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Incontinence After Catheter Removal

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Posted 1/12/2018 3:37 PM (GMT 0)
Same here - blowing nose, passing gas, coughing -- all create a spurt --- never tried to hold these things in as much as I have since the surgery
Posted 1/13/2018 12:15 AM (GMT 0)
Just to join the party, my surgery was 17-10-4 so I'm just about 3 months post catheter. I was using 4-5 pads the first week or so and over Christmas chasing my grandson around I was still wetting two pads a day. i'm now down to none at night and one for the day with not much in it(40-50 ml).

The biggest single improvement was when my surgeon told me to stop trying to drink 2 liters of water a day. I still drink a bit more than i did before surgery - probably 1 liter rather than the two i was trying for at first.

I've been seeing a physio who does not emphasize kegels - I do a set of 3 every hour when i'm sitting. The other exercises are more directed and aimed at retraining the reflex rather than strengthening muscles. I would rather be making faster progress but I am making progress so I'll stay the course.

Biggest challenge is suppressing the urge to pee when i get up from sitting or lying. I try hard not to urinate more than every couple of hours. This tends to make me less active than i'm used to but i do get out swimming and skating. we're looking forward to going south at the end of the month so we can get back to more active walking.
Posted 1/13/2018 4:09 AM (GMT 0)
You’re way ahead of me. Three months plus out still dealing with 3 to 4 pads a day. Dry at night. Just can’t stop the urge and “push” every time I stand up wish it would be quicker too. Keep hearing many posts for those who are down to almost dry and wonder what I’m doing wrong. Puts a crimp on my desire to do things and starting a time when I visit clients in evening three to four a night and very nervous of what may happen since I will be getting up and down quite frequently. Thinking of having no liquid from early afternoon on to be cautious
Posted 1/13/2018 5:02 AM (GMT 0)
I do kegals as Dr. Catalona recommends. Stop your flow for 2 seconds, let it go for 2, hold for 2 until the pressure drops way off. This way you know you are exercising the right muscle.

http://www.drcatalona.com/quest/quest_spring03_2.htm

Due to a positive margin on the bladder neck and needing more time for it to heal my Foley was in for 3 weeks. So, my bladder probably shrunk down to the size of my previous prostate size. smile But after 2 months post surgery, I am down to only 1 pad per day most days and dry at night. Get up 2 times per night.

Like others, dribbling is worse in the afternoon/evening and then standing, farting, sneezing, coughing can cause dribbles. I jog a mile in the mornings (since week 6) and am pretty much dry throughout.

So, hang in there and consider stopping the flow and let the bladder get as full as possible to stretch it. A stretched muscle strengthens. After 6 weeks I had an Axumin Pet scan and had to lay on the table for 45 minutes. I thought I was going to explode and at 40 minutes I let it dribble to relieve the pressure so they didn't have to stop the scan. And I swear, the next day it seemed like my bladder could hold more. Of course, the brain is a powerful thing.

69yr,1948 Troy MO-W of St. Louis
PSA 3.2 7/08
PSA 51.2(7/11/17)
DRE hd lft, 31g 7/24
Biopsy8/11 No PNI GS 4-8s, 4-7s/12
NUC Scan/CT Urogm8/29-CLEAR
Prolaris 9/11 T2b, 3.8/10, 10yr Mort Risk 23.5%, Met Risk 29.6%.
Consult 9/11 Rec RT/Brh/RALP
MRI 3T Ca in gland?
RALP11/15
PATH11/16
T3b,GS 9
70G Pc 40%
PLN+Rt-1/1,Lt-2/6
+Marg-apex,ureth,blad nk,SV
Lupr/Cas 11/21
Axum (-) 1/2/18
Markers 1/31
RT 3/1

Post Edited (john4803) : 1/13/2018 8:36:20 AM (GMT-7)

Posted 1/13/2018 8:46 PM (GMT 0)
@Ron42661:

I'm a BIT ahead of you. Maybe not that dramatically. One thing that made a difference for me was bigger pads - i know it sounds obvious but the Tena level II pads i was using always made me feels a bit wet. I got some Level III pads (only available from them directly online) and I went from 3 pads during the day and one overnight to 2 in the day plus one and then one and none.

I still struggle not to rush to the toilet on getting up and i would find the evening very hard. One thing I realized a while ago is that if I'm going to sit down again e.g. going from a home visit out to my car I can last.

From the physio and others I learned the trick of exhaling as i stand which helps.

Good luck.
Posted 1/16/2018 12:04 PM (GMT 0)
Just in case this is helpful to others:
This is a follow-up note re: my earlier comments on Citrucel Fibre supplement. It was making me pee way too much and was more than I needed for constipation. I'm much better off without it, and it does appear that my continence is improving as well. I now appear to be on the recovery schedule as predicted by the Doctor.
Bottom line: I don't recommend Citrucel for anyone in our situation. In my case, Fibre Choice veggie tabs are working better in many ways.

And,
I totally agree re: the Tena level 3 pads. I've begun to wean myself from diapers, most of the time, to pads exclusively, and Tena products seem to be the best. The level 3 pads had to be mail-ordered, but Tena Level 2 pads are available at Walmart.com and can be delivered to your local store for free.

Currently:
58 years young
2 weeks post catheter
Almost 4 weeks post surgery
Gleason 9 with cancer in 10-15% of the gland
Nerve-sparing surgery, using the Bladder Neck Preservation method.
Clean lymph nodes & margins. My first post-surgery PSA test will be in early February.
Posted 1/16/2018 2:09 PM (GMT 0)

december21 said...
Just in case this is helpful to others:
This is a follow-up note re: my earlier comments on Citrucel Fibre supplement. It was making me pee way too much and was more than I needed for constipation. I'm much better off without it, and it does appear that my continence is improving as well. I now appear to be on the recovery schedule as predicted by the Doctor.
Bottom line: I don't recommend Citrucel for anyone in our situation. In my case, Fibre Choice veggie tabs are working better in many ways.

