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Post Operative Incontinence

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User
Posted 06 Mar 2024 at 11:15

I had robot-assisted prostate removal surgery on Wednesday 21st February 2024. I came home on the following day, Thursday 22nd February with a catheter.

The catheter was removed on Monday 4th March. Since then I have had virtually no bladder control (today is Wednesday 6th March).

Daytime

I am wearing incontinence pants as I will spontaneously “spurt” urine without any warning. The quantity does vary from small amounts to longer periods of weeing (3-4 seconds). Once started I cannot stop the flow. And these periods of spurting/leaking can continue for 30-45 minutes.

The problem increases in frequency and volume as the day progresses, as I assume the body takes on more liquid and food during the day.

Sometimes the spurts are triggered by coughs, sneezes, bending down, sitting down or standing up - stress incontinence.

I do stop drinking and eating at around 6:30 in the evening.

I seem to be getting through 6 or so incontinence pants a day.

Night-time

During the night it seems better. I can go to sleep and wake up 4-6 times during the night and can get to the bathroom for a wee. There appears to be very little leakage during the night.

Pelvic Floor Exercises

I have been trying to do these and have the Squeezy app to help. Never quite sure that I am doing them correctly and some leakage does occur as I do them.

Summary

I realise that this is only day three after the catheter removal. Am I experiencing “normal” issues? Is there anything else I should be doing or can be done to help? Am I just too impatient!

User
Posted 06 Mar 2024 at 15:04

Hello Hammurabi

It is very early days, your journey of recovery has just started. The only thing you can and should do is light walking and start doing pelvic floor (Kegel) exercises. After my prostatectomy some years ago, on removal of my catheter I was totally incontinent. My consultant surgeon advised me to do pelvic floor exercises as follows and not waste any money on physiotherapy! It is very easy: Sit on the toilet and the urine will flow freely. Now try to stop the flow - this is intuitive - keeping your pelvic muscles under tension, count to ten and relax those muscles, then count to ten again, and repeat the process ten times. Do these two/three times a day but don't overdo it; there is a temptation to try and speed up the process. Initially you will probably notice no difference; be patient. In my case I began to notice some improvement after three weeks and two months later when I woke up one morning my pad was totally dry. When my progress flattened out at 99.9% (I leak when sexually excited and at orgasm!) my consultant told me that because of my age (I was a little older than you then) I may have to just be satisfied with that and adapt to the new normal which we have. Unfortunately some consultants are not always honest about both incontinence and the possibility of total or partial ED even with nerve sparing procedures. Be patient and you will begin to see improvement soon. Good luck.

 

 

 '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 06 Mar 2024 at 21:21

Hi there

 I had the same experience after an RP in 2020. I was so down hearted by the incontinence I experienced and never thought it would improve. Be assured it will . Be patient and do all the things that can help. I am sure you will have read about that. It is different for all men but improvement will come so do not be too despondent.

Wish you luck and I know you will feel more positive soon.

User
Posted 08 Mar 2024 at 03:12
Well, you sound exactly like I did at that time. Things will improve but it is essential that you do your pelvic floor exercises. Closest I can describe them is to pretend there is a marble on the floor. Try to pick it up with your butt. I had a cystoscopy so I could see the sphincter close when I squeezed. I too had the issue that once the flow started, I could not stop it. Sometimes, 4 months post op, I still have that issue. Be patient, it might be slow, but things will get better. For you it is still very early days.
User
Posted 06 Mar 2024 at 11:15

I had robot-assisted prostate removal surgery on Wednesday 21st February 2024. I came home on the following day, Thursday 22nd February with a catheter.

The catheter was removed on Monday 4th March. Since then I have had virtually no bladder control (today is Wednesday 6th March).

Daytime

I am wearing incontinence pants as I will spontaneously “spurt” urine without any warning. The quantity does vary from small amounts to longer periods of weeing (3-4 seconds). Once started I cannot stop the flow. And these periods of spurting/leaking can continue for 30-45 minutes.

The problem increases in frequency and volume as the day progresses, as I assume the body takes on more liquid and food during the day.

Sometimes the spurts are triggered by coughs, sneezes, bending down, sitting down or standing up - stress incontinence.

I do stop drinking and eating at around 6:30 in the evening.

I seem to be getting through 6 or so incontinence pants a day.

Night-time

During the night it seems better. I can go to sleep and wake up 4-6 times during the night and can get to the bathroom for a wee. There appears to be very little leakage during the night.

Pelvic Floor Exercises

I have been trying to do these and have the Squeezy app to help. Never quite sure that I am doing them correctly and some leakage does occur as I do them.

Summary

I realise that this is only day three after the catheter removal. Am I experiencing “normal” issues? Is there anything else I should be doing or can be done to help? Am I just too impatient!

User
Posted 06 Mar 2024 at 11:42

Hello mate. Welcome to the forum.

I had the same op just over a year ago for the first 2 or  3 weeks I had virtually no bladder control. Ove the next 6 months things improved and I regained full continence.

People recover at different rates, if things don't improve get onto the hospital and explain your difficulties.

User
Posted 06 Mar 2024 at 14:11
Yes, very early days yet - it will improve.

One technique is when standing at the loo - try and stop the flow and identify which muscles you are using to do so - these are what you need to work on with your pelvic floor exercises. You will likely leak for the first week or so doing these.

