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life immediately after catheter removal

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User
Posted 12 Aug 2018 at 07:53

Hi Im waiting to have a prostatectomy poss mid September.  having never had a catheter before in the first 2 weeks after coming home im sure that will present challenges.  But its after the removal im interested in.  Particularly do you know you are about to wee but cant stop it or does it just happen and you only know when you've wet yourself ?. 

User
Posted 12 Aug 2018 at 12:30
Hi, I am 6 weeks post catheter removal. For the first few days, it was about figuring out what was going on. Right from the start, but certainly after the first day or so, I could tell what was happening. It is a bit like having a tap with a faulty rubber washer. Works ok as long as there isn't too much pressure and it is tightened hard. Unfortunately, my ability to keep tighten hard goes down as each day progresses. Oh and my bladder capacity seems to have reduced considerably. Overnight, I get up to go to the loo 4 or 5 times and I leak 8-12 ml into a pad. I wear Tena Men Premium Fit L4 so there is no chance of problems in bed. i have pretty good control for the first 2-3 hours of the day - very little leakage. I also have reasonable control when I am sitting - ie the external sphincter is well supported. However, walking about and even standing causes a continuous dribble. Yes, you can feel it, but there is little you can do to stop it happening other than empty your bladder or sit down. my average loss is about 200 ml per day. This varies considerable depending on how active I am. Looking at the statistics, I expect significant improvement and hopefully full continence but only after a period of 4-12 months. Apparently every case is different.
General guidance is start your Pelvic Floor Exercises now and keep going with them - for ever. My suggestion is to go over the top and buy best pads and pants to cover you for the first week while you find out the characteristics of your incontinence. Make sure you take some to the catheter out appointment (which wasn't as bad as my imagination).
Good luck!
User
Posted 12 Aug 2018 at 13:27
I was really afraid of incontinence after RP. I could not bare the thought of wetting myself and being completely wet. As it turned out for the first few hours after catherter removal as soon as there was anything in my bladder it would just dribble out but not a lot of volume. So I was using tenner 3s for the first two days or so. I was completely dry at night straight away, even the first night. Then tenner 2s were enough, just one per day with leaks only when my bladder was fairly full, not the whole lot but just little squirts and dribbles when active. After about two more weeks a tenner one was sufficient and after six to seven weeks no more pads at all. My RP was 18 months ago and now I just have manageable urge and freaquency issues.

I also feared the catherter removal which was after one week. I was thinking it might get stuck coming through the knew joint. When the nurse arrived I insisted on doing it myself with her supervision, thinking if I felt pain or resistance I would be in control and be able to stop or pull more gently. She agreed. I lay on the bed, she deflated the baloon and I gently pulled it out. I literally felt absalutely nothing until a slight sensation for the last 2cm or so. An absolute breeze.

Good luck

Cheers
Bill
User
Posted 12 Aug 2018 at 14:54

Pelvic Floor Exercise a must, I was a little lax with mine to my utter embarrassment , drinking with friends & I literally wet myself without my knowledge. Now I do  Pelvic Floor Exercise every morning before brushing teeth, get into a routine you will feel better for it.


regards


James

User
Posted 12 Aug 2018 at 15:34

This phone app might be of help regarding Kegel exercises, fortunately I didn’t need to do any and had a brilliant surgeon who uses a supra-pubic catheter. Technically more complex, but the way to go!


https://www.tena.co.uk/lightsbytena/tips-and-training/pelvic-floor-fitness-app

Edited by member 12 Aug 2018 at 15:36  | Reason: Not specified

User
Posted 12 Aug 2018 at 18:53

Timbo


I was almost dry 4 days after catheter removal ,was that due to four months pelvic exercises pre op or the skill of the surgeon ? I did my PFEs when driving sometimes perhaps 10 times a day ? Another phone app for Android is prostate aerobics.


