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Incontinence update

User
Posted 22 Jul 2024 at 22:44

Been dipping in and out of here and keeping up with what everyone’s been up to but not had much to contribute lately until now….

Steve had a meeting with urologist today to check progress primarily on incontinence issue. Just over six months since RARP. Second post op PSA result also today and remains at less than 0.05, so all good there.

no change on the incontinence front, fully incontinent, ( pelvic floors with squeezy app done religiously).

Urologist confirmed the stats that 95% of men will regain 99% continence  by 12 months (with 5% of men not, or needing some intervention). In his opinion, he felt that if Steve doesn’t regain continence within 12 months, then it’s not going to happen without some further help. So he will be seen again in 6 months and take it from there.  

He also discussed ED with us, no movement in that department (80% nerve sparing) so is asking GP to prescribe Sildenafil (event dose)….we’re up for this (so to speak) but not quite sure how this will work with the incontinence! (Raincoat at the ready we think!)

User
Posted 23 Jul 2024 at 09:50
Tell him to get in touch with his urologist and ask if Perineal Physiotherapy is available to him.

After my RARP I was given 12 sessions and it helped enormously to get control of the right muscles to control incontinence.

It involves a TENS like probe inserted into the rectum that electrically stimulates the muscles for about 15 minutes. Then you have to clench the muscles around the probe to make a pointer follow a line on the screen - this is called Bio Feedback and is another 15 minutes or so. I had 2 sessions per week.

User
Posted 23 Jul 2024 at 01:00
If he isn't getting any response at all I doubt an event dose will do much other than give him a headache. If he is getting a small response then you may have some luck with the pills. BUT I can pretty much guarantee if he is worried about pissing himself it will be a massive turn off.

So what to do? See what happens in the shower? Neither of you will know where the wet is coming from anyway!

If he has zero response still then I would suggest some vacuum pump therapy, if you both get on with this it has the added benefit of stopping any accidents at least while the construction ring is on.

If the pills do work but pissing is an issue then try a regular durex cock ring or a Firmtec variety. These may be strong enough to stop the widdle and will also help maintain a natural etection.

User
Posted 23 Jul 2024 at 09:06

Hi Debbie and Steve.

 It's fantastic news that the PSA is so low. Was there an < arrow in front of the 0.05? At one of the labs that do my PSA test, they only measure as low as 0.05, anything below this (<) is deemed undetectable.

However, the incontinence issue must be difficult.

I was non nerve sparing, so ED tablets were useless. I didn't want to try the pump, so at my first ED clinic, which was about at the stage Steve's at now, I was prescribed Invicorp and it worked!

I had the peeing during sex issue for many months. I think the name for it is climacturia. Obviously emptying the bladder pre rumpy pumpy seemed to reduce the splashing.

For weeks, to combat the urine/sex problem, we used to throw a heavy duty plastic table cloth over the bed. Several times, we were lucky to avoid skeletal damage slipping off it. 😁

I'll add a link to my Invicorp thread. Even if sex due to climacturia is difficult, I'm sure just seeing that an erection is once again possible, would hearten you both. It did us.

https://community.prostatecanceruk.org/posts/t29845-Hooray-for-Invicorp

 

Edited by member 23 Jul 2024 at 09:37  | Reason: Add link

User
Posted 23 Jul 2024 at 17:06
Thanks for the input everyone…yes Adrian, psa <0.05 and that’s the lowest our lab measures to.

First time we’ve discussed with medical staff the future of penetrative sex for us, we were leaving it until the incontinence issue was ‘solved’ but clearly that’s going to be taking a bit longer!

I’ve read more on here now about Sildenafil/tadalafil, regular dosage and event dosage, so understand it a bit better… we will see what our GP prescribes when he gets the letter from urologist.

Steve’s been using a pump he bought for a few months purely to maintain penile health (again advice picked up from here). We’ve now ordered a Durex cock ring to try with the pump. Our local urology department did put Steve on waiting list for SomaErect pump expert to get in touch with us but despite a prod, still not happened, we will be chasing again.

User
Posted 23 Jul 2024 at 20:07

Hi DJC44,

I can only agree with what others have suggested.  Use a cock ring (as tight as manageable) or even better, a tension ring (which comes with some pumps or can be ordered from imedicare).  ( I have no connection to this company).  Note that the tension ring goes around the base of the penis only, whereas the cock ring goes around the penis and testicles.  You can wear a tension ring and a cock ring at the same time, if it's not too uncomfortable.  I use both together and it works for me.  I never leak.  However, do be careful when you're finished and are removing them.  You may well leak then, so have a paper towel or something handy.

Best wishes,

JedSee.

User
Posted 23 Jul 2024 at 21:28

Originally Posted by: Online Community Member

Do you think this Perineal Physiotherapy will work for my night time (bed wetting) incontinence? I am completely dry as long as long as I don't fall asleep (lying down), the only pads that can hold my wee is the level 3, the others, I wake up to a flooded bed. The only fix is no carbs and don't eat past 3-4pm daily.  It is getting exasperating to say the least.

