Post-Prostatectomy Light Incontinence & Wanting to Avoid Surgery!

[Archives1]

Hi - I am 67 years old and 15 months post prostatectomy. Still experience light stress incontinence and am down to one light pad (shield) per day and dry at night. Was hoping to be completely dry by now but still requires management. I have reached the point where I am considering sling surgery but from what I have read and men I have talked to I really want to avoid this or any type of surgery. I am told by my MDs that I could still reach continence up to two years or even beyond.

So my question is how many of you in my position have elected to avoid further invasive treatment and continue to manage your light incontinence ... and how do you do it and maintain an active lifestyle.

Thanks!

 

[Archives1]

After the difficult recovery I had, it is much easier for me to manage my incontinence (3-4 pads daily) rather than to endure another surgery with uncertain results. I am 70 and fit, 16 months post salvage RP, 11 years post radiation and Lupron.

 

[Archives1]

I am 2/12 years post RP and will be 69yo next week. I was in a very similar position to you 18 months post surgery and my Urologist advised his experience was that I was unlikely to have further improvement and recommended sling surgery. Prior to agreeing to the surgery I decided to revisit the specialist pelvic physiotherapist and we tried different exercise and regimen options for a few months ~ but I was unable to achieve significant further improvement.

So my options appeared to be live with the light incontinence using one light pad a day or try the sling surgery. I elected to go with the sling surgery and had the sling implanted 7 weeks ago on 13 December. Unfortunately I have had some complications with wound healing after an internal stitch gave way and part of the wound opened and then I came down with a really bad flu that has had me bedbound and miserable for the last 3 1/2 weeks.

I haven't been able to be very active at all to put the sling to the test as yet, but the wound is finally almost fully healed and the flu is much better. I am hoping to start easing back into my normal active lifestyle next week and looking forward to seeing how the sling affects me.

 

[Archives1]

I'm 67 and 15 months post RP. Still using 2 to 3 pads a day. I too do not want any more surgery's. I'm just biding my time and will not make any decisions until after 24 months post. Good luck to all.

 

[Archives1]

It sounds like you are doing well overall. First congratulations on electing to go for a cure by choosing the most aggressive treatment available as I did. You are doing much better than I was at 15 months. I was unable to get out of full diapers. at 2 years I was referred to a urologist who specializes in AUS and sling surgery. I'm not sure I would pursue further treatment other than non surgical ones at this point. Time and pelvic floor PT may be your best friends at this point. Six more months and reevaluate. Give it a bit more time. I elected to do the AUS and am very happy but I'm essentially where you are now, panty liner type pad with minimal leaking and dry at night. Light years from where I was pre AUS. I would still elect for the RP and AUS if I had to do it all over again but the side effects of RP are challenging.
Boomer59

 

[Archives1]

64 years old and 25 months post RP. Still slight incontinence now and again. I use a shield during the day, just in case. I use a pad for weight training and going out for a few beers. Sometimes needed sometimes not but for peace of mind and to be able to relax and enjoy myself. I don't fancy any more intrusive surgery so I'm willing to put up with this slight inconvenience.

 

[Archives1]

Hang in there it takes quite some time for recovery from that surgery. In time you’ll make the right decision for you.

 

[Archives1]

@Rallim I do the same if I’m having a few beers which is regularly. Only for a peace of mind.

 

[Archives1]

I just turned 78 had my RP 18 months ago.I measure my leakage and avg apx .6 oz per day but sress incontenance can go crazy if i get a lot of bending, etc. Just had my latest 6 month check up said i could get the sling, but i really don"t want any more surgerys. I did not want radiation which was one many of the options including seeds etc. I am glad i got rid of the cancer so i am good right now and hoping to still improve. Maybe sling down the road but as of now NO.

 

[Archives1]

Almost 2 years post RP. Manage with one Tena pad in a 24 hour period, unless a heavy alcohol nite(infrequent) and or hours of continuous standing without a close by washroom. I find this quite manageable compared to my 1st six months. I do not shy away from travel and/or sports. I to, do not want anymore surgeries. (Eleven from sports injuries/wear and tear)
Hope this helps.

 

[Archives1]

It looks like so many of us are in the same boat with a big improvement since the first 3 to 6 months but still having some leakage a year or more later. I too am in that position and pondering the sling, for example, but likewise sometimes thinking I can just learn to put up with the problem. My daughter's boyfriends dad has to have a hip replacement at 54 after years of pain. Many people have to manage conditions and sometimes I try to convince myself that I am no different having to manage incontinence. But then on other days I feel the frustration. I use one or two light pads if I'm not overly active. But I still don't have confidence if I am away from home all day and then I revert to the conveen. I know I could probably manage it Ok with pads but for me it's the uncertainty. I will be two years post op in a couple of months time and like others will review my situation after that.

