Article: Post-prostatectomy RT adversely affects urinary continence irrespective of RT regime

I was 100% continent right after surgery..I waited 5 or 6 months and then had SRT... I am still 98.5% continent 7 years later. A few stress drips now and then. I must urinate every 2 hours or so, day and night....I attribute the frequent urination to the radiation..My chart reads "Terminal Prostate Cancer" so I have other issues to worry about..

I had Adj RT eight weeks post surgery. Two years later I wear a pad per day to catch minor dribbles. I'm not really expecting it to improve. It's not really a big deal for me. A much bigger deal is having to pee all the time, day and night. Makes it very difficult to get adequate sleep. That's the way it was before treatment also. I thought the RP would improve the bladder issues...at least that's what the Uro told me. lol

Well, that is not good news for a high risk guy like me. Just one more reason for me to push additional treatment as far into the future as possible. Another year or ten sounds good to me.

Based on the responses so far looks like I am the exception and not the rule. After surgery, I was incontinent. However I was nearly dry a year later when SRT was started. Since that time, incontinence has gradually gotten worse and now I am pretty much 100% incontinent going through 10 plus pads per day. Since my episode with the failed AUS, I have started using a penile clamp. It has helped tremendously, when used, cutting pad use in half. However, the clamp does cause irritation and I have to discontinue use every three or four days until the irritation subsides.

Thanks Oldbeek. That is what I use...although it is a bit pricey.

i have found the frequent urination to be minimized by eliminating caffeine, plus eating less of certain fruits - watermelon and cantaloupe in particular. these stimulate my bladder and I get high urgency. If it gets out of control, i take oxybutynin for overactive bladder. Have your urologist prexcribe.

I think I'm a poster child for SRT going badly. I was continent within a couple of months of surgery but my PSA nadir was 0.23 and began rising almost immediately. I also developed a stricture which my uro opened with a laser treatment, saying it would have closed off completely during salvage radiation treatments. After the laser I could pee like a garden hose but there were a few dribbles again.

I questioned the choice of SRT with my rad/med onc, reasoning that with negative margins but rising PSA it must be systemic, but he brushed that off saying SRT was effective in 90% of situations like mine and much preferable to the horrific side effects of HT.

So began 36 salvage radiation treatments 200 miles from home. Fortunately my son had a place in the city where I stayed five days a week. Bowel aggravation and urinary burning and frequency set in early in treatment and incontinence worsened. I alternated between almost total retention to barely making it from the table to the bathroom before the dam burst. I was prescribed Pyridium which was useless and actually seemed to increase retention and Flomax which helped somewhat. Fatigue was a factor and continued long after treatment ended as did bowel disruption. The radiation veterans' adage "never trust a fart" is wise advice. Rectal bleeding appeared and was attributed to radiation damage by colonoscopy and internist and will still randomly occur 10 years later. Incontinence worsened and my stricture re-occured, also due mainly to radiation damage according to my uro. Basically everything leaked out a few drops at a time. This time the treatment was electro-cautery, and went right into my bladder (TURB). A blocked catheter had to be pulled early, incontinence was near total, I peed blood, clots and tissue chunks and had incredibly painful bladder spasms that forced bowel movements. Oxybutinin eventually relieved the spasms but traces of blood in urine also occasionally appeared years later. I now have a slow but stable stream and and frequent urge.

I began wearing a clamp (also prefer Dribblestop) just to be able to function and have been trying to convince myself to go for the AUS. I consulted with a uro specializing in the device who was very honest about the chances of being pad free (unlikely), revision (25% and eventually, almost certainly), infection (low but real risk). That combined with the stories of AUS complications on this forum have kept me from taking the plunge.

By the way, the SRT was a total failure and I am now on my fourth round if intermittent HT. HT is no fun, in fact it is awful but if I could find my long gone rad onc I would inform him that it was SRT that was truly horrific.