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Incontinence problems post op

User
Posted 10 Dec 2018 at 17:28
Hi All,

Another suggestion. In addition to the standard Pelvic floor exercises, I have taken up Pilates. As well as good exercises for the right areas, it is improving my feel for which muscles control what.

I had my prostate removed in June. I have done reasonably well for incontinence. Most days are now dry, but need to stay aware and I do wear a pad. Over night I seem to leak 2-3 ml.

Just keep going!

Alan

User
Posted 10 Dec 2018 at 18:11

[quote]Andy63;206331

I have invested ££ in a pelvic floor tens machine(like bicycle shorts) from a company called Innovo, 30 minute session, daily, this is working well and seem to be improving said muscle group, just a thought for anyone struggling?

 

[/quote]

My husband bought one of these   as he wasn't sure that  he was doing the pelvic floor exercises correctly even after enlisting the help of a private physiotherapist recommended by his consultant. He feels it is helping and has noticed a slight difference. Worth trying I think but can't work miracles for everyone.

Healing time  and the usual pelvic floor exercises seems to be the answer for most men but there will always be some men who never get to 100% continent. My husband is about 90- 95 % 12 months on from his RARP although mainly on heavy exertion at work.

 

Best Regards

 

User
Posted 10 Dec 2018 at 18:40
Pelvic floor exercises (or Kiegels) will help men who are left with stress incontinence after RP, as will TENS machines in some cases.

PFEs and TENS will do nothing to help a man whose urethra, sphincter or pelvic floor is permanently damaged during the RP.

It is important not to imply or get the impression that men left with permanent incontinence (or even temporary incontinence but slow progress) have somehow just not tried hard enough or didn't put the work in.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 26 Dec 2018 at 22:16

Think I've been really fortunate had op on 10th of November,completely dry at night,and just a little dribble in the day,but only if i cough,my recovery up too now as exceeded my expectations

User
Posted 27 Dec 2018 at 06:41
And another point to remember, regardless of the skill of the surgeon, is the extent of the cancer, as to how much has to be removed and what can safely be left behind to help with post-operative continence and future erectlie function.

I suppose most men become more or less continent eventually. Or do they not?

Cheers, John.

User
Posted 27 Dec 2018 at 11:53
90% of men that have had RP become continent within 1 year of the op. However, the NHS stats include 'using 1 pad per day or less' as continent, which men who need to use one pad a day will tell you doesn't feel like being continent. There is no statistic for how many men are still using pad(s) at 12 month point but our uro says it could be as high as 30%
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 Dec 2018 at 12:51

I would agree with that as my husband is about 90 - 95% there after 12 months. I think they do play down the likelihood of not being 100% to make their statistics look better.

When my husband told the Urologist he wears one pad during the day and a smaller one at night ( often dry but for security ) he ignored this and just mentioned the use of one pad on the letter to the GP. He has probably been put into the NHS stats as continent.

Edited by member 27 Dec 2018 at 12:55  | Reason: Not specified

User
Posted 27 Dec 2018 at 16:32

Hi all, I am over 2 years post OP, i wear one of the lightest pads during the day for security mainly drips and dribbles after going to the loo, any men that are 100% continent are very lucky, I think age plays a big part as all the muscles get weaker with age anyway, I am 68 PSA undetectable so happy with that

best wishes

User
Posted 27 Dec 2018 at 17:47

Hi Paul .  I would be interested to know if you found any improvement in your continence between the 12 - 24 month stage. If so how much. We are not expecting any now but would be great if there was.

 

Best wishes

Ann

User
Posted 27 Dec 2018 at 19:32

The first 4 months were the worst it was awfull then there was a gradual improvement every week, after a walk I could hold urine until I got to the loo, I was told if you can stop the flow then continence should improve, I am now over 2 years since my OP, I am dry at night and use the smallest pad during the day for security, just small drips and dribbles after I have been to the loo, I am 68 so who knows if it would be like it anyway, I use the prostate aerobics app which you can download free for Android phones but there are other apps, hope this helps, just remember it takes time and everybody is different,

best wishes

Paul

User
Posted 27 Dec 2018 at 19:49

Thanks for that Paul. Most of what we have read suggests there is no improvement after 12 months however Patrick Walsh the American urologist who first identified the neurovascular bundles and developed the first nerve sparing prostatectomies reckons recovery can continue up until about 2 years albeit  very slightly for the 2nd year following surgery.

Best regards

Ann

 

 

User
Posted 29 Dec 2018 at 16:03

[quote=OptimisticJohn;206260]

I had my prostate out January 2016 (robot). I leaked terribly for 8 weeks then quite suddenly I got most of my continence back. 3 years out I don't have any continence problems day to day with the following exceptions:
1. Hill walking. Have to use a pad. By late afternoon I've lost control. I guess my pelvic floor just gets tired.
2. Running. Solution is to run before breakfast while my bladder is empty.
3. In the gym. There are some exercises that make me leak if I do them too vigorously. TBH I find it embarrassing wearing a pad in the gym so I just avoid those exercises.

I've recently been trying to improve my pelvic floor using the NHS Squeezy app.

[/quote]

User
Posted 30 Dec 2018 at 12:00

Hello John. I was really interested in your comments.I'm 6 months after RP.

If you asked me now my two main problems would be hill walking and jogging.

The hill walking took me completely by surprise and I hoped it might improve after laying off it for this December. I'm interested to see that you have continued to leak while out walking.

Jogging also has it's issues but can  walk fairly consistently (on treadmill not hill walking) at about 5.5kph without leaking. That's why I was very surprised at the hill walking causing so much leakage.

I've also been trying to work out which exercises: crunches, planks etc I can do which are not working against the pelvic floor exercises. 

I find I can cycle for a long time without leaking at all so I've moved more on to that these days. 

I'll look at your app as I've become a bit forgetful of pelvic floor. 

Thanks Hugh

Edited by member 30 Dec 2018 at 12:45  | Reason: Some comments a little unclear

 
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