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Set-back-feeling ... anyone tried this?

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Posted 12/30/2018 1:48 PM (GMT 0)
Had succesful prostectomy almost 2 years ago, continence was kind of regained during the first months, erectile function not so good. But this is a "continence-question":

During the last month or two I quite often feel a sort of warm feeling in my urinary tube, just as if "something's on it's way". And I kegel/squeeze at once, so nothing actually happens. No drop comes out, which of course is good, but it's quite annoying to be reminded of this many times during a day. I think that some months back this whole function almost worked automatically again. Now I feel I have to be on my guard, and that I use all too much time thinking about my bladder.
Also it causes me to pee too often because the feeling goes away right after peeing. But you know, going too often can cause the bladder capacity to be reduced, so that's not a good habit.

Anyone tried this - or have advice?

Happy New Year to everyone!

Post Edited (MartinP) : 1/1/2019 6:36:11 AM (GMT-7)

Posted 12/30/2018 3:18 PM (GMT 0)
I’ve had that experience, Martin. I’m almost 4 years out of RP, it still happens on occasion but as the years have gone by, it has become much and much less frequent. These days, when I ge.t that feeling it’s actually a small leak, annoying but not enough to be troubling and ver depending on what I eat/drink.

I think you should keep doing kegels, over time it should resolve.

I’ve never heard of the bladder shrinking due to frequent peeing. I often pee as a preventive nmeasue before going out, and haven’t had that issue. Maybe someone else can comment on that point.
Posted 12/30/2018 4:37 PM (GMT 0)
Thanks a lot for your comment, Pratoman.

Yes, I do kegels, have for some time been doing them on a not-so-regular basis, but now with this feeling often coming up. I mostly do them every day. And maybe that helps a little.

On the "shrinking bladder"-issue: Maybe I reason a little "upside-down". I have been told that if you do have a problem with a bladder-capacity disturbingly small, it is a good idea to wait as long as you can before going. That should train the bladder to contain more. And to not "give alarm signals" too early.

Martin
Posted 12/30/2018 4:41 PM (GMT 0)
The mind will play tricks on you...just to trick you...get thee behind me...or get off my mind...persistence in thought...usually will solve these kind of problems...its tricky...Whot??!!...hey what else ya got to do...if you got something else to do...do it...that will usually fix the trick as well.. PS named my oldest son Soren after you know who...gots to get to Copenhagen...to visit the two most famous nemesis's there...no not Hans and Franz...but close..scuse da riddles...its part of the package with me....
Posted 12/30/2018 4:59 PM (GMT 0)
Thanks, logoslidat! Yeah, you could be right, it might be more of a mental thing, though it does feel very physical ...
Persistence in thought, I'll try that!

You certainly should go see Copenhagen and wander in Sørens footprints ... Guess it's Søren Kirkegaard, you're talking about ... We do have many Sørens over here smile

The two most famous nemesises there/here? Good riddle which I haven't solved yet ...
Posted 12/30/2018 8:48 PM (GMT 0)
Hi

I am 5 years post RALP. My bladder capacity took over three years to get back to a point where I could sleep through the night. I still have some stress incontinence so that I do where a light pad. Some days it is completely dry and some days not, depending on my activities. I have found that I have been able to curb the "urge" a little by mentally holding back. You need to go over the anatomy of what was done surgically. When the prostate is removed so is one of the "valves" which you had to hold back urine. Now you only have the one valve which is located at the neck of the bladder. I joke with my wife that only now do I understand her urgency when she says she has to go.

FWIW, S
Posted 12/30/2018 10:39 PM (GMT 0)
Hi Scooter - thanks for your answer, your story with the 3 years gives me hope that my situation can still be improved. And I also think that my condition is not very catastrophic at all ...

Yes, I know I've got only one valve left, but isn't the one that's still there, the one "further down the pipe"? While I believe that the valve at the neck of the bladder went out during operation?
Posted 12/30/2018 10:45 PM (GMT 0)
Hi
No, the "valve" that is left is the one at the neck of the bladder. The other one was contained within the prostate and that is long gone. In reality there is no valve. The neck of the bladder contains a sphincter that is a ring of muscular tissue
Posted 12/31/2018 1:16 AM (GMT 0)
It would be difficult with the Hans and Franz...as that was a American comic team...so here it is...Soren Kierkgagaard and Hans Christian Anderson were total nemesis's...thru out their life...it wasn't by any means friendly...some can be dontcha know....

