Medication for Incontinence after Prostatectomy

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Just curious. Why isn't it standard procedure to prescribe medication for incontinence after rp? Its been over 3 months for me and it just occurred to me to ask for something to help with the incontinence. Has anyone gotten meds right away? I'm doing kegels every day, and finally got a physical therapy appointment: still 2 weeks away. So I asked my VA doctor for something and I should get it next week. Will medication interfere in regaining my continence? I know I've made some great improvement and probably can get away with 1 or 2 pads a day. But, it doesn't seem to have improved much at all in the last 3 weeks. And, I'm getting radiation for leftover cancer in the prostate bed, most likely towards the end of July. Anyone else in similar circumstances?

 

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Hi Jim,

I didn't know there was medication for incontinence! What kind and what is it suppose to do?

Very interested, but no one ever mentioned anything about that to me...never even saw on this forum before.

Good luck with it and I hope it helps! Keep us posted!!!

Good luck w/ radiation, too. I may need radiation in the future, if my PSA level is ever detectable. They advised to get radiation anyhow, but said up to me as long as undetectable, and so far it is! Getting PSA checked every 3 months.

+God+bless+

 

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I was prescribed Solifenacin (name brand is VESIcare) at 6 months. I also tried Myrbetriq and Gemtessa - newer with free samples (did not add to much to reduce leakage). The older Solifenacin worked best for me.

The medicine helps with bladder - spasms, OAB (Over Active Bladder), incontinence, etc.

It can take up to a year to recover. You seem to be making good progress. Most men see improvements at 4 to 6 months. Some weeks seems like no improvement, then a month or 2 later almost dry.

Kegels and seeing a pelvic floor physical therapist helped me. Kegels will be a lifetime practice.



5 months - 30 oz; stopped muscle relaxer; nighttime from 2.3 down to 1.4 oz

6 - 7 months - 20 oz; started Solifenacin for OAB; decrease due to Solifenacin.

8 - 9 months - 17 oz; Myrbetriq and Gemtessa - did NOT provide much improvement and are not covered by my insurance





The following is more than you asked - it is the whole text file. I put the pertaint part above.


Text File __Incontience_20221004.txt

My journey - notes that I made for my doctor visits. I weighed my pads and pullups, kept a spreadsheet, and converted averages to ounces. I used a digital kitchen scale measuring in grams - 1 gram equals 1 milliliter (close enough for comparisons).

Incontinence as I see it.
Type of leakage - standing - constant (overt) dripping every 2 to 10 seconds - bladder neck / external sphincter not closing.
While I am able to keep from squirting as I am standing up, the urine dribbles or slow flow out within a few seconds. I am able to hold some urine in until I make to the bathroom.
I am able to push urine out (increase the flow rate) in the bathroom ( which I could not do or feel at 4 months).

My progression (leakage in ounces)
2 months - 60 oz; nighttime 2 pullups (strong stream shoots out Depend pullup using Northshore Go Supreme pullups)

3 months - 40 oz; nighttime 1 pullup (6 to 17 ounces)

4 months - 30 oz; Pelvic Floor Physical Therapy; nighttime from 4.3 down to 2.3 oz

5 months - 30 oz; stopped muscle relaxer; nighttime from 2.3 down to 1.4 oz

6 - 7 months - 20 oz; started Solifenacin for OAB; decrease due to Solifenacin.

8 - 9 months - 17 oz; Myrbetriq and Gemtessa - did NOT provide much improvement and are not covered by my insurance

10 months - 17 oz; Urodynamics and cystoscopy - schedule male urethral sling surgery - 17 oz

12 months - Male Urethral Sling Surgery - (Sept 2022 one year - I recommend the sling surgery)

13-16 months - self-catheterizations (1 weeks 4 times day; then twice a day; daily; then weekly; then stopped)

17 months to now (24 months) - I leak about a quarter of ounce at night. If I take migraine or headache medicine, I will leak more. I went down to just a pad in my underwear until April 29, 2022 when I released out of the pad and had to change my sheets in the middle of the night. I will always have the above sheet bed pad and wear depend pullup, pad, and underwear.

 

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I'm 1 yesr post op (RP) and my urologist has prescribed Imipramine 50mg for my minor (drips and dribbles) incontinence. It seems to work (for me) really well. I wear 1 lightweight pad per day and have very minor drips during the day. Completely dry at night.

 

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I am 9 months out and would say you are making good progress. Haven’t heard about meds for incontinence, my urologist said there are a few surgical procedures. I told him as long as I was improving, I would stay with the current plan. My Physical Therapist told me to look months back for progress not days. Using that advice put me in a different mindset and helps with the mental aspect of recovery. Psa undetectable so I would say overall it’s worth it not to have cancer. Down to about three pads a day. Two things that really helped me has been Physical Therapy and drinking lots of water. Good luck

 

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This is helpful. I am 7 weeks post RP and 6 weeks post catheter removal. The leaking is constant when standing and not too bad when sitting or sleeping. I wear pull-ups every day and night and use a clamp for golf. Meeting with my surgeon next week. Doing kegels regularly. My question is even though I was prepared for incontinence no one has told me that continual leakage is normal? This is frustrating. Any thoughts that will help me when talking to my surgeon for the first time post surgery? Thank you.

 

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No one told me about the continual leaking, either. I think its lying when the surgeon doesn't tell you the possible side effects of removing the prostate and surrounding vesicles & tissue. To say "you may be incontinent after the surgery" is an incredibly grand understatement. At 5 months, I no longer wear protection at night and use a light pad around the house during the day. The only leaking now happens when in a standing position. I still wear maximum pads when going out or doing yard work or riding my stand up mountain bike. You might ask for a prescription for pelvic floor therapy. Not all physical therapists do pelvic floor therapy for men, so best to get a written prescription. Do go to a physical therapist who does biofeedback. My strongest kegels are when lying down. Next strongest is sitting kegels. And just as standing is where my leaks occur, standing kegels are the hardest to do and hold. Ask for a medication to help with overactive bladder. Alot of them have unbearable side effects. I just started Vesicare and am hoping that helps me further. But kegels are the main exercise to do to get to full continence. I'm 10 days into salvage radiation to my prostate bed and am concerned it will worsen my incontinence, so I'm doing even more kegels and working them in every position.