Posted 2/2/2015 4:09 PM (GMT 0)
Hi Men -- My Radical Retropublic Prostectomy was 3 weeks ago today and the catheter came out 12 days ago today. The first couple days after the catheter came out I was pissing like a fire hose, just leaked strongly constantly. From the start I've worn the Depends "diapers" (which Depends confusingly calls "underwear") plus one Guards pad. I tried wearing cotton briefs + a Guard pad maybe 10 days ago but both the Guard pad and the cotton brief got soaked, and my pants a little bit too, so I went back to wearing the Depends "diapers" + a Guards pad. I feel the most confident wearing the diapers + a Guard pad. Pissing in my pants in public is something I've been culturally conditioned to feel is unacceptable. Maximum embarrassment moment, that.
Four or five days after the catheter came out, to address the fact my major leaking trigger is standing up after sitting awhile, I started putting Willy into a wide-mouth empty bottle of Sunshine prune juice, within seconds of standing up. Like clockwork I then pee into the bottle. This maneuver collects 80-85 percent of the urine I'm producing, with the remaining 15-20% going into the Depends Guard pad when I'm walking around, bending over to pick something up, sitting on the throne waiting for #2, or coughing or sneezing. With one exception when I woke up in the middle of the night with pad, diaper, sheet and bed pad all soaked, I've been dry during the night. By "dry during the night" I mean a modest to fair amount of urine was collected by the Guard pad and "diaper" as I slept.
During the first 5-7 days after the catheter came out I was in deep despair over the almost constant "fire hose" like performance I was giving. I have to say, I'm doing much better now. I get up only once during the night to pee the last 3-4 nights, and last night I didn't get up once during the night to pee. So that's real progress. Only 12 days out from the catheter coming out. And I know there are no guarantees, conditions may get wetter again before they get drier. I'm going to stay optimistic. Some men here say exercise helps. I'm reading up now on biofeedback, but don't think I'm ready for that, as I think I'm doing pretty good overall, continence-wise.
I do the squeeze/tighten Kegel maneuver 4x/5x whenever I'm peeing into the Sunshine bottle, to get practice with that. My plan is to keep peeing at home using either the bathroom when I'm close enough, or the Sunshine bottle if I'm in my office/bedroom, or trust the pad + diaper is getting it all when neither bathroom nor Sunshine bottle are available. My surgeon's discharge instructions were to experiment with going pad-free when at home, without putting any specific time frame on when starting that might be appropriate, since we're all different. His idea is I don't want to train myself to be pad-dependent. All well and good, however, my greater interest right now is keep using the Depends diaper + Guards pad for the forseeable future, at least until when I stand up after sitting awhile -- that's the danger zone for me of the highest probability of a sudden uncontrollable surge -- that some perfectly timed Kegels right then will make the urge to surge much less, or, ideally, eliminated.
Over the 3-4 years pre-surgery when I'd be driving my car, many times a powerful sudden urge to pee would be present. I'd park someplace as soon as possible, and pee into the empty bottle I kept in my car for just such an emergency need. On two occasions I remember being stuck in traffic on some long sweeping exit ramps from one freeway to another freeway, no real exits off the freeway for a mile or more, no extra lane for emergency vehicles or emergency parking with a flat tire, etc. What to do?! You know where this is going, right? Yup! On those two occasions, I grabbed the empty bottle, out came Willy, and after elevating enough off the driver's seat to ensure the bottle was lower than Willy ... this is all while I'm driving my car on the interstate ... I proceeded to relieve myself while driving my car along the highway. When ya gotta go, ya gotta go! [Another bit for the stand up (pun intended) routine.]
It goes without question it's probably illegal for the driver of a moving vehicle to pee into a bottle while operating a moving vehicle, hence that's not something I ever intend to do again "your honor." I'd guess if the driver is wearing diapers + a pad and recently had his prostate out, pissing at 70 mph, that's probably authorized by state statute.
Happy Monday. Bit of rain here in the nation's capital today.
Bill Positive
________________
[Sig Block revised 1-27-15]
age 70
diagnosed 8-8-14
PSA history: 1/08 4.6; 4/08 6.4; 7/08 3.5;
12/09 2.5; 2/11 4.4; 4/12 3.2; 4/14 5.4;
8/14 5.1; 9/3/14 4.9; 10/13/14 5.7
Pathology Report (9/12/2014, Johns Hopkins,
Jonathan Epstein) on 7/28/2014 biopsy slides.
6 cores Gleason 6 (3+3),
A. prostatic adenocarcinoma, 90%, 80%
B. prostatic adenocarcinoma, 90%, 90% ("perineural
invasion identified in this case") [Interesting the final
pathology report below found no actual "invasion"
beyond the prostate capsule, very glad of that!]
C. prostatic adenocarcinoma, 90%, 90%
1-12-15 RRP at Johns Hopkins
1-14-15 Final JHH Surgical Pathology Report
Interpretation & Diagnosis
1) pelvic nodes, left (excision); three lymph nodes and
associated fibroadipose tissue, negative for tumor
2) anterior fat pad (excision), negative for tumor
3) prostate and SV (prostatectomy): histologic type:
adenocarcinoma (conventional, NOS)
Gleason score - dominant nodule: 3+4 = 7
Tumor extent: moderate
location: (dominant nodule): left, posterolateral, apex, mid
location: (secondary nodule): [none noted]
Local extent: organ confined
Margins: negative
Seminal vesicle invasion: none
Lymphatic invasion: absent
Pelvic lymph nodes (includes all parts):
all 3 lymph nodes are negative for tumor
Extent of invasion (7th Edition, AJCC, Staging):
Primary tumor: pT2: organ confined throughout
Summary margins: negative
A representative tumor block is 3-LBP
A representative normal block is 3-LDA
Note: Pending KRAFT of 3RBA
[signed by JH pathologist 01-15-2015]