RP with Nerve Sparing - Recovery

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Radical Prostatectomy with nerve sparing 6 weeks ago and catheter removed 4 weeks ago. Religiously doing my Kegel exercises. Dry at night and minimal leakage in the mornings. Probably get through 2 lightweight pads in the afternoon if I’m doing stuff. Actively engaging my pelvic floor but occasional “spurts” which sneak up on me, if you know what I mean. Progress is slow.

 

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That sounds like you’re doing remarkably well! Progress is typically MUCH slower for the guys in this group. I'm a little surprised they’re having you do kegels already. But…hard to argue with success. Keep up the good work! Don’t expect 100% continence for a while…likely months.

 

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Consider yourself fortunate. I'm more than 8 weeks post surgery and still 100% incontinent. Yesterday I used 11 diapers, including 3 night time. 3 or 4 ended up leaking. I'm back at work 2 1/2 weeks already, and having to deal with this there.

 

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Chuck… I had my prostatectomy Nov 21 2023 and they had me start levels as soon as the catheter removed.
Dewibach1…..I still leak and use 2 or 3 pads per day. It’s the ones that sneak up on you that bug me the most . Plus if I sneeze….leak!
I can’t wait for it to stop… hopefully. But I will say the leaks are less lately!

 

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I'm 70 and about 19 months out of surgery and I’m using atleast 1 pad a day
No matter how many kegels I did never seemed to help
Just learning to cope with it

 

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I am 63 years old. Surgery 4 weeks ago. Catheter out 4 weeks ago.
I go through 8 pads a day, 2 diapers' at night. Very disturbing.
I have started Kegels, walk 4 miles a day and doing lots of stretching. My issue is I can stop mid-stream, can control stress leakage fairly well. But in a relaxed state, I just constantly drip. Any one with a similar experience? I have been told it just takes time. My main issues are not stress, nor inability to hold a full bladder, just constant dribble even after going pee. If I "Kegel" 24 hours a day, no problem.

 

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Bomholtb

I am 63 years old. Surgery 4 weeks ago. Catheter out 4 weeks ago.
I go through 8 pads a day, 2 diapers' at night. Very disturbing.
I have started Kegels, walk 4 miles a day and doing lots of stretching. My issue is I can stop mid-stream, can control stress leakage fairly well. But in a relaxed state, I just constantly drip. Any one with a similar experience? I have been told it just takes time. My main issues are not stress, nor inability to hold a full bladder, just constant dribble even after going pee. If I "Kegel" 24 hours a day, no problem.

I'm 4 weeks beyond you and same situation. I can hold it long enough when getting out of a chair or bed to make it to a close bathroom. Otherwise it's a gush and a constant dribble. I used 11? Diapers yesterday.

 

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What is Dr telling you? Just takes more time?

 

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What is Dr telling you? Just takes more time?

Yep! Just takes more time... I have my first appointment with pelvic floor specialist in 2 weeks. The Kegels let me hold it for a short time, but only activates the external sphincter. The internal sphincter seems completely useless right now.

 

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I’m 49. Had surgery 3 weeks ago and catheter out 2 weeks ago. Incontinence is not an issue at night just pretty bad during the day with maybe slight improvement. I started doing kegels about 6 weeks before the surgery and restarted once the catheter was removed. I was hoping between doing kegels before the surgery , my age, excellent health and not being overweight my progress would be much better than what it is at this point.

 

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Ricin… does prostatectomy not remove the internal sphincter ???

 

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Yes the internal sphincter is removed

 

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Ricin… does prostatectomy not remove the internal sphincter ???

I googled it, and it appears that you are correct. I've had very poor explanations from doctors. So, I guess I need to do a constant kegel to hold the external sphincter closed. I've only been told to do exercises, which I do.
I've learned much more on this website than from my medical professionals. I thought that the bladder sphincter function would return.

 

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The external sphincter should hopefully compensate for the loss of the internal sphincter. The kegels are definitely important but doing too many can cause muscle fatigue so it’s definitely a balance between strengthening the sphincter and making sure not to overdo it

 

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So, eventually that external sphincter should stay closed with out me doing Kegels? Or do I have to train my body to do a constant kegel? Sheesh, I've even said to the urologist that I have no bladder sensation or control and all they said is that it takes time, not explaining that I don't have that control anymore.

 

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So the kegels strengthen the pelvic floor muscles in general that support the bladder. The sphincter and the pelvic floor muscles work together to minimize incontinence when strong enough. Also the nerves that give sensation do tend to regenerate

 

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This site has provided all the questions that I needed to ask my Dr. He provided very little information until I asked him “what about ___”? My PT also emphasized you are reworking your brain as much as your pelvic muscles. Schedule your pelvic pt asap.

 

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Is anyone else suffering or suffered from perineal discomfort post radical prostatectomy ?

 

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Not to disappoint, but many of us veteran NAFC members are either still using pads or have sought interventions of AUS or Sling. And the interventions can have their own issues with need for reinstallation, erosion of cuff, removal, etc. I’m investigating PROACT procedure - google it. Less invasive, easily adjusted/removed, quicker recovery and Medicare covered.

I believe the younger you are the more likely healing will happen. There actually are members who have achieved dryness. Some have urologists who advised Kegels before surgery to prepare for the inevitable flood.

I have experienced 4 different urologists. The first kind of left me floating after the RP. Lots of $ in RP. I had my RP 6 years ago at 70 years,and now need 2-3/day. The more active I am - 3/wk/2hrs weights & power vinyasa yoga and on off days xeriscape - the more pads needed.

Stay as active as possible over time as you heal the leakage will improve as the body gets used to the traumatic event. WALK as much as possible. Can’t say that Kegels helped much since our internal sphincter has been eliminated. I think they work better for women whose birthing process weakened their pelvic floor. But RP is a different lead up to incontinence.

 

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Thanks for the encouragement
BTY what brand of pads are everyone using
I buy Tena brand maximum guards
Not as big and bulky as Depends Max but thicker than a Thin Depends Shields
Works well for me and inexpensive as I’m still working and on my feet 8hrs a day