

I am still consistently getting up about 5-6 times each night but more frequently just after I go to bed. By the time it gets to 2:00AM it's more like every 2 hours, not every hour or less. Still have some accidents on occassion as well but I know it will get better and look forward to maybe getting up once a night! That should be awesome and should do wonders for my health.

I'm getting a lot out of this forum. Thank you everyone for your sage advice and counsel. It means a lot!
Posted 6/14/2017 1:47 PM (GMT 0)
Hi Bessebo,

Congratulations! So far, your recovery seems right on track!

I'm a data kind of guy and tracked everything during my recovery phase. I weighed every pad and measured every pee to check my incontinence level. I'm glad I did. That data was useful down the road.

It would be useful to know how much you are drinking. Please keep track for a day or two. When the catheter was in it was a good idea to drink, walk, drink, walk, drink,... But now that it is out you might want to get back to the usual routine or modify it a bit.
A good rule of thumb to remember is: on average, a healthy well hydrated male will produce 1 ml of urine per hour per kg of body weight In English, that means if you weigh 180 pounds you will produce about 3 oz of pee per hour. 4 hours during the day you can expect to see 12 oz. Try it. Pee in a cup and check.
Now you need to know how much you can hold. Surely you measured that when you were in college! I was good for 24 ounces! Those days are gone.
Your body was subjected to a lot of trauma. While things are swollen your bladder can't hold what it used to.
Measure a full pee and see how much you can hold now. (I'll guess about 8-9 ounces.)

So, what to do about it? Drink a lot during the day. Start tapering off a couple of hours after lunch and cut off liquids 3 hours before bed. Before you go to bed, take a shower and pee while you're doing it. Make sure you really empty yourself. Go ahead, let it fly! You don't have to worry about aiming since it will rinse off the walls.
I guarantee this will reduce the number of times you have to get up.

Periodically check your capacity and your daily output. By keeping track you will see improvements before you even notice them.
Good luck!
Jeff - "Without data all you have is an opinion."
Posted 6/14/2017 1:59 PM (GMT 0)
Hi Worried Guy,
Thanks for your responses. The thing is, I have always consumed a lot of liquids. During the day at work I would routinely finish probably 64 ounces of water plus a couple of coffees and maybe a tea or two. At nights my wife and I would always have a few alcoholic drinks. I haven't had any alcohol since the 2 days before my surgery (24 days today). My wife still has her drinks but I've been having root beer, ginger ale, sparkling water, or just plain water.
Tonight I will make it a point to just have water with dinner and nothing afterwards. The thing is, we typically eat around 8PM and I go to bed around 10:00PM so 3 hours will be tough. I'll lay off the liquids I was drinking while my wife is drinking a gin and tonic to see if that makes a difference.
If it helps I'll keep up that practice for a few weeks during my recovery and hopefully I'll get some good results. Actually, I am enjoying the feeling of being pretty refreshed each morning (even though I'm up a lot to pee) without any alcohol after-effects. In fact, this surgery has been a really good thing for me in many respects. It also makes you realize who really gives a shi$ about you... smile
Posted 6/14/2017 6:01 PM (GMT 0)
Bessebo,
"64 oz of water plus a couple of coffees and maybe a tea or two. At night.... a few alcoholic drinks."
Where do you live?!?! Saudi Arabia?!?! That is 64 + 2 x 12 + 1.5 x 12 + 2 x 8 = 122 oz of liquid!!! Not including water in your food. No wonder you are peeing so much. That is like 122 oz /24 hour = 5 oz per hour. every hour. Do you weigh 5/3 x 180 = 300 pounds?
You must have a bladder the size of a basketball! smile

I think of us as thermodynamic/chemical machines that process sugars, fats, and oxygen into CO2 and energy with a water catalyst. We are nominally 100 Watt generators with our brains burning 15 of those Watts.
See? This is why you need the data.

Yes. This surgery can teach you what and who matters in life. It can actually make you a better man. Congratulations for seeing that!
Lemonade from Lemons.

Jeff
Doing the garden. Digging the weeds.
Posted 6/14/2017 9:00 PM (GMT 0)
Hi Jeff (Worried Guy),
OK, maybe I have a problem but nothing that can't be modified easily. OK, I'm going to, starting tonight, limit myself to 2 glasses of water (and no carbonated beverages) after 5:00 to see if that helps. It just might. I will certainly report back to the group.

BTW, I am 190 lbs and very active (at least I was before the surgery a few weeks ago). I work out a lot and this break is probably good for my body as well as my mind. I also drink a lot of water during workouts, working in the yard, etc.

