Me as well

Catheter removal day (30/12)

I attended Addenbrookes at 10 AM today for the removal of my pipework. Mixed feelings really as though it is inconvenient having it in I was aware that having my catheter removed could result in me being incontinent. To begin with, my puncture wounds from the operation were duly inspected by the nurse and given the all clear. She then invited in a colleague and explained what exactly was going to take place.I was told to strip naked, lay on the bed with my back on the mattress and whilst the second nurse chatted to me the first nurse ( a matron in old money) drained, using a syringe and the drain port on the catheter pipework,  the saline solution from the balloon holding the catheter in place. Once the balloon had been emptied, I was told to turn my head towards the wall and cough 3 times. During my second cough the catheter pipework was removed. No pain or sensation at all. So, a win-win. For those wondering why I was told to cough, it is because coughing relaxes the pelvic floor muscles and makes it easier to remove the catheter.

Having got redressed, "Matron" told me that I would need to show that I could pass urine and could empty my bladder before she would allow me to leave her care. She pointed out that because there were no spare beds available she was very hopeful that I could do both. I was told to drink as much water as I could, to wander around the hospital (but not the wards area)  and to try and  urinate at least a couple of times. I was duly sent on my way at around 10.30 am and told to call back at 12 noon. During my wanderings, I drunk at least 10 disposable plastic cups of water but only managed to dribble when I went to the toilet. Returning to the unit at the prescribed time, I mentioned to "Matron" that I had not been able to go too much and she suggested I try again. Interestingly, whether it was her words "you must go"or the fact she was standing outside the toilet door, but go I did and with a reasonably good stream.  The trouble was I was still leaking (thankfully I had a Tena pad in my underwear) walking back to her room and continued to do so when standing up or moving around (sitting down was fine). "Matron" suggested that my pelvic floor muscles were not strong enough ( I had been undertaking the required exercise regime daily for 6 weeks prior to my surgery) and said that I would have to continue to work on them. After checking my bladder level (it contained less than 1 ml of fluid), after giving me a couple of pairs of incontinence pants( I had only bought one spare pad with me) and further instructions and guidance I was, at 12.50 pm, sent on my way.

Based on my experience, my recommendation  when going to have your catheter removed is that you take at least one change of underwear, at least 4 pads and a couple of pairs of incontinence pants.

Ivan

Thanks Lyn for your response and for your comment that the present state of my pelvic floor muscles might not be the reason for my present incontinence level i.e. it is the aftermath of the operation I had on 21/12.

By the way, am I correct to assume that you are/were a nurse, perhaps a matron?

Ivan

Edited by member 30 Dec 2021 at 16:11  | Reason: Not specified

I am a retired nursing sister and don't have nearly the knowledge that Lyn has on this subject. As I am now the wife of a prostate cancer patient I am always interested in her views.  I have worked with many medics over the years who could learn a lot from her posts and the sensitivity with which she delivers them. 

I don't know what the sawbones have been up to (mine, telling me why the Retzius approach is unnecessary, muttered something about "sparing more Retzius structures") - does anyone know? - but continence outcomes have improved across the board. Amazing news well represented here. To me ED was important, but I see UI is more so and is less curable with eg needles (although, I would rather have an artificial sphincter than an implant). So, well  done the sawbones upping their game.

Glad to hear you are on the mend. Hope the histology goes well. Remember to really take it easy and not carry stuff even though you are feeling stronger. Im sure continence will improve. My consultant (who I think might have been the same as yours ) told me that continence also has a lot to do with urethal length and he was pretty sure I was going to be ok post op as mine was of sufficient length. You may want to ask him about this. But keep on doing the exercises. I had my first accident for a while the other day when i tried to squeeze a fart so always have to be on guard.

Great news Ivan.

Really glad things are going well. Best of luck for post op histology, I’m sure everything will be really good.

I’ve just updated my thread, we’re having a good day too so fingers crossed it continues for us all.

Thanks for all your help since the op, it’s been a pleasure sharing the same op date 😂😂

😂😂

Ivan. If I were you I would check again on that Tadalafil dosage. My understanding is that 5mg is a daily dose. You could take 20mg for an Event Dose but then I am pretty sure that you should then lay off it for 3 days afterwards.

Personally I take 5mg before sleep (to minimise any poss side effects) and then I supplement with 50mg Sidenafil (Viagra) for Events.

Thanks for your message, ProSixty

Yes, you are correct and for an "event"  I would need to take 20mg and then not take anymore for a few days afterwards. Because I don't like taking medicines unless I really have to, I took 5 mg a day for 14 days after my catheter was removed and  then stopped taking it. The consultant who phoned me  a couple of weeks after I stopped to discuss the findings of my sliced and diced prostate mentioned that I should take Tadalafil for a minimum of 2 months after surgery to aid nerve recovery and to improve blood flow. So, I started taking it again. The consultant also mentioned that I should keep my member in working order to assist the aforementioned blood flow.

I may well return to "normal" with regard to erections as all the nerve bundles on the left hand side were spared and 80% on the right.

Ivan

Thanks, Elaine, for your message.

Yes, it does appear from reading the other messages on here that alcohol and caffeine does induce leakage issues if over done. Fortunately, I don't drink alcohol or drink coffee!

I am pleased to hear that Rob is progressing nicely; long may that continue.

Ivan

An update following my 01/06 consultation with the Addenbrookes Clinical Nurse Specialist.

Items discussed:

PSA results (04/03/22 & 18/05/2) of less than 0.04 (lowest Addenbrookes test to) are excellent

My  full-on urine flow (as good as it was when I was a teenager) suggests that there are no urinary issues following my surgery

Tadalafil 5 mg tablets: It was suggested that I continue to take at least 5 mg a week ( I stopped taking them after a couple of months as I don't like taking pills) to ensure that blood flow to the penis is not restricted. It was also suggested that, additionally, I have sex or masturbate (or use a pump) at least once a week to ensure that the blood vessels (which reduce in size as they get to the end of the penis) do not whither away/harden up. This can cause problems as the years go by.

Pelvic floor exercises: I stopped doing these a couple of months after surgery as apart from leaking when I lifted really heavy items I was bone dry. It was suggested that I restart them and do them once a day.

ED: Not an issue as though I don't get as hard as I did pre-surgery I get hard enough for penetration.

Next consultation to be scheduled for early September (PSA test to be undertaken 10 days before)

Ivan

Edited by member 01 Jun 2022 at 10:07  | Reason: Not specified