And,
I totally agree re: the Tena level 3 pads. I've begun to wean myself from diapers, most of the time, to pads exclusively, and Tena products seem to be the best. The level 3 pads had to be mail-ordered, but Tena Level 2 pads are available at Walmart.com and can be delivered to your local store for free.

Currently:
58 years young
2 weeks post catheter
Almost 4 weeks post surgery
Gleason 9 with cancer in 10-15% of the gland
Nerve-sparing surgery, using the Bladder Neck Preservation method.
Clean lymph nodes & margins. My first post-surgery PSA test will be in early February.


Hey that's great - really though you are in VERY early days and you have a couple of months just plain healing ahead of you. Don't expect too much and go easy on yourself.
Posted 1/22/2018 10:45 PM (GMT 0)
Things are slowly improving.

One question: I've noticed that sometimes, after urinating well, and It appears that everything is done, Ill need to go again, with essentially the same amount, which is relatively significant, about 2 minutes later.

I've heard that this is not that unusual, but the Doctor plans to have his Physician's Assistant ultrasound my bladder on Friday. I sure hope that I don't end up with another catheter.
Posted 1/22/2018 11:32 PM (GMT 0)
Good to hear things are improving. That’s not at all unusual. It was at least 2 months maybe longer before I felt like I was peeing normally. I would have good days when I felt normal and the next day back to the dribbles and frequent trips. Nothing wrong with doing an ultrasound to make sure but I bet you’re fine. Good luck and keep us posted.

Jeff
Posted 1/23/2018 2:13 AM (GMT 0)
Dec21, surgeon suggested to me to try liftng the sack after you think you’re finished, which puts upward pressure on the urethra. He said after prostatectomy the urethra is shaped like a “U,” which allows urine to gather in the bottom of the letter. Pressure upward from below can help it get out. Works for me.
Posted 1/27/2018 12:16 PM (GMT 0)
Thanks for your input. I was fine. My urine increased because I was slightly constipated, and I should be waiting longer between bathroom visits. I've since learned that a minor spurt or two when standing is no reason to go to the bathroom. Going every 2-3 hours is better for your bladder's re-training.
Posted 1/28/2018 10:38 PM (GMT 0)
Keep in mind that the rate of improvement is often not steady. I dripped continuously for the first two months, and then overnight it got much better. Then very slow or imperceptible improvement for the next five months, and then suddenly no more leaking.
Posted 1/28/2018 10:40 PM (GMT 0)
Good to know. Thank-you!
Posted 1/31/2018 5:30 AM (GMT 0)
6 months out nearly dry. Measured my pad after 24 hrs. 4 grams = .14 oz. Have a double Jack Danials and water at bed time and 6 cups of coffee a day.
Posted 2/8/2018 2:43 PM (GMT 0)
I seem to be making pretty good progress, and I have to attribute that to the type of surgery performed by my Urologist. It's known as: "Bladder Neck Preservation", along with "Nerve Sparing".
I've been tracking everything on my PC's shared calendar, and this is the summary:

I had surgery on 12/21/17 and got out of the hospital on 12/23; -just before Christmas. The catheter was removed 12 days later, on 1/2/18. That day, I couldn't even feel myself peeing. It just came out. Later that night, the feeling returned, so I was able to get up and go.
I wore diapers most of the time for the first 2 weeks. I went through 4-9 diapers or heavy pads per day.
I limited fluid intake out of necessity.

about 3 weeks post surgery, on 1/15/18, I wore my last diaper, and switched to: Tena Level 3 (Super) pads, along with Depends Max Guards. By the way, the Tena Level 3's are highly recommended, even though they are typically available thru the mail.
I stopped limiting fluid intake, as these pads were that good.

At about 4 weeks post surgery, on 1/22/18, I was using just 1 Tena level 3 (Super) pad per day.

about 5 weeks post surgery, on 1/28/18, I switched to Tena Level 2 (Moderate) pads. Two pads that day. These are sold at Walmart.com, and can be picked up at the store, if ordered online.

The next day, I was on just 1 Tena Level 2 pad per day.

Today, exactly 7 weeks post surgery, I'm wearing no pad at all. -Just white Hanes briefs, and I had water, yogurt, oatmeal and watermelon at 5:30 AM for breakfast! I don't know how long this will last. From past experience, I'll need something more later in the day, when I get tired, but this is kind of impressive. I'll most likely put a Tena Level 2 pad back in, but we'll see.

Before surgery, the Doctor was quite confident that I would be dry, or almost dry in 4-8 weeks, because over 98% of his patients are. He attributes that to the surgery method he used, which I've found to be very uncommon. I've only identified 3 Doctors in most of Upstate NY who use the Bladder Neck Preservation method.

I highly recommend that anyone in need of a Prostatectomy seek out a Urologist who does Bladder Neck Preservation, because all 3 Doctors that I identified were the most qualified, having performed well over 1,000 radical prostatectomies on the DaVinci alone.

PSA 4.3 May, 2017
MRI - July, 2017, but the first Dr. forgot to call me with the results, so I called him 3 months later...
Biopsy with Gleason 9 identified in several cores, October, 2017
Surgery 12/21/17. 10-15% of the prostate had cancer. Significant Perineural Invasion.
Catheter Removed 1/2/18
Clean Margins & Lymph Nodes 1/9/18.
First PSA post surgery 2/5/18 at Roswell Park, the place that invented the PSA: <0.04 (Undetectable).

Post Edited (december21) : 2/8/2018 8:25:18 AM (GMT-7)

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