Incontinence Like Dripping Faucet

 Three weeks ago I had a robotic laproscopic prostatectomy and 12 days ago had my catheter removed.  Since the removal of the catheter Iv'e had total incontinence which is described in an article as being like a dripping faucet.  This dripping occurs day and night, and the only time I feel like I need to urinate is during the night while in bed.  By the time I make it to the bathroom I have leaked some more and can only urinate for about 5 seconds.  I have been doing my Kegal exercises but so far they have not made a difference.  From what I have read in the literature, it seems that this type of incontinence is not that typical.  My doctor/surgeon does not think it is unusual.  I'd be interested in knowing if others have encountered this type of incontinence and if there is some hope in getting continent with just he Kegal exercises.  Thanks in advance for any sharing of experience. 

Butch39

I had surgery almost five weeks ago and I'm just as frustrated as you are.

My doc tells me it's mostly just a matter of time. I guess we'll both just have to ride this out and try to be patient.

Hey Butch,
Welcome to Healing Well.

I too say give it time. 2 out of 3 guys will be dry by 3 months. Of the remaining 1/3, 2/3 will be dry in one year. Unfortunately I am in the "lucky" 1/9 group of leakers.

Carry pee pads in every pocket and pee jars in every car.
Good luck to you
Jeff

---------------------------------
Married 35 years, DX Age 56. First routine PSA test on April 8, 09: 17.8. Start 2 weeks of Cipro to rule out protatitis. May '09 PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, 20%-70%, Gleason 3+4=7, 3+3=6. Bone and C/T scans neg.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Gleason 7, both lobes and apex. EPE, PNI extensive
pT3aN0MX
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day. Try controlling fluids.
12/11/09 5 months: 3 pads per day, 400-450ml/day
02/26/10 7 months: 3 pads but leak is now 320 ml (5 day avg.)
03/22/10 8 months: 3 pads per day, 280 ml/day (5 day avg.) PT says all muscles are tight and working properly. "There must be another issue."
5/22/10 10 months: 2 pads per day, 190 ml/day Scope on June 15 "Short sphincter"
7/15/2010 one year: 2 pads per day. 140 ml/day, dry in bed.

PSA 7/12/2010 1 year - 0.03 (Siemens Centaur, direct chemilum); <0.01 (Roche Cobas 601 ECLIA)

Post Edited (Worried Guy) : 12/4/2010 7:13:03 PM (GMT-7)

You may try backing off on the kegels and see if that makes a difference.  If you're doing them a lot the muscles may become fatigued and unable to operate properly.

Just a thought.

Reminder,

I had my catheter out 6 months ago and still use 1-2 pads a day. Today I went for a walk of a couple miles and went through an entire pad...continuous leaking. If I'm working its usually 2 pads a day, if I'm home and take it easy, only 1 pad. I am however dry at night and have been for some time. I find drinking lots of water actually helps as it keeps the urine diluted, concentrated urine irritates the bladder.

Initially I was unable to voluntarily empty my bladder (it just dripped, 12 pads a day), it took about a month to hold fluids and that was only accomlished when I sat.

Over the same time span my ED went from nothing to great but it was a slow process. I must admit I'm getting concerned with the leakage but I'm assuming it will come with time.

r

Again, thanks to all for the replies. The last two from Bandersnatch and Arch related specifically to my problem and made me feel a lot better.
Thanks
Reminderman

Not to sound like a broken record, but giving it time is key.  I had Robotic surgery Dec, 2009.  After cath was removed, I had 0 control.  It was that way for weeks.  Significant improvement didn't come until month 3.  It took a good 6 months to get to 85%.  Hang in there...

That's great news questionsaboutit, strange that it happened so suddenly.
Soon you will have to change your signature .... to moderate incontinence and then hopefully to stress incontinence and then hopefully to just a pad for security...

Wish you all the best,
An

I guess some of the more experienced on the board will think this question is self evident because "things" get better with time, but if you think back before you had the experience you now have, this info would have been useful. I not looking for reassurance, what will happen will happen, I'm really looking for specific information from people who've had the experience. Here's what I want to know. We've all talked about dripping like a facet and no control--that's essentially my experience right now (1.5 weeks after catheter). I never have enough left in the bladder to void anything by the time I get to the toilet--it's all in the pad. If anyone remembers, when and how did you begin to be able to hold enough in the bladder to actually void something at the toilet? Any details of how that happened would be appreciated.

This cold weather here in South Florida has me leaking more. It may not be cold for you people up north but for me it's cold. It just comes on can't figure out what is going on. All of a sudden I'm leaking.

