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Incontinence for over 70s

User
Posted 16 Oct 2025 at 16:59

Can anyone of a similar age to myself (72) share their experiences of incontinence please.

I had surgery 3 weeks ago and find I leak constantly throughout the day  but not so much overnight. I did pelvic floor exercises for 3 moths before surgery and have continued them since twoc 2 weeks ago.

User
Posted 16 Oct 2025 at 19:33

Hi

It is very early days yet. The fact that you are dry at night is a very good sign. I was your age when I had RARP (Gleason 4+3) 15 years ago. My improvement was gradual - a couple of months - but then it plateaued and even now I occasionally leak and suffer from arousal climacturia which is a nuisance but easily dealt with, given a sympathetic partner. I am afraid our age at surgery can make it difficult to regain complete continence; also depends on the competence of the surgeon. Many do, so I wish you luck.  I would be happy to say more about my experience if you contact me again here or private message me. You have to have a few posts and responses before you can use the private messaging option.

 '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 16 Oct 2025 at 20:20
Coachgaz, agree with the above. I had surgery some years ago (I am about your age now) but being dry at night seems a reasonable stepping stone. My experience was that things improved over the following weeks and months but leakage was still a risk - I have never been pad free. It may take a little longer for an older patient, but not necessarily.

I am not sure I entirely agree with the suggestion is that a key factor is the competence of the surgeon. The surgeon's main aim is complete removal of the prostate and the cancer. The difference in anatomy between different men, and the fact that the sphincter at the base of the bladder isn't visible during surgery, means that no surgeon can be sure there isn't damage to that sphincter.

(That inner sphincter, or "sphincter vesicae", is made of smooth muscle, and since both the bladder wall and the urethra below the bladder have smooth muscle walls it is impossible to tell which bit functions as the sphincter - basically it depends on the nerve supply. It is not unusual for the functional sphincter or at least part of it to be partially within the bit of urethra which is inside the prostate, in which case it will be damaged during removal of the prostate).

User
Posted 16 Oct 2025 at 21:11
Hi

I am a bit younger than you at 66 ,I had surgery in January .I was pretty much dry straight away at night ,In the day I was on 4 to 5 pads per day .Walking and any straining increased the leakage .Keep doing the pelvic floor exercises ,my surgeon increased mine to 6 sessions per day (3 X10 short and long squeezes)after 6 weeks .My improvement was progressive and by. 6 months I was Pad free.

My cousin who is 75 has just had the operation he was on 1 pad per day after 4 weeks,Most men do ultimately regain continence ,although there is a percentage who do not recover fully and may need further treatment,I hope that in your case this is not necessary ,Good luck with your recovery 👍

User
Posted 17 Oct 2025 at 07:26

Everyone is different. I was 57 when I had surgery and I must have been a nightmare to potty train as a toddler is all I can say! For the 1st few weeks post surgery I could not as they say hold water. What went in came straight out again! I was on about 9/10 pads a day and wet at night. At about 3 weeks I had a ‘eureka’ moment and began to get a semblance of control and dry at night. By 6 weeks I was down to 4/5 pads a day and then gradual improvement so by 9 months I was 1 pad a day (level 3). Now some 2 1/2 years later I still need a pad (level 2 only because I get them free!) a day for the occasional unexpected drip. Some days I’m practically dry others depending on what I’m doing I may get a little dampness in the pad. I also suffer when aroused - at least there’s a something coming out at climax! All in all it’s something I’ve come to live with and adapt to. Small price to pay for hopefully removing the cancer as so far all my PSA results have been <0.001. Undetectable. Good luck and as has been said it’s early days. 

User
Posted 17 Oct 2025 at 12:03

Hi J-B

I am afraid I beg to disagree with you about what happens to the internal sphincter (one at the base of the bladder neck) during prostatectomy; the internal sphincter is removed during the surgery. It is located in part of the prostate which is removed. Since it is at the bladder neck near to where the urethra is cut (and re-attached to the bladder neck after removal of the prostate) this sphincter no longer exists.

The internal sphincter is the involuntary one. Therefore after surgery the voluntary external sphincter has to be trained (Kegel exercises recommended for this, unless you are lucky and recover continence immediately after the removal of the catheter). Because this sphincter is located below the prostate there is a risk of damage; otherwise serious total incontinence ensues.

 

 

Edited by member 17 Oct 2025 at 12:08  | Reason: Not specified

 '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 17 Oct 2025 at 21:05

These two links probably explain things a bit better. The you tube video shows what is removed during prostatectomy and the other link explains the two (external and internal) sphincters. It does explain the reason why we need maintain a strong external sphincter to maintain continence after prostate removal. 

https://www.youtube.com/watch?v=Dki04FwMs3A

https://massinitiative.org/how-many-sphincters-control-the-flow-of-urine/

 

User
Posted 18 Oct 2025 at 02:04

I posted this link, the other day, about Complete Uretha Preservation (CUP)

https://community.prostatecanceruk.org/posts/t31994-CUP--Complete-urethral-preservation#post310655

It sounds a great idea, but I'm not sure if the sphincters are preserved.

User
Posted 18 Oct 2025 at 20:34
Pratap, I think we are in basic agreement about the location of the internal sphincter except that the textbook diagrams can be deceptive. They illustrate an "obvious" sphincter when no such exists, it is part of a continuum of smooth muscle wall of the bladder and urethra. A surgeon cannot identify it as such during an operation. It is part of the smooth muscle whose innervation is what gives it the sphincter function.

However what evidence there is - and prostatectomies are part of that - suggest that in some men at least part of the funcional sphincter is in the bladder neck which is retained after surgery leaving a degree of autonomic control, while in others the function is mostly in the proximal urethra which is excised with the prostate.

User
Posted 18 Oct 2025 at 21:46

The guest speaker at a recent support meeting was a surgeon. He specialises in the Retzius technique. I asked him about relocation and preservation of the internal sprinter, I didn't get a clear cut answer, alot seemed to depend on the individuals anatomy and the location of the cancer.

Thanks Chris 

 
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