Questions on Continence after RP

User

Posted 15 Jan 2024 at 20:19

Dear All,

as I am really at the beginning of my journey after RP, I have few questions about continence after surgery, and would really appreciate feedback from who has gone through.

I had the surgery exactly one month ago, and since the beginning I was practically 100% continent but obviously not in the same way I was before it. I explain what I mean:

I need especially when I walk and I stand much more concentration and control to “keep it”. I am successful in it about 99.99% of the time with very occasional minimal leaking, but still I have this feeling that I need to hold it and hold it otherwise…is demanding!

This feeling is not continuous , sometimes is better sometimes is worse, and in general it gets better as soon as I seat or stay in bed. But even with what I would define as minimal amount in my bladder, I have this feeling of pressure.

Last but not least I go to sleep and wake up every morning dry, with no need to go to the bathroom

The surgeon said I have a very strong pelvic floor and I am doing some exercise, but the problem seems not to be my ability to control and hold but rather the pressure to hold it, much bigger than it used to be.

My question to you guys: is this normal? And it will stay like this or it will get better based on your experience?

Thank you!

User

Posted 15 Jan 2024 at 21:46

You sound as if you are doing OK, especially after just a month.
Try stopping and starting the stream when you stand at the loo - I found that helps to identify the muscles needed.
Likewise I am dry at night 99% of the time unless I have a restless night and then I need to remember to pee in my urinal bottle before trying to get back to sleep.
I can still dribble (10 months post RP) if I cough or strain to lift - but I have fixed the sneezing - just need to remember to tense the correct muscle.
Pelvic floor exercises will always help - I have a referral for a perineal physio session but having problem finding someone who can do it (France) as my urologist thinks I could be doing a bit better with it all even though I am quite happy with my progress.

So yes, it all sounds normal and it's a process that takes a bit of time to relearn the process.

Edited by member 16 Jan 2024 at 14:36 | Reason: Not specified

User

Posted 15 Jan 2024 at 22:12

Hi Federico

As I said in one of your early conversations. I think your continence recovery is truly remarkable. I had RARP almost a year ago and it took me 9 months to be at the stage you now are. I still feel a more urgent need to pee and need to get to a loo much quicker than I did pre op.

You're doing brilliantly mate.

Adrian

Edited by member 16 Jan 2024 at 05:22 | Reason: Typo

User

Posted 15 Jan 2024 at 22:43

I was told not to frequently "stop and start" urinating mid stream as it can have an adverse effect on the bladder. The occasional "stop start" is apparently okay to check the mechanical function of the pelvic muscles.Google the following " stop start urinating midstream".

Thanks Chris

User

Posted 16 Jan 2024 at 09:52

Hi Fed69

You are doing remarkably well and considering your age I would bet that you will recover fully - all you need is keep doing pelvic floor exercises.

'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.' Richard Feynman (1918-1988) Nobel Prize laureate

User

Posted 16 Jan 2024 at 10:31

Hi Fed.

I am 15 months post surgery & like you I was 99% continent on removal of the catheter, I remember having to concentrate when going From sitting to standing, sneezing etc in the first few weeks, I think your brain adjusts & does it automatically as time goes on.

I also remember getting the feeling of wanting to go to the loo frequently but if I was out & about I just had to hold it back & didn’t have a problem in doing so, eventually the urge would go & I didn’t have a problem in holding it for a good hour or so.

PS I think you are doing great.

best wishes Jeff.

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User

Posted 15 Jan 2024 at 21:46

So yes, it all sounds normal and it's a process that takes a bit of time to relearn the process.

Edited by member 16 Jan 2024 at 14:36 | Reason: Not specified

User

Posted 15 Jan 2024 at 21:52

Thanks to share your experience!

Sneezing and coughing is manageable to me, it is more this continous feeling of pressure when I stand that forces me to concentrate to hold... I make it but it is demanding!

Thanks again!

User

Posted 15 Jan 2024 at 21:54

I think just give it some more time - the RP is serious abdominal surgery and it will take a few weeks to all heal and settle down. Obviously if it hasn't improved after a couple more weeks then maybe a chat with your urologist.

User

Posted 15 Jan 2024 at 22:12

Hi Federico

You're doing brilliantly mate.

Adrian

Edited by member 16 Jan 2024 at 05:22 | Reason: Typo

User

Posted 15 Jan 2024 at 22:43

Thanks Chris

User

Posted 16 Jan 2024 at 09:17

Thanks Chris

I'll check again with my urologist when I see her however I believe (and stand to be corrected) that that advice is aimed at women post pregnancy and being performed from a sitting position on the loo.

I don't think it applies to men standing up to urinate where bladder emptying is assisted by gravity. But I will check just to make sure I'm not giving out bad advice :)

User

Posted 16 Jan 2024 at 09:52

Hi Fed69

You are doing remarkably well and considering your age I would bet that you will recover fully - all you need is keep doing pelvic floor exercises.

'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.' Richard Feynman (1918-1988) Nobel Prize laureate

User

Posted 16 Jan 2024 at 10:31

Hi Fed.

PS I think you are doing great.

best wishes Jeff.

User

Posted 16 Jan 2024 at 14:41

Just a point of clarification (Chris and I have been chatting but now his inbox is full hahaha) regarding stopping and starting peeing - my OP was badly worded (now corrected) and the advice given to me was to stop/start the pee so IDENTIFY the muscles used. When you get the feeling of which ones do the job then you can concentrate on these training these during your kegal exercises.

Just wanted to make sure we were giving the correct advice :)

User

Posted 17 Feb 2024 at 15:55

Sounds like you have/had a similar experience that I am having although I wouldn't describe myself as anywhere near 100%, but I'm only 4 days after catheter removal. I am completely dry at night and can get out of bed and empty my bladder as normal. I'm dry sitting down. But going on a walk I am leaking quire a lot and generally when standing up and moving around I'm leaking or have to try hard to hold it in. Seems like a gravity and movement thing.

How are you getting on now?

Cherrs

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