Incontinence After Prostatectomy Surgery
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Nor I, nor the person I was just responding to on this thread: https://forum.nafc.org/topic/1116/incontinence-after-prostatectomy-will-it-ever-end
Archives1
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I'm close to 4 mos and the best I can say is I'm better. On a good day I can make a pad last all day. My control is best in the morning. Afternoon and evening takes more effort. I told this to the surgeon and he said go to the bathroom more often. But I had read that holding the bladder longer helps bring back control. Until recently I didn't have bladder sensation like I had before surgery. Now if I could only stop sneezing and coughing. I was down in the dumps in the early part of recovery. That has greatly improved and hopefully helped recovery. My recent PSA result was undetectable so that eliminated further prostate cancer thoughts...until the next test. I'm doing most of what I was doing before so I'm plugging along.
Archives1
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56vw -- Your situation, including the relatively recent return of bladder sensation and the undetectable PSA, is about the same as mine, except that I'm just a few days over 3 months and will see the doc this week for the first follow-up since catheter removal. Evenings are definitely worse. Sneezing, coughing, laughing are problems. (I'm usually able to remember to squeeze before getting up from a chair, though.) I'm using "protective underwear" instead of pads; most days I use more than one.
I keep getting the feeling that things won't get much better, but I'm hoping to hear something more hopeful from the doc. He's been honest about odds and so on, so I tend to have confidence in what he tells me. If he has any good tips, I'll share them here.
So I'm plugging along, too. Best wishes!
I keep getting the feeling that things won't get much better, but I'm hoping to hear something more hopeful from the doc. He's been honest about odds and so on, so I tend to have confidence in what he tells me. If he has any good tips, I'll share them here.
So I'm plugging along, too. Best wishes!
Archives1
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For those who gradually improved, what were the initial positive signs of improvement? Was it less leakage or finally having bladder sensation? I can urinate in toilet after laying down or sitting for a while. However, any kind of standing up or walking leads to leakage and so bladder is normally empty after those activities. I am four weeks out from having catheter removed.
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Less leakage came along with better sensation for me. I was/am frustrated with progress, more so inconsistency of continence (sometimes only 30 minutes and others up to 2 hours) so starting keeping a log. Since I started it in mid Sept (5 mths post op) I've seen avg time go from under 1.5 hours to 2 hrs, and last week had back to back 4 hr stints. Never thought that would happen again so I continue to be optimistic. Still not as consistent as I'd like, but the log is the only way I've been able to see actual improvement b/c it doesn't always feel like it's getting better day to day. Still have bad days but they are getting "less bad". Physical therapy/bio feedback allows me to see how muscle control is, and shows a part of this whole thing is emotional where my mind says I have to go, but my muscles are capable.
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Some additional thoughts on my recovery. The mental part has been a sort of a gauge. After catheter removal I was constantly thinking about holding that bladder muscle when leakage seemed constant. I do 1/2 hour daily walks and saying "is this the rest of my life?"...was a burden. I think that was part of being in the dumps. But over time the mind adjusts and I think about it less. Now I need to pay attention when getting up from sitting (sitting relieves the process). Or going too long without going to the bathroom. Getting out of a car is still challenging. If I catch myself before a sneeze or a cough, I hold my crotch. I have prevented leaks doing this. What has the mental process been for you?
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Holden8285, are you able yet to start a kegel-like squeeze before you get up from a chair, and then hold that squeeze while walking to the bathroom? That felt like an important bit of progress to me.
Other than fewer diapers or pads used, a sign that felt important to me (more than four weeks in, though) was the ability to sit down on or stand up from the toilet undiapered without wetting the floor. That has continued to improve, so that now I can walk from room to room (the first few times I tried that, I held a pad in front of me). The ability to be that mindful and to exercise that much muscle control felt significant.
Related to all of that was the return of bladder sensation. I seemed to have a little sensation sometimes while lying in bed at night, so I hypothesized that I didn't feel the urge during the day because there was never enough urine in the bladder, due to all the leaking, to trigger the "gotta pee" response. (According to what I read, when a normal bladder gets filled to a certain level, it signals the brain, which then creates the sense of needing to urinate. I figured that, thanks to gravity, I was leaking so much that I never reached that signal-generating volume, except when I was lying down and gravity wasn't pulling the urine out immediately. I don't know how correct that is, but it helped me psychologically.) But that changed relatively recently: now the nighttime sensation is stronger, and there is sensation during the day as well. (After thirty years with a grossly enlarged prostate, I never thought I'd be glad to feel the urge to urinate!)
