INCONTINENCE

Hi everyone,I have a questio.Do you think incontinence is due to the surgeon or it depend on the patinet?

M y friend has been incontint for four years,but my brother whom has Laproscopy has been dry from day one. 

Interesting queston, gold horse. The way I see it is that a surgeon without top skills, experience and judgement, will leave more men incontinent than a surgeon with top sills, experience and judgement will. But, I doubt the difference would be huge. Perhaps two cases in a hundred. By the time you're through med school, qualify for specialty training, and become both a surgeon and a urologist you're in pretty rare company already. Okay, I know there are a few bad apples, but for the most part even the bottom of the barrel is cream of the crop.

Also, I believe that a great surgeon can't keep a leaker dry. By this I mean that some people's urinary tract and muscle control is such that no surgical magic is going to keep them totally dry.

Please readers take into account that the above is the opinon of a total medical ignoramus.

Sheldon AKA Sleepless

I think it also depends on the PC as well. If a patient has a high Gleason, and perhaps an EPE, or the PC os close to the edge, the surgeon is more apt to carve up the nerves a little more to be sure he got all of the PC. Better or more experienced surgeons can leave more nerves. Less experienced just whack the entire nerve bundle out.

I also have to wonder how a guy can be incontinent for 6 months and in 1 day be continent. I certainly wouldn't say that was the skill of the surgeon. It would seem that the patient was somehow able to master the kegaling and sphincter control.

It is certainly a riddle.

I was convinced that I could do kegels before surgery and afterwards and I'd have control in 90 days. If I didn't it would take three months. So, being lazy, I took the 'don't do it' route and it worked fine for me.

When the sphincter is ready, the close off will come.

Again, this is totally personal, unscientifically supported, shoot in the dark opinion.

Sheldon AKA Sleepless

Incontinence:
Lets not forget that men, prior to surgical removal of the prostate, have the luxury of TWO sphincter muscles the uppermost being primarily responsible for controlling urine flow is REMOVED with the prostate leaving the remaining muscle at the floor of the abdomen which is intended to remain open when sexual arousal occurs. I personally wonder if the guys who claim to be totally continent are perhaps hedging on us a tad. I gave up on pads as unnecessary about two months post op but do have a surprise leak every once in a while with a sneeze, certain twisting motion, heavy lifting etc. Getting horny is another issue for me, with 50MG Siagra I'm back where I was prior to DiVinci removal but leak like a sieve which is enough to put a damper on the party! Normal activities, while I may feel I need to go more often I CAN make it without leaks.

74 years old - Gleason 3+4=7 - After third biopsy 2 of 12 positive at 30% and 70% - Vatikutti DiVinci @ Henry Ford 2/10/10 - nerves spared - margins, nodes, vesicles all clear. Three month PSA .06 - Six month PSA less then .06. Six month follow-up with Dr. Peabody tomorrow 7/16/10.
Other then "parties" life is very much as before PC. (forgot to mention my prostate was 106 grams or three times normal size), Never had any real issues with recovery except when the nurse removed the pubic catheter and my bladder went into spasm. OUCH!

Posted this link in the other "incontinence" thread but others may come to this one so check this link out:
http://books.google.com/books?id=IZmhwzwGyuMC&pg=PA279&lpg=PA279&dq=prostatectomy+removes+upper+sphincter&source=bl&ots=lbeo1eh0HH&sig=