Post Operative Incontinence

Hello Hammurabi

It is very early days, your journey of recovery has just started. The only thing you can and should do is light walking and start doing pelvic floor (Kegel) exercises. After my prostatectomy some years ago, on removal of my catheter I was totally incontinent. My consultant surgeon advised me to do pelvic floor exercises as follows and not waste any money on physiotherapy! It is very easy: Sit on the toilet and the urine will flow freely. Now try to stop the flow - this is intuitive - keeping your pelvic muscles under tension, count to ten and relax those muscles, then count to ten again, and repeat the process ten times. Do these two/three times a day but don't overdo it; there is a temptation to try and speed up the process. Initially you will probably notice no difference; be patient. In my case I began to notice some improvement after three weeks and two months later when I woke up one morning my pad was totally dry. When my progress flattened out at 99.9% (I leak when sexually excited and at orgasm!) my consultant told me that because of my age (I was a little older than you then) I may have to just be satisfied with that and adapt to the new normal which we have. Unfortunately some consultants are not always honest about both incontinence and the possibility of total or partial ED even with nerve sparing procedures. Be patient and you will begin to see improvement soon. Good luck.

I had robot-assisted prostate removal surgery on Wednesday 21st February 2024. I came home on the following day, Thursday 22nd February with a catheter.

The catheter was removed on Monday 4th March. Since then I have had virtually no bladder control (today is Wednesday 6th March).

Daytime

I am wearing incontinence pants as I will spontaneously “spurt” urine without any warning. The quantity does vary from small amounts to longer periods of weeing (3-4 seconds). Once started I cannot stop the flow. And these periods of spurting/leaking can continue for 30-45 minutes.

The problem increases in frequency and volume as the day progresses, as I assume the body takes on more liquid and food during the day.

Sometimes the spurts are triggered by coughs, sneezes, bending down, sitting down or standing up - stress incontinence.

I do stop drinking and eating at around 6:30 in the evening.

I seem to be getting through 6 or so incontinence pants a day.

Night-time

During the night it seems better. I can go to sleep and wake up 4-6 times during the night and can get to the bathroom for a wee. There appears to be very little leakage during the night.

Pelvic Floor Exercises

I have been trying to do these and have the Squeezy app to help. Never quite sure that I am doing them correctly and some leakage does occur as I do them.

Summary

I realise that this is only day three after the catheter removal. Am I experiencing “normal” issues? Is there anything else I should be doing or can be done to help? Am I just too impatient!

One technique is when standing at the loo - try and stop the flow and identify which muscles you are using to do so - these are what you need to work on with your pelvic floor exercises. You will likely leak for the first week or so doing these.

Don't be disheartened - it just takes time.

I was similar. Twoc went ok but as the day progressed I leaked a bit as I got tired. I wasn’t dry until week 5 when the stitches around the bladder neck start to soften release tension on the sphincter. After this didn’t need pads. Over the next year the scar tissues slowly softens and things should improve over this time. Pelvic floor exercises also help loads especially stopping any leaks or squirts.

no issues at night other than an incident after a barrel of beer with a friend a few months in. 

Edited by member 22 May 2024 at 22:43  | Reason: Not specified

Hello mate. I'm sorry that you've had to join the Club, but welcome.

Incontinence can vary enormously, so it's difficult to even give a normal recovery rate. Nurses told me that about 80% of patients recovered after about 6 months.

Having all those toilet trips during the night must badly affect your sleep and being tired will not aid your overall recovery. If it becomes too much of a problem give the nurses a call.

Steve's urinal bottle is a good idea. I used to use one, it disturbs your sleep less than traipsing to the loo.

Best of luck.

Edited by member 01 Jun 2024 at 09:55  | Reason: Additional text

That wasn’t quite the sentiment that I was aiming for, but you’re not wrong! 😂