7 months following radical prostatectomy

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I would appreciate some input about continued incontinence seven months following radical prostatectomy and two months following the end of radiation.
While I have seen some improvement I continue to have to use 5 to 6 pads a day and two or three pull ups. I noticed that following strenuous activity the leakage is greater and more frequent although the last two days I have had limited physical activity and the leakage was worse.
I would appreciate some of your thoughts and your own experiences and suggestions.I am 83 years old.

 

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Not to disappoint, but I’m 3+ years out at 74 and still leaking- pad/day- more if active, despite being a Kegel Jedi Master. Genetics, physical fitness, physician skills, luck all play a part.

 

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Im 72 at 7 month. Did no have radiation. From 7 pull ups to now l light pad a day if I decide be out and around all day. It has been the 7th month that I had the faster improvement I'm can see the light.

 

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I'm 69 and 6 months post radical. No radiation. Leakage was significant at first but now I can wear the same thin pad for over 24 hours. Leaks if any are short, unexpected, and only occur while active. I now mostly skip the Kegels. I do my normal life and work the pelvic floor muscles through my daily physical activity if necessary. It's different for everyone. Good luck.

 

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I’m also 69 and 15 months post radical surgery. I haven’t had any improvement at all since the surgery. Everyday I do 30 minutes on the treadmill, 30 minutes on the floor doing core exercises, kegels throughout the day.I work full time up at 4:00am. I’m on my feet most of the day. I use about 8 heavy pads a day. It’s been that way since the catheter was removed. Is there anyone else that hasn’t had any improvement at all in 15 months?

 

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I am almost at 9 months. I leak about 20 ounces a day. At 2 months it was 60 ounces, at 4 months it was 40 ounces. At six months it was 30 ounces and I started Solifenacin - an Overactive Bladder (OAN) medicine for stress incontinence.

@gnp10351 Has your urologist offered any help for medicine, procedure such as Artificial Urinary Sphincter (AUS), or the male sling? Have you had any urodynamics tests?

 

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No medicine suggested and no urodynamics
Thanks

 

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Thudson 1965
I had 8 weeks of physical therapy, months 7 and 8. Like you I bought the K-Fit and also bought a Tens machine that I used as instructed by the physical therapist for several months. I had a cystoscope at one year and there wasn’t anything out of the norm. My surgeon who is also my urologist, wanted to make me an appointment with the surgeon who does all the AUS surgeries. I said no. He said they have a high rate of success. I said so did the the prostatectomy, but except for the cancer everything else was a failure. He has never mentioned anything about OAB medication.

 

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@gnp10351 I know it is a tough road and I am 6 months behind you. At 8 & 1/2 months, I saw my urologist (also my surgeon) who talked a little about the sling and AUS. At 20 ounces, I am leaning to get the AUS, but have to wait 4 more months.

I was surprised that the Solifenacin (Vesacare) brought my leakage from 30 ounces down to 20 ounces.

 

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Thudson 1965. Are there any side effects with the Solifenacin?

 

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It took me about 2 weeks to get use to the mild side effects - some nausea, but then I was good.

 

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It took me about 2 weeks to get use to the mild side effects - some nausea, but then I was good.

Hi, how long after you started taking solifenacin did you notice any improvement in leaks. Thanks.

 

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@Giles The solifenacin (Vesicare) started working in 3 days.

 

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Ok thanks.
I an 3 months post robotic prostectomy. Leaking during day time (standing/sitting) night dry. Started solifenacin for possible OAB for 2 weeks with no improvement. Absolute nightmare of a lifestyle. Ages 59,
24/7 using pull-ups. Hope yours has improved?

 

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My prostatectomy combined with the removal of a large bladder diverticula was 4 yrs. ago. I had some leakage prior to my surgery that required I wear some type of protection. Since my surgery I have developed chronic heart failure, and most recently back surgery. I now wear tape on diapers most of the time during the day, and pin on cloth diapers at night. It has become my new normal, and am slowly becoming accustom to the need to wear diapers. I don't think anyone ever becomes comfortable or use to it. I am 74 years old.

 

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@Giles At 3 months, I was leaking 40 ounces a day. You are early in your recovery.

I did not start the solifenacin until 6 months. I had done 7 weekly sessions of pelvic floor physical therapy. I walk 2 miles 3 or 4 days a week and do kegel exercise 3 times a day ( a set of 10 - hold for 10 seconds and relax for 10 seconds).

 

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I'm 13 months post total radical prostatectomy and STILL leaking. I'm 60 had no complications and nerves were intact. Dr felt I as an excellent candidate for full and quick recovery in regards to incontinence and ED. WRONG, WRONG. I had 10 months of Physical Therapy and did Kegals until I hated them. I was/am like a seesaw, it gets a bit better then I leak a bunch for a few days. I have kept a record by weighing my pads and yes, it's better than the beginning but I'm a bit resolved to either live this way or consider a sling. Most days I use 1 pad, but it gets quite full about 50-75 mil. Some days I only get about 30 which is just a bit over an ounce. In any case I just can't seem to figure it out. I never leak at night (at all), I can hold urine for a long time if needed (like while I'm driving) but it seems if I'm up walking or even just standing, there often is a slight drip. The worst part is if my pad happens to fold over, then it's a wet mess. Hoping it gets at least a bit better, but I doubt it.

 

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@jayemcee Sorry to hear that you are still suffering over a year after your op.

Unfortunately a lot of studies of success rates following radical prostatectomy class one-pad-a-day as the equivalent of a return to continence.

In my experience (admittedly my experience hasn't been positive - I'm at 4+years post op with full IC and ED) I've found that surgeons/urologists over-state how successful their proposed intervention will be and minimise how much something like a one-pad-a-day leak will impact your life.

Also - to chip in on the earlier discussion of Solifenacin (vesicare) raised by @giles. I was prescribed this 6 months after my op with no discussion of the risk to cognition. The drug didn't help my leakage but it left me in such a brain-fog that I was lucky I didn't lose my job.

Please quiz your doctor on this before starting this medication. It was only much later that I saw media articles that warned that impaired cognitive function was a known risk with the medication.

In general I've found doctors to be great at finding something to fix a problem - but really very poor at looking at the whole person and asking the question "has this really made their life better"?