Kegel tightening doesn't stop flow

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Hi all,

4 weeks from radical prostectamy. In PT 3 times a week. Floor exercises twice daily, kegels multiple times a day.

I am unable to stop urine flow even tightening sphincter muscle as hard as I can. I am very discouraged and concerned. Shouldn't I be able to stop flow by tightening at this point?

Thanks in advance.

 

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If you were able to stop the flow at 4 weeks, you would be WAY ahead of me and many others on this board. You just had major surgery. You have lots of healing to do in addition to your exercises. I know it’s frustrating, but give yourself some time. For many of us, control came back gradually over a period of months. I'll bet you'll ultimately get there. Most do. Take care.

Oh, one other thing. It's actually possible to overdo kegels. Ask your PT about that.

 

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At 74 and 3.5 yrs out as a Gedi Kegel Master, I still need one thin pad/day. As a gym rat, the activity results in the need for another after exercise, whether weights, walking, yoga, biking, etc. You’ve got a long time to go, but keep everything up. I did not find pelvic floor PT helpful after a few visits. Hopefully, you’ve got a good urologist. I’ve been through 3 and consistently find they are solely focused upon stopping the cancer - makes sense - and don’t foresee the stress (no pun intended) that incontinence puts upon the patient.
Many, in fact, see one pad per day as the patient’s return to continence. Stay with the Kegeling!

 

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Thanks for the reassurance. Without this forum, info is rare and questionable. PT said to do the kegels a few times a day. Surgeon said every hour of the day. I will ask pt again today when I am there as I have read elsewhere they can be over done also. I do appreciate your reply. Maybe I can just try to chill a bit....

 

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Dear NoControl: Others in this form are correct. Be patient. I am now a year post/Op and did not start to get significant relief until 5 months had passed. It will steadily improve after that. Now I only use a shield when golfing or exercising. In the meantime, you will question if you made the correct decision because of the side effect of incontinence. It is very depressing, but you will get there. I concer with stryder. I have a Dr just like that. BTY, my PSA is undetectable after 1 year, and for that I am very grateful. Keep on keepin on! I shot my age of 74 on the golf course a month ago. Rayl in Arizona.

 

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Thanks all. Yes urologist was focused on stopping cancer I agree. I asked about incontinence and was told I shouldn't have any problem. Have a big problem. Also, yes I have been very upset emotionally and questioned whether surgery was the right decision with the incontinence. My father and maternal grandfather both died of metastisized prostate cancer so wasn't surprised to have a positive biopsy at 59. You all have provided some relief at least for now as my emotions roller coaster onward.

 

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Nocontrol:

Never ever, ever give up. The urinary in continence will eventually subside. I am 74 and continue to do Kegels after my surgery.

 

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Too late for most of us guys, but I’ve read in the past year of surgeons that profess prostatectomy with sparing of urinary sphincter. If you have any buddies, tell them to look further than local urologist. It would have spared us from victimization of incontinence. Here in the AZ heat, it can really be trying. There are definitely worse things like your male predecessors suffered like metastasis. Kegeling must be a daily thing ad infinitude, and keep watching for the PSA every 3-6 months of <.01.

 

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I’m 69 and 16 months post prostatectomy. PSA has stayed at .001. But the incontinence has never improved. I still do the Kegel exercises, pelvic floor / core exercises and the treadmill everyday. Just hasn’t made a difference with me.

 

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What's doc say about that?

