Prostate Surgery and Incontinence

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What I learned about incontinence and prostate surgery and how to help overcome it, if not prevent it.

I was incontinent as a result of prostate surgery. I did not expect this at all from the pre-surgery research I did and from discussions with my doctor and his staff.

This is not to say anything went wrong; I am fairly young, in good health, I had a topnotch doctor at a top research hospital. My cancer was caught early and was well confined to the prostate, not even close to the borders. The surgery was with a DaVinci system. Before surgery, everything pointed to minimal problems; all the statistics looked great.

But I still ended-up incontinent. I have regained continence and wanted to share my insights so that others might have a better experience than I had.

Of course, the most important thing is that I am cancer free-the surgery was successful. I am very thankful for that.

Here are the things I learned:

1. While the surgeon and his staff were very competent with the surgical side of things, they were not very helpful regarding incontinence.
a. The pre-surgery instructions to prevent incontinence was “do kegels.”
b. Post-surgery, they had no idea how to deal with incontinence except to tell me to “do more kegels” and it may take “1-2 years” to get better.
i. It turns out this is bad advice.
2. Here is what I learned and how I regained continence:
a. The kegel muscles are very fragile muscles and are easily overworked. In other word doing more or longer kegels may actually make the problem worse.
b. Do not wait until after surgery to address the issue, start before surgery.
c. Ask your doctor for a referral to a Pelvic Floor Physiotherapist. The one I had worked wonders. I regained full continence after 8 sessions!
i. Have a consultation BEFORE surgery, this will help you be better prepared before surgery, as well as ready to start therapy if needed post-surgery.
ii. If you are incontinent post-surgery, seek help soon. The longer you wait, the less likely you will regain continence. My PFPT said that after about 1 year, you probably will not regain it.
iii. In my area, at least, the demand for PFPT’s exceeds the supply; all the more reason not to wait.
iv. Most incontinence patients are women, but PFPT’s treat men as well.
v. Continence is more than just kegel muscles; there are more muscles involved and you need to be properly trained in using them together. Furthermore, the food you eat and the physical activities you do all effect continence.
vi. Training and strengthening the muscles is a slow process at first so that they are not overworked and fail. Be patient, do what the therapist tells you to do.
vii. After you regain continence, expect to do maintenance exercises everyday for the rest of your life. If you slack off (as I have sometimes done) you will start to leak.
1. Additionally, you may find that you leak a bit in some situations-like heavy ab exercises. If so, wear a liner for those times.
viii. My PFPT advised me to urinate sitting down because for a man that more completely empties the bladder and leakage is less likely. I have found this to be true. I do not like it, but I do it-its better than wet pants.

I hope this helps and best of luck.
 
While my situation doesn’t involve prostate cancer, I would suggest supplementing the PT. I’ve been fighting urge incon for a few months now and I must say that the therapist helped but I also went to Massage Envy and did their stretching service. It’s a private session with you and anatheletic trainer and they stretch you in ways that really loosen up the mid section and everything else. That release of lower back tension along with adherence to the PT protocol has had me dry for almost 2 months.

The sessions are about $60 an hour and I did one hour session per week for 4 weeks. Worth every penny.

Edit. I continue to do the stretches that the trainer showed me on my own semi regularly along with the pelvic excersise.
 
prostate surgery [robotic ] was a snap but left me incontinent [urinary ] and my psa was not zero , follow up radiation and a script for Flomax caused me to start overflowing my heavy pad that I wear at night. I discontinued Flomax and things became manageable . I am being treated for prostate cancer that had advanced to lymph nodes in the lower abdominal area, first with proton therapy and one year later with IMRT . I am having success now with Lupron therapy which has dropped my PSA from 25 to 0.32 so far. So my incontinence seems to be a small issue that I,ve learned to live with. Life is good , spring here in western north carolina is wonderful , good to still be alive at 76 . God bless.
 
In my 70s now. I went through a Clinical Trial for Prostate Cancer, my PSA hadn't given advanced notice. My Support Group and Retreats let me know my experience was not typical - but I too got little or no advance warning/instructions about incontinence. They gave me a hardbound book that mentioned it. It was an aggressive cancer, and large. That was 2005, and i did the Klegels with a little improvement, but the incontinence was also relatively minor. My PSA stays zero. I gave up on "mens" pads, went to womens (it take two, but it works for me, better coverage pattern, more comfortable, and you get a choice of absorbancy. "Poise" #2; #3 if going to do hard physical work. Used to use #1 prior to 2017). I get up from 3-6 times a night, since 2005.
Very late last year, a series of symptoms started or got worse, very gradually. Early this year I fell and hit my head hard and had to go to the ER - the Symptoms had jumped by a magnitude or more. One was a loss of all urinary control at late night, had to go with pull-ups. They discovered Brain Cancer, 2 tumors. One tumor was eventually removed, the incontinence has reduced greatly, although not to previous level yet. It's getting there.
Now I'm scheduled for a extensive visit/appointment with a Urologist, so i appreciate GotDry's advise and input. It should be handed out to every Prostate patient BEFORE treatment!
Other surgeries where you give you a catheter seem to exacerbate urinary incontinence - and i have had about four, same experience every time, & you are back doing Klegels. Be prepared for that.
God Bless.
 
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