I will give you my experience we are all different. On the day of the trial without catheter (TWOC) I had the catheter removed and then had to drink half a litre of water steadily over a each 30 minute period until I had urinated 3 samples at approximately 150 ml esch. Quite surprisingly I got the urge to go in plenty of time and didn't leak, the first passings of urine were uncomfortable, I did my three samples in about an hour and a half. Just after getting into the car on the way home I did leak into a pad .A towel on the car seat is good insurance. Once at home I would go when I got the urge gradually trying to hold on a bit longer. Getting up slowly seemed to reduce the amount I leaked, bending forward before standing made the leaking worse.It took a while to have the confidence not to wear a pad, good job as there were the odd accidents.


Unfortunately I have had to do twocs on numerous occasions, so some tips, do not cut down on water intake, drink slow and steady on the day of your TWOC and follow the instructions of your medical team. Stay relaxed and don't try to rush things.


No PFEs while the catheter is in. To check you are doing the PFEs correctly try to stop the urine mid stream, you should only do this on the odd occasion not every time.


Hope all goes well and look forward to hearing your progress.


Thanks Chris


 

User
Posted 20 Sep 2018 at 13:47
Hi Timbo

I had my RARP 9 days ago and my Catheter was removed 2 days ago after 7 days. Like you I was nervous about the whole Catheter thing. I found I managed better than I thought at home but it was such a relief to have it removed. It took less than 5 seconds to have it taken out and I stayed in hospital for 3 hours while the nurses ensured I was able to go normally and produced enough in volume. I went half a dozen times and was told they were happy to let me go home.

Regarding your question I find it just happens and you sometimes do not know but luckily for me so far when it does it is a small amount and with the Pads I do not feel as if I am getting wet

I am 57 and have been doing the pelvic floor exercises twice a day for a couple of months before my OP. So far I am finding quite minimal leakage which is contained by the Pads and my control is much better than I had anticipated. At night I am going to the toilet more than the day time which is hindering sleep a bit but no leakages at night. I think when I am leaking a bit is when I cough or move from the chair but it is quite minimal. My wife got me a few packs of Tena Men Premium Fit protective level 4 which you can get on line or places like Tesco and they are very good. They fit like normal underpants .You can get them in different absorbent strengths and again what might suit me may not some one else but I feel confident and comfortable wearing them.

All the best with your OP and let us know how you get on. I must say like many I was nervous before hand but so far I feel things have gone very well and I coped better than I thought I would

Best Wishes

Paul

User
Posted 20 Sep 2018 at 14:09

This is really encouraging thanks paul. Ive been doing my pf exercise for a couple of months and lokks like my op wont be until end oct now so more time to do them. Take care tim 

User
Posted 20 Sep 2018 at 22:24
No problem Tim, Yes carry on doing the pelvic floor exercises and all the best with the Op. If you have any questions do not hesitate to ask.

Best Wishes

Paul
User
Posted 20 Sep 2018 at 22:41
Important to understand that not all incontinence is to do with the pelvic floor - sometimes there is a bit of a feeling that if you are incontinent you mustn't have tried hard enough.

our surgeon described the aftermath of RP as: the urethra is cut, the valve / sphincter controlling flow out of the bladder is removed and then the two ends of the tube are stitched back together. When the catheter is first removed, that join might be as leaky as a sieve until the join heals. If the valve has been removed, your brain has to re-learn bladder control just like it did when you were a toddler - more likely to have an accident when you are not concentrating or as you get more tired during the day. So incontinence immediately after the op is nothing to do with pelvic floor exercises. If you have or develop stress incontinence - leaking on exertion or coughing etc - that is what the pelvic floor exercises can improve.

Medium term or permanent incontinence is usually down to either permanent damage to the sphincter or urethra. All the pelvic floor exercises in the world can't solve that.

