Incontinence after surgery

User

Posted 31 May 2023 at 21:35

Good evening as I have been advised to have surgery I was wondering if anyone had and experience of Incontinence post op and should this put me off . 3+4 localised psa 52 . I'm torn on the decision actually.

User

Posted 01 Jun 2023 at 07:03

Morning;

Every man is different on this some have very little problem others take longer, in my case it shocked me having incontinence but I'm four months post surgery and all but dry now just few drops each day when moving but totally dry at night .

I'd say if you are advised to take the op then do it but the main point I'd make is you need to slow right down take your time and plenty of rest with a little exercise and build that up only when you feel you can .

Good luck and continue to talk to family and friends and post on here for help from those that have been there .

All the best.

Vern.

User

Posted 01 Jun 2023 at 07:47

I’d echo that - everyone is different. I am now 7 weeks post op. After my catheter was removed I could as they say hold water and was 8/9 pads a day plus a couple at night. Now I am 3/4 pads a day and 1 at night. My improvement has stalled and this seems linked to increased activity on my part as I started to walk more, back driving and just returned to work. Movement increases the leakage. My body tells me when enough is enough but I am of the view you have to try and push the boundaries a little to establish your limits within reason. No heavy lifting as I was warned it could cause a hernia - interesting that at the local support group the issue of hernias post op was raised and the common denominator amongst all who had suffered was trying to do too much too early. However I do seem to be getting more control now albeit limited. I was talking to someone who had their op 3 weeks after me and they only use 1 pad a day ‘just in case’. I am 57 and he was in his mid 60’s. There is no telling. My advice - keep squeezing!

Only you can decide on the best course of action. I chose the op after careful thought and weighing up the pro’s and cons taking into account my circumstances. The clincher for me was when I asked the oncologist what they would do - they said have the op as it keeps options open for the future. Best of luck.

User

Posted 01 Jun 2023 at 07:57

Mustard, I was 99 percent dry 4 days after catheter removal, some guys are dry immediately after catheter, but most are not. Techniques and experience of the surgeon is probably the most crucial things along with the extent of your cancer.

Hope all goes well for you.

Thanks Chris

Edited by member 01 Jun 2023 at 10:13 | Reason: Wrong word

User

Posted 01 Jun 2023 at 09:11

I was pretty much dry post surgery. Just the odd drip. Was fully dry after about 3-4 weeks. But everyone has a different experience, depends on the surgery required and the skill of the surgeon. Sadly many men never regain their continence.

Preparation pre surgery is the key; doing your pelvic floor exercises. You are loosing a set of muscles so you have to strengthen the remaining ones. Post surgery once the catheter is removed you have to continue them. But unfortunately there are no guarantees.

The surgeon should discuss this with you.

User

Posted 02 Jun 2023 at 21:41

Hi Mustard,

As others have said, everyone's experience of incontinence after surgery is different. I had my surgery almost a year ago. I've been one of the unlucky ones, in that I still need to use 2-3 pads per day, although I'm largely dry at night. I would strongly advise you to start practising the pelvic floor ('Kegel') exercises now, before surgery, to strengthen the muscles beforehand. After surgery, once the catheter is removed, you will be encouraged to resume the Kegel exercises and to slowly increase walking activity. After 5 months, I started Pilates exercises (although you can start them after 3 months). I have also noticed that if I am rushing about and under some stress, I leak a lot more. If I know I'm going to be out and about all day, with limited access to toilets, I reduce my liquid intake accordingly, and make up for it later in the day when I return home. It's important to keep up your fluid intake, in order to avoid kidney damage and urinary tract infections.

Also, one piece of information that the surgeon gave me beforehand was this: whatever level of bladder functioning you had before the surgery can give an indication of the level of control you will (eventually) regain. In my case, although I had not been incontinent before the surgery, I had experienced weak urine flow, a sense of urgency and frequency. So, I will probably always have (at least) those symptoms. I could live with those, if I could just get back to being continent 😀.

I wish you the best of luck.

JedSee.

User

Posted 08 Jun 2023 at 10:05

Hi Mustard

Firstly I have to say (4 weeks today post RARP) that the op is waaaayyy less scary than you anticipate and the knowledge that the cancer has been removed from your body will give you so much more peace of mind.

I have pretty good pee control as long as I remember to think about it - I can feel the need to pee, stand up and get to the toilet and most of the time release it on command. If I get lazy and don't hold it in (I use what is known as the 'shrink your penis' action) then I might get a dribble when standing up or standing at the toilet ready to go - it's literally just a dribble.

I started wearing the 6 drop pads and am now down to the 3's and will probably go to 2's next week.

Based on my experience so far I would highly recommend the RARP (I would name my first born 'Da Vincii' if that was possible LOL).