I know for sure I have changed due to experiencing this disease. Believe me, in my family I am not alone as I have 2 brothers who have had this surgery, one just 4 months ago from the same surgeon I used. My Dad also had PS but didn't elect for any surgery since it was so long ago and because of his age.

He did radiation and he always thought it negatively affected him going forward but it did cure the PC. So I had resources to talk to pertaining to the recovery, etc so that was really helpful. I can certainly understand how this forum can help people who have no other resources to turn to.

I know that my life has changed and certainly for the better. I wouldn't wish surgery or cancer on anyone but I'm making the best of my situation and looking at my life in a more positive light. Ya know, counting my blessings for sure... smile
Posted 6/15/2017 10:11 AM (GMT 0)
Bessebo,

I will be going in for a prostatectomy in a couple of months and most of the guys I've spoken to that have had it say one of the benefits is that eventually you can hold urine much longer -- thru the night without getting up, long cars rides, etc. Hopefully that will be the case for you in time.

I actually grew up in Manchester NH, now live outside of Boston and will be going to Mass General for surgery. Like you, I work out a lot, both weight lifting and running, and weigh 200. Not to change the subject of this thread, but I was curious -- have you lost much weight from the whole experience of surgery?
Posted 6/15/2017 10:26 AM (GMT 0)
Rick, all I can suggest to you...is start doing kegals NOW. 4 times a day, 10 reps. And get your core ready for the violation of abdominal surgery.

What I found is that yes, I can sometimes hold it longer....but I also have the experience of the shortening time lag between "I need to go soon", and "I need to go RIGHT F'ING NOW!!!!!!". One that hits, there is no waiting possible, the explosion is coming. (It's not a bad idea to have a 1 liter sized wide mouth plastic bottle in the car with you, just in case you're on a highway somewhere and you're 20 miles to the next exit.
Posted 6/15/2017 11:14 AM (GMT 0)
Hi RickTrin,
Good luck with your upcoming surgery by the way! I could've given you a great surgeon who works out of Manchester, NH (Dr. John Munoz who did my surgery and is always rated one of the top surgeons each year in NH by his peers) but I'm sure you will be in good hands at Mass General for sure.

OK, so I haven't lifted anything more than a few pieces of firewood for over 3 weeks (I was told not to lift more than 15 pounds for 4 weeks) and it doesn't appear that I have lost a lot of muscle mass. I don't have a scale at home so I don't know for sure but I have made it a point to eat really well and my wife is a really good cook so I'm certainly getting my calories.

I also happen to think that this break has been really good for my body. I purchased one of those small hand grippers at Walmart and do those every day a number of times just to be able to do something for exercise. I wouldn't really worry about it. I think that years ago if I didn't do any lifting for 3 weeks I would've lost a lot but the older I get I don't tend to lose size as quickly.

I'm glad that you found this forum because I wish I had before my surgery. Ask questions and you'll have actual survivors respond pretty quickly. All the best to you!

Best,
Bob
Posted 6/15/2017 11:25 AM (GMT 0)
Hi Jeff(WorriedGuy),
I just wanted to report back to the group after last night. I took your advice and stuck with only water after 5PM yesterday and only had a couple of small glasses (no carbonated beverages) and I only got up 3 times during the night to urinate. I was averaging about 5-6 times per night since the surgery (just over 3 weeks ago) so I consider this a success! I will continue to do the same thing and monitor going forward and hopefully it will get even better...

Thanks,
Bob
Posted 6/15/2017 12:58 PM (GMT 0)
Bessebo,
That is great news. Keep experimenting. It is worth the effort for a good night's sleep.

During my incontinence period I tried all kinds of things and since I had the data I could tell whether or not something worked.
At one point I backed off on fluids to determine what I really needed. I cut back so much my pee looked like motor oil. I slept through the night but woke up with a dehydration headache. That gave me a data point for minimum.
With a little fiddling you'll figure out your own needs and you'll be able to use that info for the rest of your life. You will never have to wonder if you can reach that next highway rest stop. You'll know!

Good luck,
Jeff
Posted 6/15/2017 12:59 PM (GMT 0)
Thanks for the advice Halbert. I have started kegels but will amp those up and try to do more core training in the time I have left.

Bessebo, that's a good idea on hand gripper as one thing you can do while otherwise staying away from lifting.

I played football through college (a long long time ago!) and back then, as I trained to get ready for an upcoming season, all summer long I would dread the hard double sessions practices in 90+ degree heat I knew I would have to go through in August. Well, I sorta feel that way now with my surgery coming up in August. I'm thinking this is going to be even harder!
✚ New Topic ✚ Reply
12