Don't be disheartened - it just takes time.

User
Posted 07 Mar 2024 at 09:11
Many thanks to all who have responded. Your thoughts have helped me a lot to understand what I am going through and I can see light at the end of a tunnel. Hopefully the tunnel is not too long and it is not a train fast approaching :)
User
Posted 08 Mar 2024 at 07:34
Hi, it is just a case of doing the exercises and being patient for now. My Husband is a bit further along than you, just over 8 weeks post op. He is still fully incontinent but is taking note of what we’ve read and everyone’s help and advice on here! Hopefully things will start to improve soon.
User
Posted 08 Mar 2024 at 15:37

Seems guys' experience of post op  incontinence ranges from total loss of control to a few lucky chaps who are completely dry after catheter removal. 

I'm just over 4 weeks post op. I have been completely dry at night since catheter removal. For me it seems to be a gravity and motion induced issue. Walking I leak a fair bit, getting up, bending down etc. Apart from just 'leaking' small amounts I can stop any other more major 'squirts'. Also does seem to get worse as the day goes on.

Overall I'd say there is a slow improvement but it's not linear - one day I think I've turned a corner next it's worse again.

Got to just believe it will slowly improve - the stats and anecdotal comments on this forum indicate a high chance of recovery. 

 

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User
Posted 06 Mar 2024 at 11:42

Hello mate. Welcome to the forum.

I had the same op just over a year ago for the first 2 or  3 weeks I had virtually no bladder control. Ove the next 6 months things improved and I regained full continence.

People recover at different rates, if things don't improve get onto the hospital and explain your difficulties.

User
Posted 06 Mar 2024 at 14:11
Yes, very early days yet - it will improve.

One technique is when standing at the loo - try and stop the flow and identify which muscles you are using to do so - these are what you need to work on with your pelvic floor exercises. You will likely leak for the first week or so doing these.

Don't be disheartened - it just takes time.

User
Posted 06 Mar 2024 at 14:34

Thank you both. I'll give it a try.

User
Posted 06 Mar 2024 at 15:04

Hello Hammurabi

It is very early days, your journey of recovery has just started. The only thing you can and should do is light walking and start doing pelvic floor (Kegel) exercises. After my prostatectomy some years ago, on removal of my catheter I was totally incontinent. My consultant surgeon advised me to do pelvic floor exercises as follows and not waste any money on physiotherapy! It is very easy: Sit on the toilet and the urine will flow freely. Now try to stop the flow - this is intuitive - keeping your pelvic muscles under tension, count to ten and relax those muscles, then count to ten again, and repeat the process ten times. Do these two/three times a day but don't overdo it; there is a temptation to try and speed up the process. Initially you will probably notice no difference; be patient. In my case I began to notice some improvement after three weeks and two months later when I woke up one morning my pad was totally dry. When my progress flattened out at 99.9% (I leak when sexually excited and at orgasm!) my consultant told me that because of my age (I was a little older than you then) I may have to just be satisfied with that and adapt to the new normal which we have. Unfortunately some consultants are not always honest about both incontinence and the possibility of total or partial ED even with nerve sparing procedures. Be patient and you will begin to see improvement soon. Good luck.

 

 

 '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 06 Mar 2024 at 21:21

Hi there

 I had the same experience after an RP in 2020. I was so down hearted by the incontinence I experienced and never thought it would improve. Be assured it will . Be patient and do all the things that can help. I am sure you will have read about that. It is different for all men but improvement will come so do not be too despondent.

Wish you luck and I know you will feel more positive soon.

User
Posted 07 Mar 2024 at 09:11
Many thanks to all who have responded. Your thoughts have helped me a lot to understand what I am going through and I can see light at the end of a tunnel. Hopefully the tunnel is not too long and it is not a train fast approaching :)
User
Posted 08 Mar 2024 at 03:12
Well, you sound exactly like I did at that time. Things will improve but it is essential that you do your pelvic floor exercises. Closest I can describe them is to pretend there is a marble on the floor. Try to pick it up with your butt. I had a cystoscopy so I could see the sphincter close when I squeezed. I too had the issue that once the flow started, I could not stop it. Sometimes, 4 months post op, I still have that issue. Be patient, it might be slow, but things will get better. For you it is still very early days.
User
Posted 08 Mar 2024 at 07:34
Hi, it is just a case of doing the exercises and being patient for now. My Husband is a bit further along than you, just over 8 weeks post op. He is still fully incontinent but is taking note of what we’ve read and everyone’s help and advice on here! Hopefully things will start to improve soon.
User
Posted 08 Mar 2024 at 15:37

Seems guys' experience of post op  incontinence ranges from total loss of control to a few lucky chaps who are completely dry after catheter removal. 

I'm just over 4 weeks post op. I have been completely dry at night since catheter removal. For me it seems to be a gravity and motion induced issue. Walking I leak a fair bit, getting up, bending down etc. Apart from just 'leaking' small amounts I can stop any other more major 'squirts'. Also does seem to get worse as the day goes on.

Overall I'd say there is a slow improvement but it's not linear - one day I think I've turned a corner next it's worse again.

Got to just believe it will slowly improve - the stats and anecdotal comments on this forum indicate a high chance of recovery. 

 

User
Posted 17 Mar 2024 at 09:13

How is it going now? Any improvement? 

 
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