Incontenence...question of the day???

Had Da Vinci on February 26th, cath in for two weeks.  Pain is almost all gone...but...the leaking continues and I don't see any changes.  No leakage when sitting or laying, it's when I'm upright and walking that I'm having problems.  Any suggestions?  Doing the exercises...Art

It can take a while sometimes. Nine out of ten men do eventually dry out but it can take months.

If you get too frustrated with your progress you could talk to your doctor about biofeedback training. It is reassuring to have the machine tell you that you are exercising the right muscle. You had two urinary sphincters before surgery now you only have one. There is a bit of a learning curve to regaining continence -- you have to figure out which bits still work.

No leakage when laying down/ sleeping is great. None when sitting is also a good sign.

It took me five months to get below eight pads and a depends pant every day, then it suddenly got much better.

Talk to your uro about seeing a physical therapist to find out if you are doing the Kegels correctly. And remember you are only one month out.

James,

It isn't unusual to have good days and bad days. If you are right on the edge of continence then on good days you will be dry and on bad days not. It can take months for the sutures in your urethra to be eliminated and when they start to go and they pop loose it can cause a temporary setback.

Even with doing kegels - 5 times a day - 20 reps each time - it too about 16 weeks before my body parts started to communicate with each other - I would lose about a cup of pee everytime I stood up to get out of the car - even considered a condom-catheter so I could be drier - but at week 16 ( was told it would take 12-16 weeks sometimes before you could regain some control) I was able to stand up and not lose it ....
-patience
-exercise
-keep drinking fluids but try to avoid diuretics ( beer, colas, coffee/tea)
-take care,
Bronson

Guessing maybe 6 to 8 pads a day, but I'm not letting them get completely soaked all the time. Due to my job I need to change them every couple hours while at work. Haven't had any leakage through, so feel fortunate for that. I really cut back on the exercises because it was hurting so much...then found out I had a bacterial infection, treated now, feel much better so will start them up again soon. Cut out all caffine, not sure how our local gas station stays in business every morning without me there!

It is very discouraging, but appreciate all of you chiming in on what you've been through, it does help! Art

I learned I was doing to many kegels and that was hurting my recovery. I was never told how many reps or exactly the right way to do them prior to surgery.

Post surgery I've been using 1 pad per day till this past weekend when it went up to two. Why the setback after 6 weeks? Not certain. I did see a PT recently and they checked to make sure I was doing kegels correctly in regards to measuring and seeing I was in fact using the correct muscle. They did detect I wasn't able to hold for the entire 10 count. They have me doing sets of 10 with a 10 count multiple times per day. I was doing sets of 60 - 80 and that was fatiguing the muscle to much.

I asked the question about whether working the same muscle every day was a problem. I'm used to weight training when you switch muscle groups daily. She explained that you don't want to work this muscle to failure as in weight training. We're working to train the muscle for endurance and hence the multiple reps where you don't work the muscle to failure. They also have me doing sets of 10 or more with a 2 count to work quick response in addition to the sets with the 10 count.

My continence issue seems to activate when shifting position. I used to leak like a sieve while walking. I was freaked out. It seemed like step leak step leak. Now that's mostly better at 7 weeks. I walk about 2.5 to 3 miles per day with my dog and that's been extremely helpful. I too have been dry while sitting and lying down since the cath came out. The only time I leak while sitting is if I, pardon my expression, shift my junk or get up abruptly. The PT told me to start consciously thinking about contraction when doing something that I've found to induce a leak.

I hope this helps.

Post Edited (BillD) : 4/4/2013 9:30:14 AM (GMT-6)

Art,
Eight months out and I am down to 3 pads a day, yeah! The first 6 months was 5-6 pads, so 3 pads for me is a big improvement. Last month I walked 6 miles on 2 different days and both days I wet my pants. That was a first, I had never wet my pants until that point.

We knew when we elected to have surgery that this was a majoe SE of it. My wife keeps reminding me how many years she wore pads and to basically "don't complain, at least you appear to be cancer free".

I was told by my doctor to do 10, 10 second kegels an hour. If I drink coffee, chose decaf, don't eat spicey foods, stay off hot tea and cut back on my water intake. He said you probably are dry at night,in the morning and in the afternoon, the flood gates open up. I said that about sums it up. He said that your body gets tired in the afternoon and you leak more, especially when you stand. I am in retail sales so I stand a lot talking to customers. Change pads as frequently as you have to. If you can spell urine, others can also.

Everybody is different, my prostate was twice the size of a normal one so it was pressing against the bladder for many years slowing my urinary flow. I guess I am one of the unlucky ones BUT I am starting to show improvement.
As others have said, patience. It will come.

Bill from Florida

I have very good luck with the biofeed back, and pelvic floor therapy.  Went into it at five pads a day and ended up padless after eight weeks.  Insurance wouldn't pay for it, but it worked for me and well worth the out-of-pocket.

For guys who only have surfgeery my understanding is that they get better over time (until old age takes effect). For guys who have RT in some form it is less clear, but the side effects of RT can get worse over time.
I had surgery and then SRT and while I was doing fine after surgery I am now definitely worse than I was before I had my SRT and am now using one pad per day to deal with minor dribbles. (Although I usually use two pads to keep things fresh)

Alf

You sound like me at 6 weeks post op. I was still using depends most of the time at your stage. I was still leaking at 3 months and had to wear a depend on my morning walk and pads the rest of the day. By 4 months I was wearing no protection all day long but still had the occasional drip. It takes time.
good luck

Yesterday was my 9 week post-op mark. 1 pad per day and it's virtually dry. The time I had the most issues was when exercising or doing some heavy yard work like digging, lots of bending, etc. Just finished 2+ hours of heavy yard work and dry. Did 20 miles on my road bike Wed night at a reasonable pace (15.5 mph avg) as my local doctor cleared me to ride. Best thing I did. Felt like a new man getting back to a normal routine. No bleeding, continence improved the couple days following. Hoping this is a trend. Also should note that my continence DID get worse at around 6 week before it got better. This was a point when I was REALLY frustrated and stressed out due to complete stoppage of communication from caregivers I HAD BEEN RELYING ON (read, not communicating with them any more). Local doctor explained that it sometimes gets worse before getting better.

Today got my PSA results and they were 0.01, down from 0.03 at 30 days post-op. Let's hope this is all a sign of things stabilizing.

For the record for my fellow cyclists out there, my local doctor is best described as "a surgeon's surgeon" and one of the top open rp guys around. I opted for robotic which is why I went to Michigan. His advice was that based on my healing and being almost 9 weeks out that I was better off getting back to my normal activities ASAP as I was not going to injure the surgical area at this point. Obviously I'm going to ramp my mileage up slowly and not go hard core flat out for a bit but getting back to what I do did a world of good for me mentally and physically.

NOTE: I am NOT advocating that just anyone 9 weeks post-op get on a road bike and ride like I do. My doctor knows me and examined me and cleared me. Your mileage may vary but just wanted to let you know there is hope and light at the end of the tunnel!