 

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Hi my name is paul i am 54 yrs old from mass.In feb 2018 i had my prostate removed.the next day came home and that night i ended up with a temp went to the hospital on friday they did a cat scan and sent me on my way.I ended up with a massive infection and was hospitalized the next week. I recovered and then 4 months after surgery my stitches never dissolved and ended up with a UTI.Needless to say i was changing pads 5to6times a day from incontinence.after the first year passed i was nowhere near any type of recovery from incontinence.My urologist sent me to their surgeon that only does sling surgeries.well i ended up doing a dynamics test and was told i would be a good candidate for sling surgery with a great chance of being incontinence free. 1 thing the dr didn't tell me was a few days after surgery i might be constipated due to anesthesia and pain meds so as your dr i recommend taking a laxative so it doesn't cause any pain down there or maybe ruin your surgery.well 3 days after surgery i had to poop and was so backed up that i experienced 1 of the most painful traumatic experiences in my life and days after that i started to leak more and more to the point where it was like never having the sling surgery.Due to this my dr said he could fix it , and what happened was unfortunate.So i ended up with surgery #3 back in march of this year and told him i would be taking a enigma 2 day's after my surgery and everything went well.So why didn't he tell me to do that the first time.well here we are 4-5month later i am still wearing pads changing 3-4 times a day ..I have been so depressed not being cured from the second surgery and have realized i might be this way the rest of my life ...i was told of another surgery called AUS.I am lost i tried keevles for months after the first surgery with no difference.I am at a lost i don't want another surgery all i want is a answer to what can i do to get past this and be cured from incontinence.Is there any medication to slow this stress incontinence down or to
cure me completely. .

 

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As a former life long MA native/educator - Carlisle, Chelmsford, Lowell - my heart goes out to you. I’m 3.5 years out, still suffer 1 pad/day, and have retired to the beauty and heat of AZ. Have gone through 3 urologists and feel strongly that they are totally focused on saving the prostate cancer patients’ lives - makes sense - with little regard for post surgical, qualitative issues like incontinence, ED, etc. I find your trying experiences unconscionable. It took me 3 years to find this forum, and have learned lots of valuable information and received support. Keep communicating with your fellow survivors.

 

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Thank for your support ...from fall river ma .Yes i know exactly how ya feel in all honesty i wish i was going thru just i pad a day.I go thru 3-4 in a day .this has been so depressing for me and 1 thing is i am cancer free but going thru stress incontinence is horrible.i hope they find a cure

 

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Paul at Tylersway, keep at the Kegeling. I know Fallriver. You must be battling humidity and mosquitoes. We just went through 3 wonderful days of monsoon rains pushing up humidity, but nothing like MA.
I’ve been in your pad frequency and sometimes go back if I’m very active, which I am often. What kind of exercise are you doing beyond pelvic floor? I was unfortunately originally ‘assigned’ by my urologist to an in-house, supposed, pelvic floor specialist. Found her unhelpful and never returned to another. Largely doing my own thing to strengthen external sphincter, and you’ll see variations in this forum. Squats with Kegels helps, and lots of walking while squeezing. Again curious about what your PT is recommending? One urologist had also advised me to stop peeing often aiming for 150 brief stops per day with the goal of one drip of urine. I think your youth is in your favor, because as a septuagenarian at 74, my musculature is less able to change. Keep fighting!

 

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No Control,

I had my radical prostatectomy on March 8, 2021. I’ll share my experience as it is similar to others on this forum. Even then bear in mind that all of us are recovering at our own rate.

Like you I leaked like a sieve for the first month using 5 or more pads a day. I did my Kegel exercises daily and I attended by sessions with my pelvic floor physical therapist at least twice a week.

I found the I couldn’t measure progress in days but could look back on the past week and see where things were slowly improving.

The first signs of recovery was not during the day but finding less and less leakage while lying prone in bed at night. It seemed that the bladder needed to be retrained on when to send the “urge” message to get up and use the toilet. The minute I’d stand up the drain opened up and leakage proceeded. The good news was things were improving at least at night.

Then slowly I started to see the bladder starting to come back on-line and start retaining some fluid. At this point in the recovery any sneeze, cough or even trying to pass some gas resulted in a leak.

For me significant leakage started to abate three months after surgery. I kept up with the Kegel exercises but cut back on the visits to the physical therapist. Bladder control continued to improve and I was down to 2 or 3 pads a day.

By month 4 I was down to a single pad unless I was really physically active and then it was more than a single pad.

This is my recovery and as many have noted, your recovery will be different but the general sequence of recovery is the same.