I can't give you a definitive answer on that as my issue was standing, not lying down - but it really did help me to get control so all I can say is see if it's available to you and give it a go. It certainly won't do any harm and is frequently used by ladies after childbirth - so a well proven treatment.

User
Posted 24 Jul 2024 at 00:16

Hi Ian…great you got the op out of the way, it’s early days for you so wishing you a speedy recovery!

hope all goes well with the TWOC and really hope you’re one of the lucky ones who are dry from the get go! I’ll follow progress! Fingers crossed for best outcome possible on the biopsy too, I know it’s an anxious time!

I have been reading the posts but not had much to say, I think waiting for the urology appointment this week to see what came of that.

despite the incontinence and whatever we have to suffer with the ED…we still know it was the right decision for Steve to have RARP.  I think we were expecting the Incontinence to have improved by now but I guess we will have to be patient a bit longer!

take care

Debbie

User
Posted 26 Jul 2024 at 12:31

Originally Posted by: Online Community Member

Originally Posted by: Online Community Member

 

Do you think this Perineal Physiotherapy will work for my night time (bed wetting) incontinence? I am completely dry as long as long as I don't fall asleep (lying down), the only pads that can hold my wee is the level 3, the others, I wake up to a flooded bed. The only fix is no carbs and don't eat past 3-4pm daily.  It is getting exasperating to say the least.

Hello mate,

I was going to pm you to see how you were getting on. The last time I heard from you things seemed to be improving a bit. I'm sorry to learn that that is not the case. 

Thanks Ady, things went south a little, as I got fed up with the monotony of doing the kegel exercise and the using the pump for penile health. I just thought after 26mths, thought to myself what is the benefit. I don't like routine at the best of times.. However, I noticed my night time incontinence and natural elections have gotten worse. I have since gone  back to the kegel exercise (squeeze app) 5x a day and not flooded the bed for the past 3days! Seems the kegel exercise is for life!😒

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User
Posted 23 Jul 2024 at 01:00
If he isn't getting any response at all I doubt an event dose will do much other than give him a headache. If he is getting a small response then you may have some luck with the pills. BUT I can pretty much guarantee if he is worried about pissing himself it will be a massive turn off.

So what to do? See what happens in the shower? Neither of you will know where the wet is coming from anyway!

If he has zero response still then I would suggest some vacuum pump therapy, if you both get on with this it has the added benefit of stopping any accidents at least while the construction ring is on.

If the pills do work but pissing is an issue then try a regular durex cock ring or a Firmtec variety. These may be strong enough to stop the widdle and will also help maintain a natural etection.

User
Posted 23 Jul 2024 at 09:06

Hi Debbie and Steve.

 It's fantastic news that the PSA is so low. Was there an < arrow in front of the 0.05? At one of the labs that do my PSA test, they only measure as low as 0.05, anything below this (<) is deemed undetectable.

However, the incontinence issue must be difficult.

I was non nerve sparing, so ED tablets were useless. I didn't want to try the pump, so at my first ED clinic, which was about at the stage Steve's at now, I was prescribed Invicorp and it worked!

I had the peeing during sex issue for many months. I think the name for it is climacturia. Obviously emptying the bladder pre rumpy pumpy seemed to reduce the splashing.

For weeks, to combat the urine/sex problem, we used to throw a heavy duty plastic table cloth over the bed. Several times, we were lucky to avoid skeletal damage slipping off it. 😁

I'll add a link to my Invicorp thread. Even if sex due to climacturia is difficult, I'm sure just seeing that an erection is once again possible, would hearten you both. It did us.

https://community.prostatecanceruk.org/posts/t29845-Hooray-for-Invicorp

 

Edited by member 23 Jul 2024 at 09:37  | Reason: Add link

User
Posted 23 Jul 2024 at 09:50
Tell him to get in touch with his urologist and ask if Perineal Physiotherapy is available to him.

After my RARP I was given 12 sessions and it helped enormously to get control of the right muscles to control incontinence.

It involves a TENS like probe inserted into the rectum that electrically stimulates the muscles for about 15 minutes. Then you have to clench the muscles around the probe to make a pointer follow a line on the screen - this is called Bio Feedback and is another 15 minutes or so. I had 2 sessions per week.

User
Posted 23 Jul 2024 at 15:51

Originally Posted by: Online Community Member
Tell him to get in touch with his urologist and ask if Perineal Physiotherapy is available to him.
After my RARP I was given 12 sessions and it helped enormously to get control of the right muscles to control incontinence.
It involves a TENS like probe inserted into the rectum that electrically stimulates the muscles for about 15 minutes. Then you have to clench the muscles around the probe to make a pointer follow a line on the screen - this is called Bio Feedback and is another 15 minutes or so. I had 2 sessions per week.

