Continence at night incontinent during the day

Greetings,

I'm new here. I had a prostectomy 4 weeks ago. I'm doing ok. I know I'm suppose to allow 6 to 18 month to gain control, but I was wondering why I can sleep at night, sometimes wake with an urge to urinate, get up, go to the bathroom, and urinate some what normally. During the day is the complete oposite. I hardly ever have the urge to go, and if I move like stand from sitting, or just reposition I go with no control. I try to hold it until I get to the bathroom but seldom make it. I have been doing my exercises regularly & I am going to be patience, but is gravity the reason I'm better at night or is it because of sleep? Is there anything I can do differently during the day?

Thanks for all replies.

Phil

Hello Phil,

Welcome to the forum. Sorry you find yourself here.

What you describe is very typical for men who recover continence slowly after RP. It's mostly gravity and also somewhat the tone of your bladder muscles.

Before your surgery you had two urinary sphincters (one on each side of your prostate). One of those went with the prostate and your remaining sphincter is needing to get stronger to handle to load.

While you are laying down gravity isn't pushing urine against your sphincter, and your bladder muscles relax somewhat, too, while you sleep. The net result is that even a fairly weak sphincter can hold against the lower pressure. When you get up the sphincter has to work harder and it gets tired. Where you are now in the process your sphincter can probably hold for a few minutes before it becomes too tired (that's why you can make it to the bathroom at night). During the day while you are mostly vertical (and possibly drinking acidic drinks such as coffee that stimulate your bladder muscles) your sphincter wears out quickly and sort of gives up.

As things progress you will find that you do better sitting down than standing up. And later you will find that you may be OK all day but start leaking in the evening when your sphincter gets tired. (That's where I am now, 10 months after surgery, but I am unusually slow to recover and you'll probably do better.)

Since your leaking is caused by your sphincter getting tired you can time your Kegel exercises so you don't do them in the afternoon (when your sphincter is already tired) and that will make you leak a bit less in the evenings. Aside from that it just takes time and sticking to your Kegel exercises.

Good luck. Tell us how we can help.

Phil,
Welcome to the club. That is just how I was. When I got up at night I would intentionally go to the distant bathroom rather than the one in my bedroom. I figured waiting even a little bit would help me regain control quicker.
Patience my friend.

Unintentionally, you are learning a lot from this experience. You will appreciate the value of clean, available public toilets. You will be more compassionate to the elderly. You are learning why the local pharmacy has an entire aisle devoted to incontinence products. You will appreciate the value of a support network and, most important, will be quicker to help the more unfortunate.
You are a richer (albeit wetter) man.

May you be one of the 2 out of 3 guys who are dry in 3 months.

Good luck to you.

I started with 5 sets of 10, and got worse. We cut back to 3 of 10, and I made slow progress. Probably could have tolerated 4. Everybody is different, but once those muscles get tired, the rest of the day is soggy.

Welcome Phil. You are not alone. I am 3 weeks out and doing the same. I'm walking a lot now hoping that will help. Im using about 6 pads a day. It's been very fustrating but I know it's still early. Just keep working on the kegels. Good luck to you.

Don

My doctor said do 1 set of 10, 10 second Kegels an hour. Hold for 10 seconds release and wait 10 seconds. I only manage about 6 sets of 10 a day, I keep forgeting to do them. Each doctor is different. 9 months out and still use 2 pads. Doc told me to Stop Wearing Pads at home to get my mind working with my body. Started 3 weeks ago, seems to work a little.
Going to pelvic floor rehab tomorrow to try to end this dribble.

Bill from Florida