Don’t get discouraged, you are amongst friends here.

 

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Thanks green. Nights are better for me and I awaken a few times a night and run to the bathroom. No retention ability but able to get a good amount in there. Same in the morning. So there has been progress there. These replies have given me hope and realization that this is going to be a long process. Stressed about returning to work like this but taking things a day at a time. Got up and did my walking and floor exercises and feel better about staying the course. Much appreciated.

 

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Stryder and greensleeve ...yes fall river full of humidity and yes mosquitoes lol...after my surgery the infection i got pretty much did me in im assuming and on top of any damage i may have to the sphincter or muscle.then came the uti 4months later after 1 yr of anything i did i was leaking like a faucet.i ended up seeing a pelvic floor therapist for 3 months and nothing got better to the point she pretty much was like i did what i could but sorry.i continued with the exercises at home still no change.A urologist told me no kegel will help so i did the sling surgery twice as i stated ..i tried doing kegel exercises but i ended up in pain on one side and seemed to leak more.one thing is i am better than i was i am like 3-4 pads a day but in bed i dont wear pullups anymore like before. I leak maybe with a cough a little but i try to brace myself and prevent a leak when lying down and 9 out of 10 times im dry.i started to try and go to the bathroom like every hour in a half to see if i can possibly retrain the muscle.not sure if it will work but going to keep trying.Also after a few more months i will try the kegel again.im just at a lost living like this .Someone has to come up with a possible cure or a medication that will prevent us from leakage.anytime i sneeze fart cough lift i leak and always try to brace but there is times i just cant and will leak.Def have stress incontinence...

 

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Hi all,

4 weeks from radical prostectamy. In PT 3 times a week. Floor exercises twice daily, kegels multiple times a day.

I am unable to stop urine flow even tightening sphincter muscle as hard as I can. I am very discouraged and concerned. Shouldn't I be able to stop flow by tightening at this point?

Thanks in advance.

 

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No control Hang in there. I am 66 years old and 4 Months out from a Radical Prostatectomy. No Chemo or Radiation after surgery.

Like you I had no control 1 month out. My Surgeon did not adequately prepare me for the waterfall event that was to come after my catheter was removed. Using 8 to 10 depends a day in the beginning and protection pads on every chair I sat on. Kegel exercises did not work in the beginning. In fact the pelvic floor muscles were sore from surgery and I could not do any Kegel exercises for about 2 months after surgery. I could not do any of my normal activities of walking and biking. I am diabetic so without activity my blood sugars were getting higher which caused me to leak even more. Also was suffering from constipation which caused more leaking and control problems. To sum it for you 1 month out I was not in a good place on regaining any urinary control and on returning to my old normal life.

I started PT 9 weeks out from surgery. My PT person did not start me out with a regiment of Kegels but set me up with meds to resolve my constipation issues. Also worked with me on a more stringent diabetic meal plans to lower my blood sugar levels caused by my lack of physical activity. Pt person also asked me if I felt empty after peeing I said no. She asked me if I was sitting down to pee or standing up. I was going so often it was more comfortable for me to sit down. PT person said that guys bladder and surroundings have a different shape than women’s bladders and I needed to stand up to get better emptying voids. After about 3 weeks Blood Sugars were lower, constipation was eliminated and I felt empty after peeing. Than they stated me on Kegel Excises

Flash forward to 4 months out I am using 3 to 4 depends a day that are not full. Leakage control is better. Bladder is building more capacity. I went out on a paddle board in a lake for 45 minutes yesterday with no leakage. Kegel exercises 3 times a day. Pelvic floor Muscle not sore. Am I were I want to be on my incontinence, Not at All! Am I better than I was 1 month out from surgery, you bet I am! Will I be better at 6 months after surgery I am guessing yes! So be aware of what your situations are, make changes as needed. Keep looking forward! And my guess is you will be better in the future too!
Be Well.

 

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Retiredguy…that is excellent information and advice! Exercises are extremely important, but so is attitude. Your attitude is wonderful.