4 months post RP

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I had TURP surgery 4 years ago and it’s now been 4 months since post robotic assisted RP catheter removal, still have stress incontinence and kind of a constant drip. I’ve found myself using pull-ups more than pads as that seems to work best. I’m 64, not overweight and otherwise very healthy as I’m active and take no meds. I do my kegels and stretching 3 times daily as well as walking 2 to 4 miles. Leakage isn’t too bad while sitting but not good when standing and walking. Everyone tells me to keep doing what I’m doing, but what exactly needs to happen for me to gain near complete bladder control? Do my pelvic floor muscles just need to still get stronger? Trying my best to be patient and stay positive, I just keep wondering if this might be my new normal and something I’ll always have to deal with. Thank you and I look forward to your feedback.

 

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Pelvic floor needs to get stronger. I have been going to Pelvic therapist for 6 weeks and went from very challenging to walking around without a pad on for periods of day. Hoping in next month to be pad free. I am 3 month removed from surgery.

 

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Apparently it takes time. I had my surgery at the beginning of the year and super bad incontinence after. Total lack of control. After 6 weeks of post surgery necessary wait time physiotherapist took me on. For the first 4 weeks I had no improvement until she noticed that my palvic floor muscles are way too tense . She asked me to limit Kegel exercises from 6 times a day to 3 and while sitting on the toilet learn how to relax pelvic floor muscles. Kinda trying to drop them all the way down by relaxing it. Within a week I have noticed a huge improvement in my bladder control I still leak a lot however now more often than not I am able to walk on the treadmill for 10 minutes and be dry. Something unheard of before. Am very encouraged by this. Obviously now I know that I was overusing my PFM BEFORE , exhausting them to the point when they could function properly anymore. Too many Kegel exercises a day did me in. So it seems

 

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Just keep doing what you are doing and have patience. That was the hardest part for me.

 

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Being 6 years post RP, and still needing 2-3 pads/day at 76 years, I don’t expect miracles! Still more active than many 30 year olds doing weight machines, power vinyasa yoga for 9hrs/wk, but still leaking. Am considering PROACT surgery.

 

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Dr. Sandhu ,incontinence urologist, at Memorial Sloane Kettering, has said Proact is not a procedure he is in favor of.

 

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larryw61- did the doc say why or did you ask, because I was told almost the identical response from another forum member who also did not ask! It has been around only a few years, but seems to be working, less invasive, easily adjusted or removed, shorter recovery, and quicker procedure than sling or AUS. Problem is few urologists offer it, are trained in it and, in my opinion, is consequently less lucrative. It’s Medicare covered as well. So ask questions. I think many of us were naive as to post RP expectations, because we didn’t know what to ask and were subsequently freaked out by our actual life changing experiences. BTW, do you realize what an RP reimbursement rate is?

 

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Stryder This procedure sound amazing.I have read about it recently. This is the one I would be interested in if things will not improve. You are absolutely right about some doctors directing patients towards a procedure which is most profitable for them. We are programmed to look up to members of medical profession, at times forgetting that these people are humans and some, hopefully minority, will place profits above patient's well being. Case and point.. on the recommendation of an eye doctor I had a cataract surgery done which didn't go well for me. Later I was told by another doctor that it wasn't appropriate for me to have the surgery done since the cataract wasn't severe enough to justify the procedure at that time. Well, someone was more than happy to cash that $5000 chegue. I am still straggling with consequences of that decision and the doctor/surgeon -I am told -doesn't deal with post surgery complications, he just does the actual surgery plus cashes the cheque I gather. Good luck getting an appointment to see him. Do your own DD and get a second opinion if you can, from someone independent who doesn't benefit from the procedure in question.

 

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My approach to medical care is to use the best doctor at the best hospital that's available to me.
I look at his reviews and ask other professionals their opinions. I don't however look at their bank accounts. If that factors into your selection then the poorest doctors are the best and the richest must be the worst.
Thats not to say there aren't other great doctors but I'd rather play the odds and go with the best I can find, but nobody bats 1000

 

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In Canada we can't pick and choose a specialist however you can only choose a GP or a dentist. Most specialist are chosen for you by the system ( whatever that means ).You get to see the next available specialist who will be looking after you.... or not. I wanted to change the urologist and my GP suggested that I should move to USA this is Canada she said laughing.

 

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larryw61, your premise is wrong. For most of us in US as we’re,predominantly, age-wise, Medicare covered with same RP reimbursement rate. Once they do the surgery, you’re merely a regular consult follow-up, unless you choose incontinence intervention, which also has no assurances. I have found follow-up pretty lackadaisical and gone through 4 urologist. The one I now have, always has his PA see me, whom I actually prefer for his honesty.

 

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Josh
Thanks for the post
I am five weeks after radical prostatectomy and have no control whatsoever over my bladder when standing or walking
How did you relax your pelvic floor muscles during the day? Did you sit a lot? Was that enough?
Totally desperate
Matthias

 

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Matthias, like you I still struggle. Some days I am doing ok and the next day is a step backward. Since I started practicing pfm relaxation technique things improved to some degree. At least some walks ( 15-20 minutes ) I am able to complete without leaks, but only on the treadmill. For some unknown reason when walking outside I don't feel much so leaks are common. Mind you my walks outside are much longer too. The therapist suggested that I should concentrate more on relaxing pfm which involves sitting on the toilet to pee and simply let it go, letting tension around the area go and learn how to completely relax it, that includes pfm, glutes, abdominal muscles, sort of like meditation with normal breathing. Imagine letting muscles go completely numb, letting the tension go. Also she suggested less exercises so at this time she recommended 2 type of exercises 5 reps each 5 to 6 times a day. The main focus is on relaxation after each rep, resting muscles Iittle longer let say if the rep takes 5 seconds rest for 10 seconds. She also suggested that since I have problem leaking when upright I should do these exercises while standing up, over the toilet , at least for the time being. Hope this helps. Good luck. P.S. I should add that I am implementing relaxation technique when sitting on the toilet and the same when standing up during my daily pfm exercises.