Good luck

Steve

User

Posted 08 Jun 2023 at 21:11

Many thanks the decision to go gor surgery was made today so your post was most helpful 👍

User

Posted 11 Sep 2023 at 11:26

Open4321 that was a good post and pretty much reflects my experience (4 months post RARP) - I am now down to a #1 pad for day and most days it is clean at the end of the day unless I either cough/sneeze or if I strain and forget to tense the muscles. I don't practice Kegal specifically anymore but just remember to hold it in if needed.

I can go quite happily for a couple of hours and even handle a full bladder for some time. My flow rate has significantly improved from before the surgery and I completely empty on first go - no more waiting and peeing a bit more. So overall very happy with the urinary side of things.

Fred, I cannot see any reason why it would not help but I would imagine different people are affected differently by RT and the does and targetting - but all of the literature does stress how it can help all sorts of incontinence - bladder and bowel - and not just for RP patients. So I would definitely give it a try.

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User

Posted 01 Jun 2023 at 07:03

Morning;

Good luck and continue to talk to family and friends and post on here for help from those that have been there .

All the best.

Vern.

User

Posted 01 Jun 2023 at 07:47

User

Posted 01 Jun 2023 at 07:57

Hope all goes well for you.

Thanks Chris

Edited by member 01 Jun 2023 at 10:13 | Reason: Wrong word

User

Posted 01 Jun 2023 at 09:11

The surgeon should discuss this with you.

User

Posted 02 Jun 2023 at 21:41

Hi Mustard,

I wish you the best of luck.

JedSee.

User

Posted 08 Jun 2023 at 10:05

Hi Mustard

I started wearing the 6 drop pads and am now down to the 3's and will probably go to 2's next week.

Based on my experience so far I would highly recommend the RARP (I would name my first born 'Da Vincii' if that was possible LOL).

Good luck

Steve

User

Posted 08 Jun 2023 at 21:11

Many thanks the decision to go gor surgery was made today so your post was most helpful 👍

User

Posted 10 Jun 2023 at 22:07

Many thanks did the surgen manage nerve sparing surgery pls ...

User

Posted 11 Jun 2023 at 11:37

My appt with the surgeon is on the 24th when I can discuss in more detail what nerve sparing was possible. Apart from the lack of any erection yet, I can make him twitch - not sure what that means however until I have the conversation :)

User

Posted 11 Sep 2023 at 08:56

I know that the original question has been answered, but I’ve found the personal stories on this forum have been really helpful in my journey through radical prostatectomy, so I’ll add my experience for anyone new concerned about the process.

First of all, the operation was far easier than the worry beforehand. I’m now six weeks post surgery and feel more or less back to normal, with a few exceptions on the sexual side.

As others have said, every man is different. I began doing pelvic floor exercises as soon as I decided to go ahead with surgery. That meant six weeks worth of preliminary work building up muscle strength. I use an app called Squeezy which is excellent and makes sure you don’t miss a session. I had no symptoms prior to diagnosis and so I think my preparation and lack of problems has led to me now being fully continent four weeks after my catheter was removed.

im still not quite sure how it all works down there. I was expecting the floodgates to open once the catheter came out but it was nothing like that. Having a wee felt very uncontrolled to begin with, and for a few days could start before I’d fully got my penis out and ready. It also felt strange - not painful, but a funny sensation. This has now gone and my seeing is back to how it was. I made sure that I drank a lot to ease bowel movement which returned to normal three days after the operation, and currently I’m taking the opportunity to wee when I need to or before embarking on a period where it might be difficult to find a toilet like a long bus journey.

when I did get leaks, it was like I sometimes get at the end of a wee when there’s a bit more to come out. The pads dealt with this admirably. This tended to happen at the end of the day when your muscles get tired.

A couple of final points: when I empty my bowels, I will sometimes wee without consciously intending to, and at least one of my orgasms has produced is small amount of involuntary wee.

User

Posted 11 Sep 2023 at 11:06

Hi,

While on the subject but as related to Kegel exercise after RT?

Is Kegel exercise also needed or works for incontinence after RT ?

User

Posted 11 Sep 2023 at 11:26

User

Posted 11 Sep 2023 at 11:52

The literature all says do the Kegel exercises after the operation and start before if you can. I’m still doing mine three times a day as it’s really takes no effort at all. I’m not sure how long I will keep this up. Probably until I’m 100% sure I’m not going to get any nasty surprises.

Things that might prompt little leaks are coughs, sneezes, standing up, and for me, passing wind. The physio I saw prior to the operation told me that in time you develop muscle memory so you automatically tighten the muscles that control the flow when you do these things.

One other experience I had was when emptying my bowels. For a couple of weeks, my pelvic floor muscles really contracted hard at the end of poo which felt rather weird. I suppose the muscles which control both bowel and urinary movements, were in a heightened state of readiness. Anyway, that has now settled down and everything is back to normal round the back, except the odd dribble of wee before I go.

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