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Incontinence after robotic prostatectomy

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Posted 8/2/2018 7:59 PM (GMT 0)
I am at 3 weeks post-op for radical robotic prostatectomy. My Foley catheter was removed on July 23rd. I am fine when I am in a recliner or laying down. But when I stand up and am walking around the urine pretty much just leaks out of me. I do not have any problems urinating and I can stop my urine stream anytime. I have been doing my kegels like the doctor instructed me to do three times a day 10 reps of 3 seconds and resting in between for 3 seconds. In fact I have been doing the Kegel exercises more often than that. My main concern and question is- is it normal for urine to pretty much just leak out of me when I am standing or walking and will it improve more than it has? Am I just being too impatient and will things improve with time?
Posted 8/2/2018 8:07 PM (GMT 0)
Brimmer welcome to the forum.
I’m a surgery guy as well. I think it’s way to early for you to draw conclusions. Everyone is different, but progress can often be slow and we are all impatient, only natural.
It’s possible that you are doing too many kegels. Try doing exactly what your doctor recommended. Too many kegels can tire out the sphincter muscle as I understand it.

In any case, it could take weeks, or months. But I think you will see progress over time.

Good luck
Posted 8/2/2018 8:44 PM (GMT 0)
Thank you Pratoman. I guess I thought I would be seeing a better Improvement by now but patients with this sort of thing has never been a virtue of mine.
Posted 8/2/2018 9:11 PM (GMT 0)
Good question about kegels. In my research over the past couple of months, I have seen anywhere from one set a kegels a day, three sets a day, and have even been told to do them any time I think about them. And holding the kegels anywhere from three seconds to up to twenty seconds. I do see the logic of doing too many a day and tiring the sphincter muscle. But is there a true accepted number of and timing for the kegels?
Posted 8/2/2018 9:20 PM (GMT 0)
Brimmer,

You probably have instructions from your surgeon about how, and how often, to do your Kegels. You should stick fairly close to that. If you overdo the exercises you can tire out the muscle and make your leaking worse.

As for how long it generally takes after surgery for men to get dry here is a rule of thumb: two men in three will be dry at the end of three months. That includes the very-few men who were dry when the catheter came out and the men who regain continence before the three month mark. Of the men who still leak after three months, two out of three of them will be dry at one year. Many of them will have had some sort of physical therapy or biofeedback training which do help. The men who still leak after a year (one guy in nine) will want to talk to their surgeon about fixing the problem with additional surgery.

So at this point your odds of getting where you want to be are pretty good but it will probably take weeks to months to get there.
Posted 8/2/2018 9:23 PM (GMT 0)
What you are experiencing is unfortunately quite normal. Men normally have two sphincters to hold back urine. We lose one with the prostatectomy. It takes time for the lone remaining sphincter to gain the strength to block urine. It will just take time, and the odds are you will be fine. Hang in there!
Posted 8/3/2018 12:17 AM (GMT 0)
Normal and keep up the walking!
Posted 8/3/2018 12:36 AM (GMT 0)
Early days, walking, kegels and time is the formula.

Hang in there, you're body is still healing.

Andrew
Posted 8/3/2018 5:17 PM (GMT 0)
Actually it is good that you only have problems when standing/walking. My experience was similar and I was free of pads in less than three months after surgery. I was weighting pads daily and I found a consistent decrease on weekly basis. Knowing that was a great reassurance that I was in the right walk to stay continent. I did not Kegels after surgery, I tried to avoid dribblings when walking and I thought that this was enough to make the sphyncter stronger and extra exercise could add too much stress on it.
Posted 8/3/2018 7:58 PM (GMT 0)
I had the surgery May 14th and after three weeks I was right where you are; but I've been back to pretty much normal (about 2 or 3 days a week I will leak a few drops, which is actually better than it was before this all started) for a while already now. So from my point of view the answer to your first question is yes and yes and to your second probably. My impression is a lot is up to the skill of the surgeon but also up to just the rate at which you recover from the surgery and the way our bodies adapt to the new geometries inside, which of course can vary for no real reason and not much we can do to change. Certainly what you are experiencing is within the range of normal. You might not get better but odds are very good you will, and there's nothing to warrant too much worry at this point. Not yet.
Posted 8/5/2018 2:50 AM (GMT 0)
Thank you all for the info.
Posted 8/6/2018 4:17 PM (GMT 0)
I'm 13 months post and still have zero control, had the AMS800 install and it's not working either
Posted 8/7/2018 3:57 AM (GMT 0)
hi Brimmer
I had my surgery December 4 2017
I was leaking alot up until 3 to 5 months
post surgery.
Healing takes a long time.
Posted 8/7/2018 4:00 PM (GMT 0)
im 7 months post-op I,m still leaking a lot. You are not the only one. Just keep walking and do kegel exercidse. It will soon stop leaking..
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