 

[Archives1]

@bcarr - Hi bcarr - Because you are the one who posted first, I am replying, but this of course is for anyone who wants to comment. - Obviously I am not a man, and incontinence issues are very different for men and women. - But, honestly, I have to say - if I could get away with one pad a day and be dry all night, I would be positively THRILLED! Truly!!. - If in the end you go for the sling surgery, I hope that it fixes everything for you perfectly - Pam

 

[Archives1]

Guys lots of consistency about the hope of time healing. But, if not, then should one avoid further surgery, 6 months+ of sore scrotum, stitch issues, neurogenic bladder, etc. For many guys the hassles and risks are worth planned total dryness. It seems that many have gone into sling or AUS due to excessive leakage, i.e., multiple pads/day, but they still need pad(s) nonetheless. Still nobody mentions PROACT surgery, which I’ve asked about several times because it’s described as less invasive, speedy recovery, quickly performed out patient, cheaper, easily reversed, Medicare approved, but few urologists offer it. WHY?
Personally, I tolerate 1-2/day, am extremely active at 76, 6 years post RP. Prefer to be thrilled at PSA of <0.1, but no more surgery on the genito/urinary area - if things stay this way. Still harbor some surgery regret as my surgeon led me to believe I’d have no problems being continent and wouldn’t have ED - wrong! Also believe that age is a major factor in recovery, so once you hit 60-65, total continence is near impossible after RP. Increasingly, urologist are opting for watchful waiting, to avoid the terrible side effects most of us are afflicted by. Do your research before making your decision for more surgery.

 

[Archives1]

5/27/21 RP
8/26/22 AUS - would do it all over again
I'll be 80 in July and very active

 

[Archives1]

I am 72 and had RP at age 66. Following surgery, PSA was slightly above 0.1 and had radiation and Lupron. PSA has been undetectable since. I use 3 to 4 Depends/day with no leakage at night. I have thought about additional surgery to improve leakage but am managing pretty well so far. I also wonder if the radiation treatments may have degraded some of the internals which could make the surgeries less effective. Being retired makes dealing with this issue a little easier. If I were only 15 months post prostatectomy and down to one light pad (shield) per day and dry at night, I would likely stay away from any additional surgery for fear of making things worse.

 

[Archives1]

I am 69 and 16 months post op. Leakage use to get me really down but that was psychological rather than the practical impications.I think it caused me depression. I was on 4 pads a day initially.I had two accidents in bed and one accident when I was out in the early days. Nobody realised except my wife. I remember being sickened to think I'd wet myself.Now I think that was probably due to upbringing and also all those toddlers I've known whose big goal (often with rewards) was to become dry. The fact is I, like so many others, can control this matter adequately with pads. It is just a case of understanding and getting use to that and adapting. I have been down to light leakage for many months now which would have needed 1 pad a day. However, I have been using Tena washable incontinence under pants as a standard since my op. I think they look smart and nobody would be any the wiser. I have been using them with pads inside when necessary all the way through. I now put a pad on as a matter of course if I'm doing manual work or out with people, etc.

 

[Archives1]

These comments have all been very helpful. I'm 8 months post RP. Confitex underwear and one or two pads during the day and one Pull up at night with now leakage. Play golf frequently and need pads while walking the golf course or working outside. Hoping things get better as I really don't like the vibes I'm getting from these posts regarding AUS surgery. Thanks to all for your posts.

 

[Archives1]

@DouginOz You said that 2 1/2 years post surgery you still experienced light leakage (1 light pad/day)? Given everything you have been through with the sling, do you now think sticking with the light leakage would have been OK? Thanks and good luck with the sling! I hope it gets you dry!

 

[Archives1]

It sounds like you are doing well overall. First congratulations on electing to go for a cure by choosing the most aggressive treatment available as I did. You are doing much better than I was at 15 months. I was unable to get out of full diapers. at 2 years I was referred to a urologist who specializes in AUS and sling surgery. I'm not sure I would pursue further treatment other than non surgical ones at this point. Time and pelvic floor PT may be your best friends at this point. Six more months and reevaluate. Give it a bit more time. I elected to do the AUS and am very happy but I'm essentially where you are now, panty liner type pad with minimal leaking and dry at night. Light years from where I was pre AUS. I would still elect for the RP and AUS if I had to do it all over again but the side effects of RP are challenging.
Boomer59

Thank you, Boomer59. I have no regrets having the prostatectomy. My primary obj was to remove the cancer and so far this has been accomplished! Your advice is sound and I will certainly give it more time and more PT to see if I can get a little dryer!

 

[Archives1]

64 years old and 25 months post RP. Still slight incontinence now and again. I use a shield during the day, just in case. I use a pad for weight training and going out for a few beers. Sometimes needed sometimes not but for peace of mind and to be able to relax and enjoy myself. I don't fancy any more intrusive surgery so I'm willing to put up with this slight inconvenience.

Rallim, Sounds like you're in a pretty good place with this. Still very light leakage and manageable. I think I am getting close to that and, if so, would definitely shelve sling surgery for the time being. Thanks for the response!