A minor post script which I kinda knew but didn't connect till after I posted my response to you...Kiergagaard coined the word angst...to my knowledge....also I don't care if he and Hans didn't get along...who can not love DannyKaye ( as Hans) and the lil bald child as he told the story of the ugly duckling who became a swan...You may not be aware of the film but anyone here late 60's(age) and up know it well... I rave on and on...what to do...blessed
Posted 12/31/2018 2:45 AM (GMT 0)
Hey Martin, i get a little leak or two every other day or so. It is somewhat unsettling. I pretty much take it as it comes now. I’ve never done any real “kegaling” to speak of.

Im getting up twice a night now. So I’m guessing I might outta start holding more during the day. My cath was in a month after surgery. I was told then to “hold it” to stretch my bladder back out. It worked.

Sometimes I think that bladder neck gives me some false urges to go when I don’t really have to. But that’s just a personal theory of mine. So...don’t quote me on that one. 😂
Posted 12/31/2018 3:10 AM (GMT 0)

MartinP said...
Hi Scooter - thanks for your answer, your story with the 3 years gives me hope that my situation can still be improved. And I also think that my condition is not very catastrophic at all ...

Yes, I know I've got only one valve left, but isn't the one that's still there, the one "further down the pipe"? While I believe that the valve at the neck of the bladder went out during operation?

Yes, you are correct. The one that was taken was the one that was involuntary, it held the urine inside the bladder until your autonomic nervous system told it to open. It required no conscious effort from you. It was normally closed, if memory of long ago anatomy classes serves. It opened to allow urine to leave the bladded when your autonomic nervous system told it to.

The one that is left is the one that could be used to voluntarily shut off urine flow, if you needed to stop urinating for some reason. It also stayed open during ejaculation to allow sperm to escape in one direction, while the one at the bladder neck automatically/autonomically stayed closed to prevent semen from traveling in the wrong direction into the bladder, and to prevent urine from leaving along with the semen. That one is gone, and much missed by many of us.

But while the one that is left is normally open, and we only closed it with a voluntary contraction(a Kegel), it closed when we willed it to do so. It appears it can usually be retrained to accomplish a normally closed function, which is how most of us regain most of our continence. Thank goodness for that. You can't voluntarily hold that thing closed all day. Climacturia occurs when it acts normally, and relaxes during orgasm to allow sperm to escape(if there was any sperm anymore), and urine can come right along with the imaginary semen. Since there is no longer a urethral sphincter at the bladder opening to hold the urine in. So if that other more distal sphincter opens- look out!

My minor problem has been small spasms that have never stopped. This might happen once a day or 5 times a day. It feels like the muscles of the urethra- or possibly the bladder, suddenly contract and try to force urine out, even if I just emptied. Sometimes, even with a fast Kegel to try and hold it in, a drop or two escapes. Never enough to show through, not since the first year. But some days I still wear a small shield just because I don't want to have to think about it, I don't want to have to be in "fast reaction" mode all day. But when I do, when I remove that small pad right before bed time, it always feels pretty dry.
http://www.ivyroses.com/humanbody/urinary/urinary_bladder_urethra_male.php
Posted 12/31/2018 3:38 AM (GMT 0)
http://www.drcatalona.com/quest/quest_spring03_2.htm

Somebody said...
"When a surgeon cuts out the prostate, a gap is created between the bladder and the urethra. The bladder must be pulled down and the urethra pulled up so that the two can be surgically reconnected," Dr. Catalona explained.
"Frequent urination is normal after a radical prostatectomy."

The larger the prostate the bigger the gap and sometimes the more difficult to reconnect the bladder and the urethra. In addition, the internal sphincter muscle, the muscle that involuntarily controls bladder output, is removed with the prostate.

After the operation, men who had three layers for holding back urine – the internal sphincter muscle, the prostate lobes pressing against each other, and an external sphincter muscle – have only one, the external sphincter.

"The external sphincter can do all the necessary work to hold in the urine, but it has to be strong. That's why the Kegel exercises, both before and after surgery, are so important," Dr. Catalona said.

He explained why procedures during the surgical removal of the prostate cause temporary incontinence and how time and the healing process usually fix the situation.

The bladder and the urethra must be connected to each other but if they were just sewn together, postoperative swelling of the tisues would close the opening for the urine to pass through. Temporarily, they need a stent to preserve the opening, and that stent is the catheter.

The bladder is always being emptied by the catheter. The bladder isn't holding urine and therefore doesn't expand as long as the catheter is in place. When the catheter is removed, the bladder is a shrunken version of itself.

"Over weeks and months, the bladder expands again and, most often, returns to normal size and normal function," Dr. Catalona said.

Posted 12/31/2018 6:37 AM (GMT 0)
Thanks for many thorough and kind answers. I think I got my anatomical knowledge updated now and will read dr. Catalona's article.
All the best to all of you.
Posted 12/31/2018 5:22 PM (GMT 0)
Good info BB --- thanks!
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