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Penile clamps

User
Posted 10 Jan 2020 at 21:59

Oddly, I've found very few people mentioning that they use a clamp.

My Prostate cancer was found on a 'routine' PSA (strong family history), MRI showed a suspicious area, biopsy confirmed the need for treatment  -  Gleason 7  -   and I opted for RRP, which went well. Histology showed 60% involvement of the prostate, but no breach of the capsule, and no gland involvement. The catheter came out after two weeks (November 5th) , and the expected incontinence was immediately a problem to get to grips with.

I've been lucky with being almost completely dry at night,  getting up once on average. By day, it's a different matter. The mornings can be reasonable, but because physiologically one produces more urine in the morning, it can be an effort. Going out for a walk, or to do anything (shopping, jobs in the workshop etc) was really problematic. My surgeon, and also the urology physio, recommended trying a Dribble-Stop clamp. Yes, they cost a great deal more than you might expect for a small plastic device. But, what price continence?! The effect is amazing. I can do an hour's walk, or more, or be out all morning, perhaps lunch out. An occasional visit to the loo to release the clip and empty the bladder, is all that's needed. I never use it more than half the day. It gives the poor old pelvic muscles a rest, and makes it that much easier to cope with the rest of the day clamp-free.

Whether it can make the pelvic muscles lazy, seems to be a matter of dispute. But even if it does delay the full recovery of continence that we would all look forward to, it does mean that 'normal' life can carry on  -  visiting friends, going to the cinema, playing with the grandchildren. And that counts for a lot.

Glad to report that my first PSA was undetectable, no matter how hard they tried to find some!

What experiences have others had?

User
Posted 10 Jan 2020 at 23:06
Many urologists strongly discourage the use of clamps, sheaths, etc, because men who use them stop trying to use their pelvic floor muscles. They’re great for men who have long-term incontinence, but not recommended for men recovering from a recent RP and trying to regain their continence.

Best wishes,

Chris

User
Posted 11 Jan 2020 at 12:01

A flaccid penis is already ischemic (low on blood/oxygen supply), and it seems to me a clamp can serve to make this worse.

A google quickly found this paper:
Tissue response to applied loading using different designs of penile compression clamps

but note they didn't let the test subjects wear clamps for longer than 50 mins at a time, for fear of possible damage.

User
Posted 11 Jan 2020 at 12:41

The particular one recommended (by the Consultant) only compresses from top and bottom. The blood supply of the penis runs alongside, and so is not compressed by the clamp  -  hence the design.  The paper cited above did conclude that use of clamps is safe, within the tested wear-time of 50 minutes maximum.

Maybe more to the point, the lack of nocturnal erections can contribute to a gradual lessening of blood supply, and atrophy. This can be countered by use of a vacuum pump (SomaErect, for example) for which I was given a prescription, and waiting to collect. Regular erections, even if brought on by the pump, will give the penis' blood supply a workout. So use of the clamp, from time to time, seems to me an ideal way of fending off the very dispiriting effect of constant dribbling and reluctance to venture out.

Edited by member 11 Jan 2020 at 12:49  | Reason: Not specified

User
Posted 11 Jan 2020 at 15:41

I suspect people who use them will do so most of the time.

By the way, when you go to pick up your pump, you might want to take an opaque carrier bag. The outside of the box is not in the slightest bit discrete. As with any medications, she asked if I'd used it before. I said yes - I used it in the clinic, but on reflection, I might have said no, just to see how the conversation went after that...

Note that a pump only stretches the external visible half of the penis, not the internal half. It will help blood flow in the whole organ though.

Edited by member 11 Jan 2020 at 15:43  | Reason: Not specified

User
Posted 11 Jan 2020 at 16:10

Ha ha, yes!  Good advice. Though it seems to me that every prescription dispensed there is issued in their special white paper bags, which come in all sizes. Still, I shall have my own bag at the ready!

I certainly don't use the clamp unless I've good reason to do so  -  long walk, for instance. It can be miles from the hospital carpark to the hospital itself. Much of it downhill, and I don't know if others find that the worst? There seems to be something about putting your leg forward and down that inhibits the pelvic floor muscles  -  same with going downstairs. Up is much easier, but at times, any walking requires more effort in keeping the PFMs sufficiently tight to prevent leakage. It's like non-stop PFM exercise!

Edited by member 11 Jan 2020 at 16:18  | Reason: Not specified

User
Posted 11 Jan 2020 at 16:16
I thought I was reading from the S & M section of the ‘Love Honey’ catalogue. I think they do nipple clamps too!

Sorry, I’m a fourteen year-old in the body of a sixty-four year-old - without the pubescent erections of course!

Keep smiling (and breathing).

Cheers, John.

User
Posted 22 Sep 2020 at 10:13

Catch-up report: it's now 11 months since my RRP.  Luckily, the current pestilence hasn't come knocking at the door. I would say that I'm 95% back to normal (ie pre-op) continence  -  despite the dire warnings against clamps etc. I don't think I needed the clamp for more than 2 or 3 months, and that was intermittent. But, as I said previously it did make all the difference in allowing me to get out and about.

The SomaErect vacuum device is still used, but whether or not it's contributing to the improvement, it's hard (sorry!) to tell. And, as I've described in another thread, I have been using Hypopressive exercises which help to reduce the natural raised abdominal pressure that presses down on the poor old bladder.

The Level of the pads has steadily dropped from the original 'maxi', through 2, then 1, and now, mostly, the Level 0 'shield' which simply acts to prevent the risk of an embarassing moment. But on a quiet day, at home or mostly inactive, no pads are needed. On the other hand I wisely used a Level 1 the other day on a longish (5-hour) walk up in the Brecon Beacons  -  would have been impossible a few months ago. And meanwhile, the PSA remains stubbornly absent from my bloodstream.

 
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