Speaking of nighttime: whereas earlier I was getting up every 2 hours to pee, the rate then went down to a couple of times per night. Currently, it's only 1 or 2 times, and recently I slept through an entire night. I don't know what the mechanism is -- maybe things are just "calming down" -- but I'm not complaining.
I've recently been learning that, as Mlrichards said, the urge doesn't necessarily mean that I need to get myself to the bathroom right away: that can be more anxiety than physical necessity at this point. That feels like a milestone, too -- by now (3 months), those muscles really are doing some serious work. (Maybe that's related to the reduction in nighttime trips?)
I hope that's helpful.
Other than fewer diapers or pads used, a sign that felt important to me (more than four weeks in, though) was the ability to sit down on or stand up from the toilet undiapered without wetting the floor. That has continued to improve, so that now I can walk from room to room (the first few times I tried that, I held a pad in front of me). The ability to be that mindful and to exercise that much muscle control felt significant.
Related to all of that was the return of bladder sensation. I seemed to have a little sensation sometimes while lying in bed at night, so I hypothesized that I didn't feel the urge during the day because there was never enough urine in the bladder, due to all the leaking, to trigger the "gotta pee" response. (According to what I read, when a normal bladder gets filled to a certain level, it signals the brain, which then creates the sense of needing to urinate. I figured that, thanks to gravity, I was leaking so much that I never reached that signal-generating volume, except when I was lying down and gravity wasn't pulling the urine out immediately. I don't know how correct that is, but it helped me psychologically.) But that changed relatively recently: now the nighttime sensation is stronger, and there is sensation during the day as well. (After thirty years with a grossly enlarged prostate, I never thought I'd be glad to feel the urge to urinate!)
Speaking of nighttime: whereas earlier I was getting up every 2 hours to pee, the rate then went down to a couple of times per night. Currently, it's only 1 or 2 times, and recently I slept through an entire night. I don't know what the mechanism is -- maybe things are just "calming down" -- but I'm not complaining.
I've recently been learning that, as Mlrichards said, the urge doesn't necessarily mean that I need to get myself to the bathroom right away: that can be more anxiety than physical necessity at this point. That feels like a milestone, too -- by now (3 months), those muscles really are doing some serious work. (Maybe that's related to the reduction in nighttime trips?)
I hope that's helpful.
Archives1
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Thanks for the info. I do a Kegel squeeze after sitting/laying down for a half hour or more. By doing that, I am able to cut down on leakage on the way to the bathroom. Then, I empty my bladder. The one positive so far has been the increasing amount of urine that I am able to empty from my bladder. However, I still have the leaky faucet syndrome when walking or standing. I hope that will improve over time. Also, I have no sensation with my bladder.
I am doing three sets of Kegels a day. From what I read, you need to do them regularly but not overdo it. That part is somewhat confusing. Also, no one at the urology office is emphasizing the Kegels.
I am doing three sets of Kegels a day. From what I read, you need to do them regularly but not overdo it. That part is somewhat confusing. Also, no one at the urology office is emphasizing the Kegels.
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Sounds like a lot of us are in the same boat. Gets better over time siting or laying down. But everyone seems to still leak when walking around for any period of time. I thought maybe someone would give a hint of optimism and say they were good after 4-6 months. Makes you wonder if most people don’t get bladder control back enough to not have to wear pads. I am 53, and while I am glad I am cancer free. I hope I can get to a point where I fantasize have to wear pads. Thanks everyone for sharing your story
Kirk
Kirk
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I'm at 10 weeks post surgery as of today. I'm at one Depends pad per day. I'm 52 yrs. old. Still have an occasional bad day, where I need to change to 2nd pad but that is happening less and less frequently, although this week I've been fighting a cold/cough and leakage has increased slightly. I've been to about 5 physical therapy sessions and my PT says she wouldn't be surprised if I'm dry by the end of the year. I have my doubts but that would be a helluva Christmas gift. I went padless one day while at at home and wore regular boxer briefs for about 4 hours with little to no issue but haven't tried that since. I kept my activity to a minimum when I tried that. The kegels and pelvic floor muscle training has helped. I'm pretty diligent about it. You can definitely overdo it and muscle fatigue will set in and cause more leakage. Just have to follow the directions from the PT. I see the doc next month for first post-op PSA test. I appreciate these posts and people reporting their progress. The mental part definitely plays a factor in my opinion. I get down on a day I feel like I've regressed, but overall I'm seeing improvement and am encouraged.
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