Incontinence after Radical Prostatectomy

Welcome Steve. I have no experience with the clamp, but just wanted to say i think you are jumping the gun. 4 weeks is not a really long time and you will likely improve over the next couple of months. I hope thats the case. With that said, i know thats not the answer to the question you were asking, and I'm sure others with experience will chime in over the next 24 hours or so. It can be quiet here on the weekend.

Prato and Mumbo - Thanks for the fast responses. I hear you both. In my post I said: "I know, it takes time to heal and I fully expect healing in time. My urologist said it may take months, so I am patient. I am just thinking ahead, just in case the incontinence remain there for a long time or maybe never going away." I did not mean to do this right away, just wanted to plan ahead and discover options. I see that the clamp is a drastic option and I guess it does not encourage the urinary sphincter to do its job. From both responses I can see that this is really not a solution, just a short term bridge. I will not pursue this method but rather have the Kegel exercise regularly and give it time to heal.

The good thing is that during the night I do not seem to leak and when I wake up in the middle of the night my pee is almost normal. During the day when I stand or sit I leak and really I can not pee normally since my bladder does not have enough pressure. So, thanks again you both, your responses are very valuable to a newbie like me. Steve

alephnull - Thanks for the response. See my post to Pratoman and Mumbo. Sorry to hear that after 8 years you are still leaking. I guess you are part of the 15% or so. I wish you get better with the leak. I am still hopeful to become continent. Steve

halbert - Thanks for the encouraging words. Yes I am hopeful by the non-leak status overnight. Up until now I did the Kegal in a sitting position only. You added another Kegal variation which I certainly will start doing. Thanks again!

Thanks Jeffff for the well wishes and the good advice! I can see why do Kegel while peeing is one of the best exercises.

VinceInMT - Thanks for sharing your experience. I am glad that the artificial urinary sphincter worked for you. Good info. I am fresh out of the operation just 4 weeks ago. I did not expect it to be such a big one, it lasted 2.5 hours. If and when the situation presents itself, I will think about artificial urinary sphincter and I definitely want to talk to you then to get as much details as possible. Thanks again!

jmadrid - Great post, thank you! Your weighting method adds a different dimension because one can monitor accurately the changes in time. I was encouraged by your method, so this morning I measured a brand new pad and the pad I wore overnight. There was no defference in weight, so now I can prove that I did not leak overnight unless I leaked very little and it dried out. Eiher case it is good news for me. Now I will check the daily amount of leakage. The clamp is out for me, see earlier posts in this thread. Thanks again for suggesting this method.

Hi guys, I need your help. I may have an issue since the Nov. 17 catheter removal. My take is that I either have to pee and/or leak and from the catheter removal until yesterday I may have had little pee and not enough leakage. Yesterday (Nov 30, 24 hour span) suddenly I started to pee normally (about 1,950 ml with 6 cup of water) with some leak (75 g in the pad). Before yesterday my pee was weak, not sufficient (I did not measure it) and the leakage was not sufficient either (I did not measure it either, I just felt it by the weight of the pad). Actually I did not know what to expect but after yesterday's pee output I started to wonder. By the way, I started to measure input and output yesterday based on jmadrid's suggestion. Interestingly, possibly by coincidence, I started to pee normally that day.

As I said yesterday I started to pee normally with a normal stream and sufficient amount with some amount of leakeage. However, today (Dec 01) I seemed to be back to the original situation. I consumed 7 cups of water today producing a weak stream of pee with the volume of about 695 ml and the leakage was about 20 g. So it seems to me that today with roughly the same water input I got only about 36% of the previous day's pee output. My question is where the difference in pee volume (1,950-695=1,255 mL) might have gone, if any? I am afraid that my bladder may not have been water-tight since the removal of the catheter, but this may be an over-reaction. If any of you can share your thoughts, I would very much appreciate it.

In any case I will call my urologist's office tomorrow but it will take some time since he is very busy. Your input would be very helpful.

Thanks for your help.

Steve,

It's not a linear progression. You'll have days that go great, then other days that feel like setbacks. This is normal. There are some guys who purchase a high quality scale and weigh their pads. I never got that crazy about it.

One thing I learned, and is still true today, 6 1/2 years later: I'm more likely to leak if I let myself get dehydrated. It's like the valve/pelvic floor muscles need to have something to push against. It sounds counter intuitive, but it seems to be real to me.

A couple of points to clarify my previous post. I also had daily fluctuations, depending of water (and alcohol) intake, exercise, efforts or just random. The numbers I considered were averages over the 3-4 days. I learnt the method from this forum and I also know from here that no everyone experience such a text book exponential decrease.

patrickm - you said exactly what I have been thinking about. I am an engineer and test is a big part of our practice. I was always wondering how does the urologist know that there is no internal leak, although my urologist had a pressure test during the operation according to his report. However, the real test is done after the healing of the joint. You just answered the question about internal leak. This 'pressure test' can be done any time by simply inserting a catheter or a cystoscope.

The whole point, guys, is this: recovery from surgery is a marathon, not a sprint. We have to be willing to give it time. And, we're human beings, not widgets, so each of us experiences the healing processes differently. Just because I recovered in a certain sequence and in a certain time, doesn't mean that someone else will be on my exact path.

It's statistical. We can say that 90% of men will recover 90% of their function within 6 months of surgery. But, are YOU in that 90%? You won't know until you get there.