2 Years after Prostate removed due to cancer and still urination issues

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All, I had my prostate removed in Jan 2020 due to cancer (gleason 3+3 and contained). I had a UTI as soon as the catheter was removed. It took a while on meds before clearing up. I am incontinent and go through 3-5 pads a day. My question is after I urinate (about every 1 1/2 hours) I still drip and squirt as I feel urine in the urethra. I drip and squirt for about 2-3 minutes after urinating but even then I have to cover my penis with toilet paper because I still drip as I go to pull up my underwear and I fell urine coming out even when walking out of the bathroom. I talked to my urologist about that and he does not have an answer or knows why this happens. Does this happen to anyone here on this board and if so can you give me any advice or possible fixes? Thank you very much.

 

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To joer; I’m about 6 months out and that’s exactly what I do. Dribble and squirt. I don’t do pads, too much leakage, just do pull-ups. I assume it’s just part of the process of “healing”, although 2 years out is not the normal, according to “experts” and everything I’ve read. At this point I would possibly look at surgery for relief.

 

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I'm sorry to hear your incontinence is still at this level after two years! I'm one and a half years post surgery, and am not 100% dry, but nearly so. I've recently upped my kegals and saw some improvement. Are you still doing those?

As far as dribbling after urination, I experience that from time to time. I'd look into YouTube videos about how to completely empty your bladder. I saw one recently that recommended trying to relax, and take some deep breaths after urinating to try to empty completely. I've tried it, and it seems to help some, but it takes a few minutes. Don’t give up! I hope others here will have more suggestions for you.

 

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thudson1965 replied to the thread AUS:
Other threads concerning AUS Artificial Urinary Sphincter

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Joer, have you considered, or spoken to your doctor about, a male sling? I'm coming up 3 yrs and still have some leakage. I met with my doctor and he did a basic (non invasive) test after asking a few question and says I'm a good candidate. I'll be scheduling my procedure in the coming weeks. Worth consideration even if you choose that it's not for you.

 

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All, I had my prostate removed in Jan 2020 due to cancer (gleason 3+3 and contained). I had a UTI as soon as the catheter was removed. It took a while on meds before clearing up. I am incontinent and go through 3-5 pads a day. My question is after I urinate (about every 1 1/2 hours) I still drip and squirt as I feel urine in the urethra. I drip and squirt for about 2-3 minutes after urinating but even then I have to cover my penis with toilet paper because I still drip as I go to pull up my underwear and I fell urine coming out even when walking out of the bathroom. I talked to my urologist about that and he does not have an answer or knows why this happens. Does this happen to anyone here on this board and if so can you give me any advice or possible fixes? Thank you very much.

 

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I also had my prostrate removed and have been leaking ever since. I use Mens Liberty, Bio Derm. I change it every 2 days and Medicare pays for it. I was a huge improvement over pads. I am able to lead a normal life except for the sex part. I have had consultations and seen you tube videos about an aus but for some reason I just can't bring myself to do it. Maybe someday when there is some new and better alternative. I am 74 and sex is just not that important anymore. There is a learning curve with Bio Derm but once you get it right it won't leak for 2 or 3 days. It only takes 15-20 minutes to put on and your good for at least 48 hrs.

Sincerely
Bert

 

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I have a similar experience of not completely emptying. Someone in another thread posted the suggestion of lifting the crotch after peeing. I do this and it usually helps to extract more, thus less dribble in the pad. I will say your situation sounds more serious, though.

 

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I had this problem before RARP. I needed an extra minute or two after peeing. Also the scrotum lift and toilet paper to catch and dry.

I had the male urethral sling surgery. I went from leaking 17 ounces a day (determined by weighing) down to a quarter of ounce at night caused by alprazolam (Xanax). I am living much better.

Hopefully you have been doing kegels and have seen a pelvic floor physical therapist.

Based on your time since surgery and post dripping, consider a male sling or AUS (artificial urinary sphincter). The side-effects of getting to be cancer free causes some of us sever problems.

 

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Hi
I am 2 years 3 months post op and am 100% incontinence. I’ve had 35 radiation treatments and 18 month of harmone therapy. I have been off harmone therapy for 6 months and my PSA has gone from 0 to 1.1 which means cancer is still in me. I am back on therapy and will be retested in 4 months. If still rising we will discuss treatment.
I have been using Men’s Liberty external catheters and Uro pants for two years. Best thing that I have found.
I have CHF and take lasix so an AUS would constrict my activities to much. Pants and pads fill up too quick and are expensive. My insurance pays 100% of Men’s Liberty.