Do you think this Perineal Physiotherapy will work for my night time (bed wetting) incontinence? I am completely dry as long as long as I don't fall asleep (lying down), the only pads that can hold my wee is the level 3, the others, I wake up to a flooded bed. The only fix is no carbs and don't eat past 3-4pm daily.  It is getting exasperating to say the least.

User
Posted 23 Jul 2024 at 17:06
Thanks for the input everyone…yes Adrian, psa <0.05 and that’s the lowest our lab measures to.

First time we’ve discussed with medical staff the future of penetrative sex for us, we were leaving it until the incontinence issue was ‘solved’ but clearly that’s going to be taking a bit longer!

I’ve read more on here now about Sildenafil/tadalafil, regular dosage and event dosage, so understand it a bit better… we will see what our GP prescribes when he gets the letter from urologist.

Steve’s been using a pump he bought for a few months purely to maintain penile health (again advice picked up from here). We’ve now ordered a Durex cock ring to try with the pump. Our local urology department did put Steve on waiting list for SomaErect pump expert to get in touch with us but despite a prod, still not happened, we will be chasing again.

User
Posted 23 Jul 2024 at 17:48

Originally Posted by: Online Community Member

 

Do you think this Perineal Physiotherapy will work for my night time (bed wetting) incontinence? I am completely dry as long as long as I don't fall asleep (lying down), the only pads that can hold my wee is the level 3, the others, I wake up to a flooded bed. The only fix is no carbs and don't eat past 3-4pm daily.  It is getting exasperating to say the least.

Hello mate,

I was going to pm you to see how you were getting on. The last time I heard from you things seemed to be improving a bit. I'm sorry to learn that that is not the case. 

User
Posted 23 Jul 2024 at 20:07

Hi DJC44,

I can only agree with what others have suggested.  Use a cock ring (as tight as manageable) or even better, a tension ring (which comes with some pumps or can be ordered from imedicare).  ( I have no connection to this company).  Note that the tension ring goes around the base of the penis only, whereas the cock ring goes around the penis and testicles.  You can wear a tension ring and a cock ring at the same time, if it's not too uncomfortable.  I use both together and it works for me.  I never leak.  However, do be careful when you're finished and are removing them.  You may well leak then, so have a paper towel or something handy.

Best wishes,

JedSee.

User
Posted 23 Jul 2024 at 20:53

Sorry to hear Steve is still struggling with his incontinence Debbie, I did wonder how he was getting on as I haven't seen you on here lately. I hope it starts to improve for him (and you) soon. I'm sat here leaking my way through 5 pads a day even with the catheter still in, so suspect I may have a tricky time ahead when it comes out on Thursday.

All the best to you both.

Ian.

User
Posted 23 Jul 2024 at 21:28

Originally Posted by: Online Community Member

Do you think this Perineal Physiotherapy will work for my night time (bed wetting) incontinence? I am completely dry as long as long as I don't fall asleep (lying down), the only pads that can hold my wee is the level 3, the others, I wake up to a flooded bed. The only fix is no carbs and don't eat past 3-4pm daily.  It is getting exasperating to say the least.

I can't give you a definitive answer on that as my issue was standing, not lying down - but it really did help me to get control so all I can say is see if it's available to you and give it a go. It certainly won't do any harm and is frequently used by ladies after childbirth - so a well proven treatment.

User
Posted 24 Jul 2024 at 00:16

Hi Ian…great you got the op out of the way, it’s early days for you so wishing you a speedy recovery!

hope all goes well with the TWOC and really hope you’re one of the lucky ones who are dry from the get go! I’ll follow progress! Fingers crossed for best outcome possible on the biopsy too, I know it’s an anxious time!

I have been reading the posts but not had much to say, I think waiting for the urology appointment this week to see what came of that.

despite the incontinence and whatever we have to suffer with the ED…we still know it was the right decision for Steve to have RARP.  I think we were expecting the Incontinence to have improved by now but I guess we will have to be patient a bit longer!

take care

Debbie

User
Posted 26 Jul 2024 at 12:31

Originally Posted by: Online Community Member

Originally Posted by: Online Community Member

 

Do you think this Perineal Physiotherapy will work for my night time (bed wetting) incontinence? I am completely dry as long as long as I don't fall asleep (lying down), the only pads that can hold my wee is the level 3, the others, I wake up to a flooded bed. The only fix is no carbs and don't eat past 3-4pm daily.  It is getting exasperating to say the least.

Hello mate,

I was going to pm you to see how you were getting on. The last time I heard from you things seemed to be improving a bit. I'm sorry to learn that that is not the case. 

Thanks Ady, things went south a little, as I got fed up with the monotony of doing the kegel exercise and the using the pump for penile health. I just thought after 26mths, thought to myself what is the benefit. I don't like routine at the best of times.. However, I noticed my night time incontinence and natural elections have gotten worse. I have since gone  back to the kegel exercise (squeeze app) 5x a day and not flooded the bed for the past 3days! Seems the kegel exercise is for life!😒

 
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