Incontinence and urge sensation

I agree with Pratap, it's early days, you're recovering from major surgery and it takes a while for your body to repair itself. Within a few days you feel great and want to power on through but your body is reminding you to slow down. Try not to get down about the leakage, it should improve as your recovery continues. 

Good luck, 

Kev.

I am now 10 weeks after the surgery. At your stage I was very similar. Before the surgery I was very fit and active.

What I find was that progress was very slow at the start but gradually got better.

If I had been out and had got very tired the day before I find that that really affected the incontinence in the day following.

on several occasions I've been out for a walk and have ended up with wet clothes which was not great.

But things have improved it is sometimes hard to see day-to-day that there is improvement but week to week there is.

You will get there don't worry too much about it it just takes time.

One thing that I have find that makes a big difference is making certain that I do poos before I go out because I have found that if I have the need to do that it puts a lot of pressure on the bladder and causes a lot of leakage so you don't want to have that feeling and result whilst walking.

I ensure I eat lots of food and veg and fibrous food and what I do is walk around the house for maybe five or more minutes until the urges comes to do the business.

I hope this helps.

Hi

I am 66 and had the RALP on 25th Jan ,Catheter removed after 1 week.

9 weeks post op I am reasonably dry during the night and use 4 or 5 medium pads during the day .

When I am walking or playing golf I tend to leak more .

At my 6 weeks review with my Surgeon he suggested I was using more pads than he would expect at this stage ,although he did then state that obviously some guys will change more frequently to avoid “an accident”.

I have been using the Squeezy app ,which I find acts as my Pelvic Floor exercise PA ,it won’t let you forget.

He said I could increase from 3 sets of 10 long and 10 fast squeezes per day to 5 sets but ensuring they were spaced out equally .

I think it’s important not to overdo it .

We are all different and will be affected by the surgery differently ,don’t stress too much what your experiencing seems pretty normal and from what I have learned on this site and from the published data on the side effects of RALP most of us will regain continence in time.

On a positive note the surgeon did advise me that the Biopsy on my removed prostate showed good margins and the cancer had not escaped ,this puts my incontinence issue in perspective.

Good Luck I hope you have a good outcome and that your incontinence situation improves.

I had my RALP on 9/1/25 and was doing 5 sets of kegels a day using the Squeezy app and got told off by my consultant a month later for over doing them.

He said I should follow what they outline on this site at: https://prostatecanceruk.org/prostate-information-and-support/living-with-prostate-cancer/pelvic-floor-muscle-exercises

I am in this same group: RARP January 15, 2025 catheter removed Jan 29

I am 71 so this likely changes things. I consider myself fit, active etc  at the same time as we age- just like old cars, some of the parts wear out and things take longer to heal

After catheter removal I was very incontinent. However in the weeks following I noticed some improvement in being able to sleep and stay almost dry during the night  (this may have been 2-3-4 weeks)

I now struggle with both stress and urge incontinence

the progression goes like this

* dry at night, semi dry at night

* better in the mornings ( drier, less pads less urge and/or stress incontinence)

* as time goes on better longer in the day, less pads each day

However, this is a trend and there is considerable variability

For many men this progression can go from three months to 18 months, some of course have no incontinence issues, some have chronic incontinence

I have noticed a need for more research and agreement about all of this especially in terms of treatments

Almost everyone recommends kegels (some do not) however, and I think this is a big deal there is a recognized lack of agreement regarding how many, what type and how often) this is sited in the latest meta-analysis specifically on this issue even the experts in the field recognize a lack of agreement and lack of good efficacy research. Still, it seems a good bet that kegels, bladder re-training, working with a specialist pt ( trained to work with men following prostratectomy) and bio-feedback

it worries me that some professionals continue to advance ten sets a day ( more is better, no pain no gain)

the recommendations seems to be all over the place ( two sets, three sets, five sets, ten second repeats of long kegels only, 20-30 repeats of 2030 second holds (hold as hard as you  can)

some do not recommend the short ones

as patients and in the prostrate community, we should work hard to find out what seems the better recommendations and share experience with one another

I have learned (experiment of one) that

* doing kegels correctly is very important

* too many are definitely counterproductive

* it is very important to not just train, build up bulk and make those muscles stronger and more responsive, it is equally if not more important to allow those muscles to rest, avoid over-training, and go along with some natural progress (listen to my body)

My therapist has me on two workouts a day

one set of progressive kegels (1/3 contraction, 2/3 contractions, full hold for few seconds then back down 2/3 -1/3 then rest)

one set of slower full contractions ( usually 15 seconds hold 15 seconds rest

four sets of ten fast contractions and and rest about two seconds each

Besides this, I am doing core strength exercises that incorporate kegels, stretches to help with abdominal space and pelvic floor expansion and rest

I have had one biofeedback session. I am now getting a handheld biofeedback device so I can incorporate this at home. For me, I really do need to keep an eye on form, make sure I am resting pelvic floor muscles (PFM) correctly and the biofeedback helps.

I have heard that others have benefited from the the various electrical stimulation devices exercisers. I am happy for those that benefited from these. However, there is anecdotal research that for some these can be problematic same for the emsella chair. My pt and in a recent consult with a leading urologist in my area, they advise against these techniques. My pt has personally encountered males who had major setbacks because of these. That was enough for me, again if it works for some, great

I share all of this in hopes it is helpful to some  I hate incontinence, it has definitely compromised my quality of life. I tend to be optimistic, the cancer seems to be contained now which is great, I tend to believe the incontinence will get better- I had no idea it would be like this but it could take me a year to get better and if it does not there are alternatives. Meanwhile, I want to be as careful as possible that I do everything I can to get better with continence.

as a small example, I tried riding my exercise bike after my first month, I kept the workouts short ( 20 minutes hill workout) after three mornings of doing this- I had a major setback in terms of continence. 

I backed off and tried again a few weeks ago ( three months out) I kept the workouts short about 20 minutes, similar results on the night of the third day, major setback, no sleep, little control, major leakage

I really need to take it slow which I hate, but I also hate being incontinent /

Any tips, suggestions, feedback is really appreciated

thanks everyone

I appreciate everyone that is part of this and shares