incontinence confusion after prostatect

User

Posted 28 Oct 2024 at 14:55

Hi fellow trail runners- I am 69, 6 weeks after robotic prostatectomy. I've been walking two miles a day and added a tiny bit of jogging during walk after 4 weeks. My morning routine for decades has been up at 5am, big glass of water, large cup of green tea (this encourages my bowel movement before morning run around 8am). Seems strange but I don't need a pad from 5-8am and get very clear nerve signals when it's time to pee and my pelvic muscles are strong because I've been doing the exercises for two years prior to surgery, while on Active Surveillance.

I tried my favorite hilly trail route a few days ago first hiking. It felt great going uphill, had pad on but no leakage going uphill, then some on the flats and downhill, maybe pad halffull. Then I ran it two days later. No pad for uphill 1.5 miles then had to stick pad in, but was super excited to complete 3 mile run (very slow jog)

I have been easing back to my pelvic floor training exercises because they were causing some discomfort and increasing incontinence. Last week I finally felt I could do my routine of fast and slow, front, middle, rear, pelvic bowl (pull-ins).

Issue is late afternoon, (especially when on my feet--I have to cook lunch and dinner for my autistic son and wife going through radiation for breast cancer) evenings, and bedtime slow constant leakage seems to get a little worse after great run and fuller pelvic floor exercises (go figure) It almost feels like the pads stimulate an only partially filled bladder to pulse out the pee. So I fill up about 6 pads during these hours. I have to set my alarm every two hours during sleep then I can make it to jon for a big pee instead of waking up with a full pad (yuck)

Do I keep running and pelvic exercises anyway? I have first appt with a local pelvic PT today. I hope that helps.

Thanks for any advice fellow post prostate surgery trail runners.

Trail Runner in CA USA

Edited by member 30 Oct 2024 at 13:50 | Reason: I would like to limit my responses to fellow runners who are passionate about their running, especia

User

Posted 28 Oct 2024 at 22:08

My immediate reaction is that you are overdoing it. You need to slow down until you have control over your incontinence. The outer sphincter, which is the only one you have now, needs to be 'trained' gently over a period of time. I was about your age when I had prostatectomy and it took me three months to regain a reasonable level of continence when I started doing long walks and gentle exercises. Patience is a virtue. Of course my opinion is subjective based on my experience and advice from my urologist.

'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.' Richard Feynman (1918-1988) Nobel Prize laureate

User

Posted 29 Oct 2024 at 22:28

Brian, you are at a pretty early stage so you can expect massive improvements.

But your experience matches what I had, and to a lesser extent still have. Basically, before the operation you (and I) had two sphincters one at either end of the prostate. Removing the prostate often damages the function of the top one leaving the other to cope - but that muscle tires as the day goes on. And it will tire more according to what you do.

I am not a trail runner, but I enjoy good walks and those are fine in the morning. My wife likes us to go out on a summer evening, but under those circumstances I leak. It is easier to rationalise in retrospect than to plan, but it is clear that anything the works the remaining sphincter hard makes me leak more at the end of the day. That can be as simple as holding on to a full bladder, unavoidable if you are away from home but increasing leaks later in the day. Or something that involves using the "core" muscles, so exerting when gardening or even just holding a position while doing something like a bit of decorating. And like you say, working the sphincter with the pelvic floor exercises can reduce the stamina to keep functioning as the day goes on. I now just do those exercises in the evening.

Good luck, in my case it took around 6-8 months to stabilise.

User

Posted 29 Oct 2024 at 22:43

Thanks J-B. I appreciate you sharing your experience.

Brian

User

Posted 29 Oct 2024 at 22:45

Thanks Pratap. My new pelvic floor PT ok'd my running so I plan to proceed. Still I like hearing your perspective.

Brian

User

Posted 30 Oct 2024 at 05:36

I am with Pratap - you are overdoing it. Your pelvic floor is only getting a rest at night and you get the benefit in the morning.

It took me years to get reliable control in all circumstances, any physical stress would be what caused a leak. Being tired made it worse. I was also advised to stick to the pelvic floor routine and not overdo them.

Notification

Join the online community now.