Greetings all. I am 52 and will be having a robotic prostatectomy on 20 January. I realize incontinence will be a temporary side effect of the surgery. Any suggestions and advice on how to overcome this as quickly as possible would be greatly appreciated.
The healing process is relatively slow, making patients an absolute. Somewhere between the third and fourth months, you should see major improvements.
AS you have been told, doing your Kegels exercises, along with other pelvic floor exercises, is essential because you are training muscles that have never had to work as hard as they do now. Depending on how large your prostate was, the amount and location of the disease will have impacted how much of the bladder neck could be saved during the procedure. In general, normally the internal bladder sphincter muscle and the bladder neck work together to control urine flow, while the external sphincter plays a minor role. IC issue after the prostate is further impacted if the prostate was enlarged, as the enlarged prostate acts as a constriction point for urine flow, allowing the internal bladder sphincter and the bladder neck muscles to atrophy.
After the prostate is removed, urine flow is improved, but part of the bladder neck muscles has been removed during the process, plus the internal bladder sphincter muscle has been traumatized. How much of the bladder neck muscle is spared is dependent on a number of factors, but the size of the prostate is a major component.
The Kegel exercises are intended to strength those remaining muscles, but it is important to be mindful of how you do the Kegels. My PT person described it as follows: you have rear and front pelvic floor muscles. Men have a naturally stronger rear pelvic floor. Think of this muscle contraction like you are trying to hold in a fart. The forward or front pelvic floor muscle is much harder for men to activate. This muscle contraction is often referred to as the "Guts to Nuts", the best way to learn this contraction is by standing in front of the mirror while doing it. You should see your nuts lift, and you should learn to hold this contraction.
Other floor exercises, like Bridge lifts, scissor leg lifts, squats, and other core workouts will speed your recovery. Remember, now that the cancer is gone, you have the time to heal, you need to be patient, but consistent with your body.
As you progress, you will want to do bladder training as well. Bladder training is straightforward. Learn to hold your pee for 2 hours plus. Over the course of a few months, you'll see improvements. I'm attaching a document that you may find helpful, I know it helped me manage my expectations.