Good luck. I hope you find something that helps. Urologists diagnose, treat but don’t know beans about post care.

 

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I would turn to a good pelvic floor therapist before undergoing surgery, if you haven't already done so.

 

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You see you’re in good company. I’ve had a urologist tell me most men are continent within 2 years, if it’s going to happen. I’m 4 years out RRP AT 74 and still leaking, but cancer free. I’m an Olympic Kegel candidate including multiple methods that haven’t stopped it, but have definitely increased my degree of continence. The vacuum pump assist with ED, along with an engaging wife. I’m considering Tri-mix injections to stiffen even more, although the pump does a good job. Have been reluctant to have further surgery (AUS,etc.), as I think with many urologists it’s once and done with you. I prefer being extremely active and not letting another surgery impede my lifestyle, and haven’t heard enough consistent success after AUS to risk it. They work until they don’t without another procedure to correct the first or second.

What I find perplexing with the huge number of men at all ages and societal levels (actor William Hurt just died from invasive prostate cancer), is why the medical world is not doing more meta-analyses to study new interventions and surgical methods to save more of the urinary sphincter muscle and protect the nerve bundles necessary for erections. Certainly, the docs are rightly focused on keeping us alive, but at nasty side effect costs. Medical science needs to prioritize the matter more than they are at present.

 

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If your not sitting on the toilet, try that and squeeze out as much as you can. I heard this is the best way to completely empty the bladder. I'm 18 months post surgery and only leak with a sneeze if I don't do a keigle just before. I no longer need a pad. Hope you get better control soon.

 

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This is simple, but it helped me with drips. Take a half sheet of quality absorbent paper towel. Fold it longways so it is about 2” wide and 8” long. Wrap it around the end of penis after urinating. It will absorb a lot of drips. Carry 1 or 2 spares in your back pocket so it is easy to have a fresh one each time. I tried the small pouches that you can buy to cover the end of penis, but the paper towels work much better and are much cheaper. Hope this helps some of you. After 3 years, which included surgery, hormone treatment, and radiation; I had the male sling which worked very well for me.

 

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"What I find perplexing with the huge number of men at all ages and societal levels (actor William Hurt just died from invasive prostate cancer), is why the medical world is not doing more meta-analyses to study new interventions and surgical methods to save more of the urinary sphincter muscle and protect the nerve bundles necessary for erections. Certainly, the docs are rightly focused on keeping us alive, but at nasty side effect costs. Medical science needs to prioritize the matter more than they are at present."

Well said!!!

 

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I had the incontinence physical therapy for a few months but without the additional electric therapy for the sphincter muscle. I did all the kegels but nothing seemed to help. I am in my 50's and all my urologist suggests is to get an AUS. I can't seem to find a doctor who will at least say lets take a look at it to see what is going on to see if something could be fixed via surgery or at least examine the urethra/bladder area to rule out anything before just defaulting to "get an AUS". Can anyone suggest a good doctor for diagnostics and also one for putting in an AUS in the Baltimore area. Thanks.

 

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@joer - Look into both the male ureteral sling surgery and AUS. Both are just as invasive, but if the sling surgery works, it should not have to be redone in 7 to 10 years like the AUS.

@56vw - I agree that the 6% to 8% of men with long term incontinence after prostatectomy is low as most men would not tell or complain about one or two pads a day.

After my sling surgery, I mention problems with bladder retention and had to self catheterize for a couple of months. When I had a spreadsheet, my urologist talked about cutting the sling and sounding - at that appointment, I was just stunned. It was not until a follow up call that I was able to tell my urologist that I was happy with the results of going down from 17 ounces of leakage a day down to a quarter of an ounce at night. The nighttime leakage caused by relaxation/sleep medication. I can handle and deal with using a depend pull.

 

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Joer - AUS is considered "the gold standard" because it's mechanical and will clamp down and ensure no leakage. But I'm with you that it's a last resort at best. Give Dr. Goldfarb a try at Chesapeake Urology. He's practical and doesn't go right to AUS. He specializes in the post prostatectomy needs of patients. He's in the Columbia office but may move around to some of the other locations. I've met with him and he will be doing my sling later this year (working around some personal commitments or it would be done already).

 

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Joer, I’m two years post prostate removal this week. I have 100% incontinence. Nothing worked for me. I had a physical floor therapist, bought two tens units, did kegels, core exercises and the treadmill everyday, with no improvement. Nothing worked for me.I have scheduled an appointment with a surgeon who specializes in the AUS device. Wishing you the best of luck going forward.