Thanks Mike. My current state is that I am pretty dry when sitting, or in the morning laying in bed. When I stand, I can feel it all coming out. I have made it to the toilet (just out of bed), sat and had some squirt out, once a decent amount. It felt like normal urination, but I did not have the sensation of controlling the bladder. And when I get up from sitting, absolutely no control over it, just a steady stream into the pad. I like your scientific catalog of pad/urine volume as a function of time. I'm more interested in the actual circumstances under which some sense of control returned.

The only time I was continent after catheter removal was when I was lying in bed.  For several weeks, 4 to 6, I would have to squeeze my penis tightly to make it to the toilet.  Initially I would get up 2 or 3 times a night.

After about a month or so, I could make it for most of the night, but the trip to the potty was still a challenge.  During the day I would use 4 or 6 pads.

As I continued to kegel, I would see small anmonts of progress.  But for about 2 months, I would use a Cunningham clamp dusing the day so that I didn't wet my pants through the pads during the day.  Working at industrial sites on electrical panels wasn't conducive to wet pants.

Slowly I could see improvement, but at 4 months I was still at 1 pad during the day, and 1 in the evening.  I continued along to where the pads became less and less damp, but still necessary for protection.

Occasionally I would not wear pads on weekends and started to feel better.  Maybe even going to church or some social activity where I wouldn't be exerting myself or lifting heavy objects.  It was a gradual process.

Finally , on Jan 1, I decided to go padless.  Once in a while I would drip a little more than my undies could hold, get a wet spot, but that too happened less and less.

Today, at about 19 months, i will occasionally drip a little here and there depending what I drank, (iced tea with sweetner is the worst ),  time of day, fatigue, I may get more than a few drops, but on the whole, I am totally continent.  Sometimes I change my underwear because they get a little moist, but I can live with that.

Life is good, very good.  I can live with a drip here and there.  Good luck on your journey.  Patience is a key word here.

Goodlife

To Recovery: OK, actual sense of control. I can address that to some extent. It is not a distant memory but something I am struggling with right now.

First, I am sure you have read ad nauseam that continence comes in 3 phases. Dry when lying down, Dry when standing and Dry when getting up from a seated position. I think the phases are way to broadly defined by my own experience and the experience of others here.

For this discussion we are focusing on the dry when standing and getting up combination. For me, my first big breakthrough was when I could stand up (leaking through the getting up motion) but then when standing perfectly still nothing leaked too much. A little movement left or right might bring a squirt or two. OK, your focus is on the sensation of retaining urine and feeling sphincter control. For me it does not feel solid and tight yet. The sphincter still feels a bit floppy and prone to letting go. It feels like it wants to let go when I shift position quickly, when I breathe in deeply, if I bump my crotch on the edge of a solid object like a countertop table, if I have any gurgling going on in my GI tract. As time progresses, it just feels a little more stable and able to hold back urine.

Since I am still working, that routine becomes a roadmap for the day's events. I repeat the same cycle nearly every work day. So I have been able to gauge progress based on doing the same thing over and over but having the urinary results come out differently as progress is made.

I knew when things starting to get significantly better when I could walk any distance and still have something to void when I completed my walk. Again, the sphincter did not feel solid and tight. Before that, I would walk and a slow but steady stream would come out with every step. A bit later my walk would be punctuated by a lesser stream with every step and if I stopped my leak stopped, but starting up again, I would void everything I had held while stopping and then continue dribbling what was just being produced by my kidneys.

I also noted progress when after a shower, when drying myself I did not have to be so delicate with the towel around my crotch. Early on drying was a delicate operation and once I gained more control, I could use a towel more vigorously and not leak.

As I gain control I deliberately add a bit more fluid to my routine, especially in the morning. Before, I would not drink much until I got to my office so that my 1 mile to work from my train station to the office would not be a leak festival. Within the last week I have challenged myself to hold more fluid and not stop at every bathroom I encounter in my path to work just to empty myself.

I also find that a moderately full bladder leaks less than an empty one. My doctor confirmed my suspicion about that and said it was normal to have the sphincter hold against the fluid better when fuller rather than empty.

This morning was a good one. Drank more fluid than usual. Hit the bathroom at home before leaving. Skipped the bathroom at my local train station and waited until I got to my destination train station to go. Walked my mile to work and as I walked I leaked a bit as usual for no apparent reason (stepping into divots in the road, high curbs, etc) and by the time I arrived at work had a strong urge to urinate. Hit the bathroom at work and by golly, my pad was pretty dry and I had a respectable amount to void.

Again, for me the measurement diary give me some sense of making progress. Without my postal scale, as I am at work, all I can do is stare into the pad and make a gross generalization about my leaking. It is like reading tea leaves but without the leaves.

I hope this helps. I agree with others that we all know the process takes time but we can share in the feeling of how we are progressing and what happened in a particular sequence during recovery.

Mike S.