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Continence after surgery

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Posted 2/28/2013 4:10 PM (GMT 0)
Had prostate removed Feb. 14...Surgeon took 2 lymph nodes....divinci surgery. Continence pretty good sitting or laying down but add gravity and I am soaking a depends every 2 hours.  Must stand at my job.  Doing Kegels three times a day...what else can I do?  Would like to know others experience in combating this after effect. shakehead
Posted 2/28/2013 4:14 PM (GMT 0)
I did the Kegels 4 times an hour and became continent within 6 weeks, cut women's panty shields in half and put them side-by-side in my underwear just in case. I know doing the Kegels is a pain but it works the muscle.

Keep working it.

Joe
Posted 2/28/2013 4:21 PM (GMT 0)
While my husband never experienced incontinence to the point where he soaked a pad, he did suffer from "squirting" especially whenever he did anything involving the lower muscles. At his last visit with the uro (who always asks how the incontinence is going), my husband told him that he still needed a pad to protect himself from squirting. The uro said to try this exericise and to do it repeatedly throughout the day: squeeze your rectum as if you were holding in a fart. Believe it or not, since initiating this exercise, my husband hasn't used a pad in a couple of months. Try it...according to my husband it's easier than the Kegels and can be done anywhere.
Posted 2/28/2013 4:21 PM (GMT 0)
Regaining continence seems to depend on a lot of variables, but kegels do seem to help.....if done properly.  The wisdom seems to be that too many kegels can actually make the situation worse.  The muscles can become fatigued rather than strengthened.  So, I would encourage you to talk to your uro or do some more reading about proper kegeling.  And be patient.  In my own experience, complete continence took 8 weeks, and it can certainly take longer.  Good luck.
Posted 2/28/2013 4:41 PM (GMT 0)
Moderate kegling, time, patience should do the trick.
Posted 2/28/2013 5:00 PM (GMT 0)
Biofeedback helps. Ask your uro about it. My biofeedback tech used six of those sticky electrodes like they use on an EKG machine -- three on my stomach to measure my abdominal muscles and three on my butt to measure the nerve that is shared between the anus and the remaining urinary sphincter. (I've heard other guys talk about a probe that they put in their anus to measure the actual squeezing but mine was a sticky electrode pad stuck in my plumber's crack area to measure the nerve impulse.) A man has two urinary sphincters before his prostate is removed and only one after. Part of becoming continent after the surgery is learning to use the remaining sphincter (which is why people talk about "holding back a fart" -- it shares the same nerve bundle).

Also, let me echo clocknut's comment that too many kegels can make things worse. On of the things you get with biofeedback is that the technician acts as a personal trainer for your pelvic floor muscles. Three or four sets of ten reps spread out during the day is usually plenty.

Finally, it can take a long time sometimes. You are, what? two weeks out of surgery? Most guys are pretty leaky at that point but two thirds of them will be continent after three months and, of that remaining third, two thirds will be continent at one year. That last one guy in nine may need more help (which is available). I am about 8 months out and am finally making progress.

Helpful tip: Depends (and other pull-up incontinence underwear) can be fit in your pants pocket if you refold them carefully. Folded as they come from the factory they are too big and will hang out of your pocket.
Posted 2/28/2013 5:39 PM (GMT 0)
You are just out of surgery and it is very early in your healing process. My husband did kegels but was incontinent at a little over 2 months out of surgery. He then did biofeedback. He became continent within about 4 to 5 weeks after starting biofeedback. He wears no pads now - pretty much fully continent. I don't know the details of what he did in biofeedback. What he did tell me is that he is doing about 100 kegels a day. His biofeedback therapist told him that he will have to do kegels for the rest of his life. So while other posters have not had good results with a lot of kegels, for my husband 100 kegels a day made him continent.
Posted 2/28/2013 5:51 PM (GMT 0)
Wow, what a Valentine's day you had !

You probably are pushing it a bit. Average time to full continence seems to be 3 to 4 mo ths on here. Sorry.

I actually used a Cunningham clamp for a while which actually pinches it off. Sounds horrible, but they are adjustable, and I could wear it for 6 hours or so without any real discomfort. Sometimes you just gotta do what you have to do.

I might also recommend pads instead if depends, just from a cost issue, and they are easier to change.

Good luck. It will get better. Took me 8 months.
Posted 2/28/2013 6:50 PM (GMT 0)
I think I'm an extreme case but, 17 months after DaVinci surgery, I'm still severely incontinent. I started Kegel exercises right after the catheter was removed but saw only modest improvement. I brought up the subject with my urologist a couple of times but he would tell me it can take a long time to heal and keep doing the Kegels. Well, I plateaued at 3 pads per day (about 600ml of leakage). Finally, I stopped being patient asked my urologist about next steps since Kegels had gotten me only so far. He referred me to a specialist in pelvic floor rehab and I had my first visit yesterday. I now have a better idea of how to do the Kegels and hope that leads to further improvement. If not, my doctor and I eventually will have a discussion about more invasive solutions (sling or AUS). Anyway, I envy those of you who have gotten fairly dry within weeks or months after surgery - wish I was a member of your group.
Posted 3/1/2013 1:35 AM (GMT 0)
I had my first pre-surgery biofeedback session today. (Same office where bluebird123's husband went.)

Here is what they did...
They put a probe in the "back door" which was connected to a computer. (The probe was a bit larger than my thumb.) They had me do kegels and the probe measured the duration and intensity of each one. Then, they used the computer to deliver electric pulses which caused the muscle to contract. (Basically, it is the computer causing the kegels to occur for you instead of doing them yourself. This lasted for 10 minutes.) Having electric pulses in there felt a bit odd, but not painful.

My homework is to do 100 kegels per day: 5 sets of 20 kegels at different times of the day. Each kegel should be held tight for 10 seconds, followed by a rest of 10 seconds. That routine will continue daily until I'm fully continent (hopefully) at some point after the surgery.

I'm doing a total of 2 biofeedback sessions pre-surgery, and then can do another 6 more after the surgery if I have incontinence issues. (According to the doctor's office, insurance companies will only pay for 8 sessions per year.)

-Gedman
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