Exactly What is Continence & Can I ever have it again?

Okay.  Wednesday I have my final session w/biofeedback tech. The first session was with a sub since my assigned one was out sick.  Week # 2 my assigned one took over & I've had two sessions with her.  Both were very, very positive about my outcome as was a Uro who looked up inside me with the systo.  Said the Uro, "Your muscle looks good." I supposed he was speaking of my remaining sphincter.  Said tech # 1, "You are a good candidate to being dry when we finish with you."  Said tech # 2:  "You have made excellent progress.  You will be dry by the time we finish with you." 

I have one more session and I'm not dry... yet.  So I am asking myself (and I shall ask the tech on my last visit) "What is continence for one who has had an open prostatectomy?"  I will ask you who will give me a little time the same question.  I know your answers will most likely be, "When you stop dribbling."  I know some of you have spoken about being dry and some about being completly dry, even some have been dry from the time cath was removed.  But is that really a good practical answer and definition for dryness for someone like me who is now at seven months post surgery and still dribbling?

Tech # 1 wanted me to hold everything and pee only every one and a half hours.  Somehow I could not make her understand that the only way I can hold everything is by sitting for that long, getting up, squeezing until I get to the potty, and then peeing. 

Tech # 2 has said go pee from one to two hours. 

Can someone like me, who has worked the Kegals and continues to drip during activity really expect continence?  Or should one like me be happy with getting up from the seated position, squeezing, peeing, and forgetting it until I can sit and retain again?  What I have heard and read is that between 3-6 months, continence will return.  It has not for me (and others).  Should I just forget it after these sessions and should I expect that it will happen if I keep kegaling?  How long must I keep keagling?

Ok.  It's gotten too long.  

I'm not really depressed about my situation... or at least I don't think I am.  I'm willing to go on in life and function.  I just don't know when I should stop all this keagling, padding, etc. and just put the clamp back on and forget it.  What do y'all think?  Is there potential for dry underwear in my future?

Gene   

Hey Gene,

You have had a difficult time since surgery with the strictures, bleeding etc. These probably contribute to your incontinence so don't be discouraged about it. Your body will heal in time and with the excellent support you are getting from therapists and doctors, you should be in great shape. We are all different so don't let the few early successes discourage you. They are the exception.

Good luck...

Jim

Hi Gene,

I can sympathize with you. I am four and a half months post surgery, the laparoscopic type. My continence situation has remained unchanged since the day my catheter came out, and it sounds like it's exactly the same as yours. I went to my local urologist and he did a cystoscope (tv camera on a tube) up the urethra
and saw what he described as a stricture near the anastomosis (the place where my urethra was cut and sewn back together when the prostate was
removed.) Apparently this happens in less than 10% of patients who have this procedure.

The doc said that the stricutre was preventing my urethral sphincter from completely closing in its relaxed state-- the result is that I have
constant leakage. Slow but steady leakage, especially when I am standing.

This doc said he would not treat me and recommended I talk to my surgeon. I talked to him on the phone, and of course, he said he would treat me, after taking a look
with the scope himself. There are two treatments:

Serial dilation: an instrument is inserted into the urethra to expand the stricture to break it down. Apparently this is done several times with a
larger and larger instrument? or something. And as an outpatient procedure. Also, some patients have to have this procedure repeated several
times.

Surgery: a lot of different methodologies here, but it involves a hospital stay and a catheter for a week or two afterwards. not something I'm eager
to do. And I am not sure exactly what they do once they are inside to fix the problem.

I don't totally understand the mechanics of why the stricture is preventing my sphincter from working normally. More troubling then that, though, is
that I am not sure that the doctor that looked at it really understands what is going on. Another doc I spoke to said that the anatomy of the urinary tract is very delicate, and very complex, and that even very small problems can upset the balance. In other words, "measure twice, cut once".

Before I undergo any of these treatments I want to learn more. I am seeing another doctor in two weeks. I don't want to get any treatments until I
totally understand my situation, and the risks involved. I also want to make sure that I have the absolute best person doing the work.

My situation is neither improving nor getting worse, so I feel like I should not rush into a treatment that I am not sure about. I am hoping that as I learn more I will feel comfortable about another intervention, but at this point, I am more comfortable leaking. By the way I am using the AFEX product on days when I am very active. It's a collection system, versus an absorptions system, and while it's not foolproof, it allows me to go longer between having to visit the bathroom and change pads.