But it is absolutely right to get into good habits before your op - all adults should do regular PFEs throughout their life.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Posted 12 Aug 2018 at 12:30
Hi, I am 6 weeks post catheter removal. For the first few days, it was about figuring out what was going on. Right from the start, but certainly after the first day or so, I could tell what was happening. It is a bit like having a tap with a faulty rubber washer. Works ok as long as there isn't too much pressure and it is tightened hard. Unfortunately, my ability to keep tighten hard goes down as each day progresses. Oh and my bladder capacity seems to have reduced considerably. Overnight, I get up to go to the loo 4 or 5 times and I leak 8-12 ml into a pad. I wear Tena Men Premium Fit L4 so there is no chance of problems in bed. i have pretty good control for the first 2-3 hours of the day - very little leakage. I also have reasonable control when I am sitting - ie the external sphincter is well supported. However, walking about and even standing causes a continuous dribble. Yes, you can feel it, but there is little you can do to stop it happening other than empty your bladder or sit down. my average loss is about 200 ml per day. This varies considerable depending on how active I am. Looking at the statistics, I expect significant improvement and hopefully full continence but only after a period of 4-12 months. Apparently every case is different.
General guidance is start your Pelvic Floor Exercises now and keep going with them - for ever. My suggestion is to go over the top and buy best pads and pants to cover you for the first week while you find out the characteristics of your incontinence. Make sure you take some to the catheter out appointment (which wasn't as bad as my imagination).
Good luck!
User
Posted 12 Aug 2018 at 13:27
I was really afraid of incontinence after RP. I could not bare the thought of wetting myself and being completely wet. As it turned out for the first few hours after catherter removal as soon as there was anything in my bladder it would just dribble out but not a lot of volume. So I was using tenner 3s for the first two days or so. I was completely dry at night straight away, even the first night. Then tenner 2s were enough, just one per day with leaks only when my bladder was fairly full, not the whole lot but just little squirts and dribbles when active. After about two more weeks a tenner one was sufficient and after six to seven weeks no more pads at all. My RP was 18 months ago and now I just have manageable urge and freaquency issues.

I also feared the catherter removal which was after one week. I was thinking it might get stuck coming through the knew joint. When the nurse arrived I insisted on doing it myself with her supervision, thinking if I felt pain or resistance I would be in control and be able to stop or pull more gently. She agreed. I lay on the bed, she deflated the baloon and I gently pulled it out. I literally felt absalutely nothing until a slight sensation for the last 2cm or so. An absolute breeze.

Good luck

Cheers
Bill
User
Posted 12 Aug 2018 at 14:54

Pelvic Floor Exercise a must, I was a little lax with mine to my utter embarrassment , drinking with friends & I literally wet myself without my knowledge. Now I do  Pelvic Floor Exercise every morning before brushing teeth, get into a routine you will feel better for it.


regards


James

User
Posted 12 Aug 2018 at 15:04
Yes I should have said, I did the pelvic floor excercises as soon as knew I was having the RARP. I did a lot and still do three sets per day. I'm not sure if I still need to, just afraid to stop. They're good for you anyway and some say can help with ED.

Cheers
Bill
User
Posted 12 Aug 2018 at 15:34

This phone app might be of help regarding Kegel exercises, fortunately I didn’t need to do any and had a brilliant surgeon who uses a supra-pubic catheter. Technically more complex, but the way to go!


https://www.tena.co.uk/lightsbytena/tips-and-training/pelvic-floor-fitness-app

Edited by member 12 Aug 2018 at 15:36  | Reason: Not specified

User
Posted 12 Aug 2018 at 18:53

Timbo


I was almost dry 4 days after catheter removal ,was that due to four months pelvic exercises pre op or the skill of the surgeon ? I did my PFEs when driving sometimes perhaps 10 times a day ? Another phone app for Android is prostate aerobics.


I will give you my experience we are all different. On the day of the trial without catheter (TWOC) I had the catheter removed and then had to drink half a litre of water steadily over a each 30 minute period until I had urinated 3 samples at approximately 150 ml esch. Quite surprisingly I got the urge to go in plenty of time and didn't leak, the first passings of urine were uncomfortable, I did my three samples in about an hour and a half. Just after getting into the car on the way home I did leak into a pad .A towel on the car seat is good insurance. Once at home I would go when I got the urge gradually trying to hold on a bit longer. Getting up slowly seemed to reduce the amount I leaked, bending forward before standing made the leaking worse.It took a while to have the confidence not to wear a pad, good job as there were the odd accidents.


