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Incontinence, 5 weeks post op

User
Posted 10 Sep 2019 at 16:24

Dear Folks


Wondered if you all could give me some reassurance or other advice regarding my incontinence.


I am 52 with reasonable fitness pre Robotic prostatectomy, now exactly five weeks since OP and 26 days since catheter removal.


I have been doing the Kegel exercises as recommended, learning from various you tube videos and the fact sheet from this website.


The degree of incontinence was somewhat more than I expected which I came to terms with, but  my worry is that II haven't seen any improvement at all. It is exactly the same. I know everyone is different, and may be early to note any changes, but should there be not some step change after 5 weeks?


Am I not doing my Kegels correctly?


Are there pelvic physiotherapists in UK, who would be able to advise?


Any advice will be gratefully received


Best regards


 


I had bilateral nerve sparing procedures.

User
Posted 10 Sep 2019 at 20:49
At this stage, incontinence is rarely about the strength and efficiency of your pelvic floor muscles so kegels will make little difference. Your internal plumbing has been rearranged, you have lost at least one of the two structures that control urine flow and the other may have been moved or jiggered. Your brain needs to relearn bladder control, similar to when you were a toddler being potty trained. If you are fatigued or overdoing things, the brain can't cope with learning bladder control on top of everything else. Generally, urinary control does not improve at a steady pace; it leaps forward in bursts and then plateaus before jumping forward again. That can go on for up to a year.

Are you dry at night? That is usually where the first real progress is seen.

It is the case that some men have permanent damage to the urinary sphincter which means they remain incontinent. Any suggestion that incontinence is because someone didn't try hard enough or didn't do their exercises is a myth that can cause great distress. Fortunately, it is too early for you to start worrying about permanent problems.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 10 Sep 2019 at 22:14

If you said what area you are in, someone might point you to a continence service.


I just wrote up a presentation given by the Continence Advisory Service for Berkshire at a local PC support group last Friday, and if you are in Berkshire, you can refer yourself directly to them without even going through your GP. Some members in the audience said they'd already used them, and they were good and very fast at responding.

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User
Posted 10 Sep 2019 at 20:49
At this stage, incontinence is rarely about the strength and efficiency of your pelvic floor muscles so kegels will make little difference. Your internal plumbing has been rearranged, you have lost at least one of the two structures that control urine flow and the other may have been moved or jiggered. Your brain needs to relearn bladder control, similar to when you were a toddler being potty trained. If you are fatigued or overdoing things, the brain can't cope with learning bladder control on top of everything else. Generally, urinary control does not improve at a steady pace; it leaps forward in bursts and then plateaus before jumping forward again. That can go on for up to a year.

Are you dry at night? That is usually where the first real progress is seen.

It is the case that some men have permanent damage to the urinary sphincter which means they remain incontinent. Any suggestion that incontinence is because someone didn't try hard enough or didn't do their exercises is a myth that can cause great distress. Fortunately, it is too early for you to start worrying about permanent problems.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 10 Sep 2019 at 22:14

If you said what area you are in, someone might point you to a continence service.


I just wrote up a presentation given by the Continence Advisory Service for Berkshire at a local PC support group last Friday, and if you are in Berkshire, you can refer yourself directly to them without even going through your GP. Some members in the audience said they'd already used them, and they were good and very fast at responding.

 
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