Post-Prostatectomy Light Incontinence & Wanting to Avoid Surgery!

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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.

Fontoban, Thank you, it does. Sorry to hear you are "shying" away from travel and sports. I get that but I wont allow this to happen to me becuase I am physically active and love to travel (last year Africa and japan while still managing leakage!) Incontinence at my stage is funny. I do weight training, bike, and ski, very minimal leakage (still a light pad no problems). I go for a long walk or have a couple of beers, more leakage ... sometimes significant. It is all manageable but still requires attention and management!

 

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@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

Pammy53 Thank you for the kind and supportive comment. I do consider myself very lucky to have removed the cancer from my body and have reach this point of mild incontinence. It sounds like you have more to deal with and I admire the strength and attitude that you and others with more severe incontinence display on this forum. I wish the best for you! Bart

 

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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.

Thanks for the comment. I did ask my MD about ProAct. She said it is new and she is aware of it. It is not an option for me at this time at the hispital where I receive care. I agree with you that age is certainly a factor but doesnt negate the possibility of getting near or reaching continents. It sounds like you are active and managing with 1-2 pads/day which sounds like you have found a good place at this time.

 

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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.

heslepf, Good advice! That is where I am right now. I have read a lot of good experiences with sling surgery but also read from others that it wasnt as effective as hoped or in a very small number of cases, made it worse. If sling surgery were to fail the next step is AUS which I really want to avoid at this point in my life!

 

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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.

Static, This is a great comment! I do agree that acceptance and appropriate management are key in dealing with light to moderate incontinence. I have learned over the past months that managing with 1-2 light pads with occasional use of penile clamps, mostly when enjoying occasional beers, have made it much more tolerable. I think, and its sounds like you have found, that figuring out the right management techniques can make life much better!

 

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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.

Stick with the kegels and PT! Good luck!

 

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58 and 16 months post RP. Wear 1 light pad per day. I don’t think I’m going to get the sling for that.

 

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58 and 16 months post RP. Wear 1 light pad per day. I don’t think I’m going to get the sling for that.

Sounds like a great place to be! Do you experience any change with increased activities? Hope it continues. Thanks!

 

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@Rallim Quick Question ... I realize you are 25 months post Prostatectomy. How many months after the surgery did it take for you to reach this point of what appears to be almost continent? Did you do a lot of PT/Kegels? At 15 months, I am debating whether I should wait to 18 or 24 months to see if things dry up any more. What do you think? Thanks!

 

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I certainly wouldn't consider surgery if I was consistently down to one or two light pads. The problem is when the leakage is a little more than that or when doing really heavy work. I guess that those who opt for AUS are leaking quite heavily and getting down to a light pad is a big improvement. I just wonder if those who have lighter leaking to start with are in a better position to become dry after surgery compared to those whose starting point is worse.

 

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@bcarr As I said, it came down to 2 choices. I am very active walking my dog and working in my vegetable garden every day and I could feel the involuntary little squirts and found it really annoying. And the Urologist advised the sling surgery is very effective dealing with light to moderate leakage and as an age pensioner I was able to have it done through our public hospital system with my same Urologist at no cost to me. So when I was unable to get rid of the leakage with pelvic exercises I decided to give the sling surgery a try. It was more a mental thing with me and only time will tell if I made the right call. I'm not keen on any further surgery so if the sling doesn't enable me to do away with pads entirely I will just have to deal with that and manage it.

 

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Hey fellas Im 3 months post rp and my leakage is pretty significant. If Im active and work around the house or active, I can go through a pad every hour or 2 and some cqn be soaked , and others better. its rough. Im 54 and struggling with this. Was anyone here this bad first few months and saw improvement by six months? thanks

 

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Hang in there. Sounds like you are ahead of where I was at your timeline. I’m 58 and 18 months post RP. Currently wear one light pad per day. 3 months out I was soaking 6-8 pads per day and wore and external catheter for a little while after retraining to work. Do your kegels and walk as much as possible. Also have patience. And check out some earlier posts for ideas and to help you realize you are not alone.

 

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Thanks Jim, I appreciate the comforting words and input. This has been a wild ride. my two moth psa post rp was undetectable and Im going friday for my 90 day psa test and fingers crossed. I had high risk high grade, so rp was what i chose..I dont have regrets because i wanted it out but ill admit the ed and incintinence is a rough consolation prize at 54. God is in control and hoping for best , I hope you find some solutions also man. Thanks again.

 

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I agree. I will say a prayer for your recovery. I also have ED problems now. Tried a pump with some improvement but realize it will probably be a permanent problem.

 

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Thanks man ditto on the prayer. tbh im more hyperfocused on psa for now , and battling the incontinence. unless there are hicups like more treatments or other issues, I will get a implant pump and just go bionic after a year, Im hopeful but not willing to battle with ed also for yrs in addition to all this other noise. This is chamlenging enough as it is. Cheers

 

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Thanks man ditto on the prayer. tbh im more hyperfocused on psa for now , and battling the incontinence. unless there are hicups like more treatments or other issues, I will get a implant pump and just go bionic after a year, Im hopeful but not willing to battle with ed also for yrs in addition to all this other noise. This is chamlenging enough as it is. Cheers

@Nelson1oliva I have read your posts here and in the string you initiated. What you are experiencing is what most of us are going through or went through. It can be a long journey requiring patience and focus on physical therapy and other life behaviours (alchohol intake) that can influence incontinence. PT is really important at this point in your recovery so stay with in no matter how uncomfortable. If you dont like the digital rectal exam ask your therapist for biofeedback which is not as invasive. You will see very gradual, incremental improvement over months but you will see it! I am at 15 months post surgery (no follow up radiation) and am down to a pad a day and dry at night. I continue to work to get 100% dry. Good luck, stay patient and stick with the kegels!

 

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@bcarr thank you for all the feedback it is deeply appreciated andcwell received. Cheers

 

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Nelson1oliva. We have to be honest and say there are no guarantees of the outcome. Some recover from incontinence pretty well and a small percentage remain totally incontinent and will probably look for surgery. Many are in the in between situation as you will have gathered from the many posts. On a personal note after three months I was still struggling a lot. I had COVID for the next month and all the heavy coughing didn't help. Then I started to improve considerably and by 6 months things were much better. However, at 2 years post op in March I still leak. Dry at night and for a while in the morning if not overly strenuous. Sometimes I can be quite active and just use a couple of light pads. Other days, and for no reason I can determine the leakage can be worse. At the moment I have a very heavy cold and am coughing a lot. Consequence, a lot more leakage. I think for many in this in-between situation the difficulty is deciding if this is very manageable with pads as my surgeon put or do I want to consider a surgical option.
N
At 54 of course the ED is a big challenge. I found that at 67/68. I unashamedly use a vacuum pump and constriction ring and I encourage you to keep developing intimacy even if is inevitably different than previously. It can still be enjoyable and fulfilling. There is a website called Recovering Man which has some personal stories of recovery in regards to the intimate side of life. You still have time to see improvement over the next few months and up to a couple of years. There is no short cut, just patience and persistence.

 

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I agree. I will say a prayer for your recovery. I also have ED problems now. Tried a pump with some improvement but realize it will probably be a permanent problem.

Talk to your urologist about Bimix. 58 is to young to give up. It worked for me and luckily I am all good now.
Hang in there.