Unfortunately I have had to do twocs on numerous occasions, so some tips, do not cut down on water intake, drink slow and steady on the day of your TWOC and follow the instructions of your medical team. Stay relaxed and don't try to rush things.


No PFEs while the catheter is in. To check you are doing the PFEs correctly try to stop the urine mid stream, you should only do this on the odd occasion not every time.


Hope all goes well and look forward to hearing your progress.


Thanks Chris


 

User
Posted 20 Sep 2018 at 13:47
Hi Timbo

I had my RARP 9 days ago and my Catheter was removed 2 days ago after 7 days. Like you I was nervous about the whole Catheter thing. I found I managed better than I thought at home but it was such a relief to have it removed. It took less than 5 seconds to have it taken out and I stayed in hospital for 3 hours while the nurses ensured I was able to go normally and produced enough in volume. I went half a dozen times and was told they were happy to let me go home.

Regarding your question I find it just happens and you sometimes do not know but luckily for me so far when it does it is a small amount and with the Pads I do not feel as if I am getting wet

I am 57 and have been doing the pelvic floor exercises twice a day for a couple of months before my OP. So far I am finding quite minimal leakage which is contained by the Pads and my control is much better than I had anticipated. At night I am going to the toilet more than the day time which is hindering sleep a bit but no leakages at night. I think when I am leaking a bit is when I cough or move from the chair but it is quite minimal. My wife got me a few packs of Tena Men Premium Fit protective level 4 which you can get on line or places like Tesco and they are very good. They fit like normal underpants .You can get them in different absorbent strengths and again what might suit me may not some one else but I feel confident and comfortable wearing them.

All the best with your OP and let us know how you get on. I must say like many I was nervous before hand but so far I feel things have gone very well and I coped better than I thought I would

Best Wishes

Paul

User
Posted 20 Sep 2018 at 14:09

This is really encouraging thanks paul. Ive been doing my pf exercise for a couple of months and lokks like my op wont be until end oct now so more time to do them. Take care tim 

User
Posted 20 Sep 2018 at 22:24
No problem Tim, Yes carry on doing the pelvic floor exercises and all the best with the Op. If you have any questions do not hesitate to ask.

Best Wishes

Paul
User
Posted 20 Sep 2018 at 22:41
Important to understand that not all incontinence is to do with the pelvic floor - sometimes there is a bit of a feeling that if you are incontinent you mustn't have tried hard enough.

our surgeon described the aftermath of RP as: the urethra is cut, the valve / sphincter controlling flow out of the bladder is removed and then the two ends of the tube are stitched back together. When the catheter is first removed, that join might be as leaky as a sieve until the join heals. If the valve has been removed, your brain has to re-learn bladder control just like it did when you were a toddler - more likely to have an accident when you are not concentrating or as you get more tired during the day. So incontinence immediately after the op is nothing to do with pelvic floor exercises. If you have or develop stress incontinence - leaking on exertion or coughing etc - that is what the pelvic floor exercises can improve.

Medium term or permanent incontinence is usually down to either permanent damage to the sphincter or urethra. All the pelvic floor exercises in the world can't solve that.

But it is absolutely right to get into good habits before your op - all adults should do regular PFEs throughout their life.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 11 Oct 2018 at 17:08

I had mine out this morning but so far have only been peeing in very short bursts and not clearing. The urology team brought me back in and did a bladder scan. I was worried I might need the catheter back in. After the scan and department discussion they let me go home. In my case they think it’s taking a little time for the nerves and muscles to wake up.


I‘ve seen most people’s flow seems ok, I wondered if anyone else had experienced a slow start?


Like most people I had some blood at first. 


My experience of the catheter removal was uncomfotable with some pain for the last couple of seconds. I had quite a lot of blood on removal. 


It‘s interesting to see that many of us have a lot in common going through this but everyone is different so it’s probably wise to expect the unexpected and ask as many questions as you feel you need to. 


Wishing you all the best.


 

Edited by member 11 Oct 2018 at 18:07  | Reason: updated

User
Posted 11 Oct 2018 at 17:42

Best of luck m8  always a difficult time im sure. Got mine scheduled for 7th. 

 
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