Incontinence Issues at Week 5

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I'm new to the site but have been following some of the topics and find much of the information insightful. I am approaching week 5 post RP surgery. Seemed like things were better in terms of continence after week 2 or 3 than today. My surgeon doesn't want me practicing Kegel exercises until I see him in another week and a half which is the first appointment since they removed the cath.

I don't leak when I sleep or lie horrizontally. In the first few weeks the same was true for the most part when I would sit. For the past 10 days or so I oftend tend to leak sitting and and after standing for more than 20-30 minutes I begin to leak. This is better earlier in the day but by afternoon I sometimes I can't stop the leaking at all.
Wearing a pull ups with a pad and mostly just the pad is wet when I change, generally change once a day but sometimes twice. On bad days the pull up is wet too.

From what I read on the internet you can begin Kegel exercises after the cath is out. Does anyone know why I might be told to not do Kegels until the next visit to the urologist or have you been told the same? Has anyone as well experienced the same in terms of my leaking from week 2 or 3 getting worse today? I have a feeling this may be a result of my core getting weaker.
Any insight or help would be appreciated.

 

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Welcome @Uf04075!

That would make sense - as the urologist may want to conduct a cyscoscopy to examine the urinary tract post RP to see how things are opening and closing of the urinary sphincter so that you can successfully "kegal" without damaging your urinary tract.

That would be my only guess as to why they may have you hold off until the first appointment. Don't get discouraged by the way, many men who have undergone this surgery suffer from hiccups and setbacks post surgery in the weeks of recovery. What you are experiencing is normal from what I've seen on here.

You will find many a great men and women here at the NAFC - you are among friends here.

Blessings for a speedy recovery,
Honeeecombs

 

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I have no idea why you have been told not to do the Kegels. You are correct to say that most people are recommended to begin them after the catheter comes out. With regards to progress in the incontinence journey you must remember that progress is rarely a straight line graph. At least that has been my experience. At the beginning I was leaking 600 MLS per day. Now, some days I can be in low double figures ( eg 15 to 35 mls) I can also have occasional days when the leakage is a lot worse. Sometimes I can put that down to heavier work, but on other occasions I can find no particular reason why the leakage is worse. I remember one contributor on this forum saying not to measure progress on a daily basis but to look at the picture over a period of weeks. That was good advice.

 

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Thanks for tyhe insights. I know I'm not the most patient person. I did fail to mention that the urologists concerns in not doing Kegels were for the urinaty tract to heal from the stitching he put in to re-connect it after the surgery. I'll have to look up cyscoscopy. Not something I'm familiar with but sounds like fun. Learning about this as I go.

 

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Thanks for tyhe insights. I know I'm not the most patient person. I did fail to mention that the urologists concerns in not doing Kegels were for the urinaty tract to heal from the stitching he put in to re-connect it after the surgery. I'll have to look up cyscoscopy. Not something I'm familiar with but sounds like fun. Learning about this as I go.

You may have had one before but don't know the name - its overall a scope of your bladder and urethra. Sometimes they fill your bladder with saline - but fret not, if you haven't had the procedure done - don't tense your muscles. Try to stay as relaxed as possible.

Blessings,
HC

 

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Hang in there and be patient. I am 10 weeks post RP. Similar to you that never leaked much sleeping or sitting. Walking I went through 6-8 pads a day for nearly 2 months. Last 2 weeks has got much better and down to 2-3 pads. First 2 weeks back to work had to use external catheter and leg bag. I started Kegels few days after my catheter was removed. I also notice that leakage gets worse later in the day. Hang in there and keep us updated.

 

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thanks for sharing your experience! All of this really helps

 

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I had my catheter for 3 weeks because of bleeding and clotting and had catheter change via cystoscope. I had sedation and had no pain and don’t remember anything. I don’t think it is a normal procedure done with RP. Not 100% sure but don’t think it is done for incontinence.

 

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I’m 3 months out and still leaking, including at night. I’ve done kegals and other exercises I learned at another PT practice. Not much has changed. You’re doing fine for just 5 weeks. It seems that time to conquer incontinence varies widely. I’m going to consult with PT at Univ. of Michigan, where I had the surgery to be evaluated. The two PT practices that I’ve used are very different. The first relied 100% on kegels, the second 100% on other exercises that focus more on the core. So I’m hoping for some clarity.

 

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I truly think walking helps a lot too. I try to walk 2-3 miles a day. You will probably leak more while walking but just learn to deal with that knowing it gets better.

 

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My urologist wanted me to limit my walking until I see him next but I know I'll leak more once I can walk my normal daily amount similiar to you. I had focused on my core in the gym for the 2 months prior to my surgery so hoping that has helped some. Thanks again for everyones input. Hope things get better for your soon Cyclist.

 

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My doctor recommended Kegels daily. I obliged and in 6 to 8 weeks was completely dry. I don't get the delay?

 

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My urologist had me start kegals BEFORE my robotic RP, so no sure why the wait.

May be worth a call to the urologist office, ask to speak to that Dr's nurse and ask the question...


Just a thought.

I think the kegal work before and after the surgery helped me improve quickly.
I wouldn't do them w/o permission, but I would ask the question and walk as much as possible.

 

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From what you've already read in these postings you see that your have lots of companions on this journey. I hope that puts things on some perspective for you at least.
At almost 3 months post RP i can say the leakage is significantly improved and still I'm going through 2 or 3 pads in a 24 hour cycle (but the pads are smaller and remaining more and more dry). I've never been so elated by a stream of urine when i voluntarily urinate.
I believe the improvement is counterbalanced by the increase in activity: especially walking, sudden body movements and lifting. I was told to be aware of using your body and prepare for these movements by doing a kegel in the moment. That has helped a lot.
When you are allowed to begin, i was also told to add a single full clench kegel every hour, in addition to the full sets you might begin to do 2 or 3 times a day.
One last thing that wasn't mentioned is the change of weather. From my experience and from what I've seen on the group the onset of the cold weather is another reason for increased leaking,
If you can, try to channel your impatience in the direction of increased awareness of the actions and situations that effect how you are doing, together with accepting that you are not in control of all the variables, and do more of whatever appears to be helping.
And from a broader perspective, i have found it very valuable to hold onto the reason for which i had the RP. Whatever your reason was seeing the bigger picture will help to appreciate even the sometimes annoying, sometimes embarrassing, sometimes depressing side effects of the operation for the greater good that it will hopefully bring you.

This seems like a good opportunity to thank this group for the cameraderie, the support and the compassion that you have shown to me and to one another. Although a priori none of us might have chosen to be in the situation to be here, having now found you has brought me profound comfort. Wishing all happy and peaceful holidays.

 

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Thanks to all for the different perspectives, suggestions, and experiences. I was reluctant to reach out but so glad I did. Happy holidays to all.