Enlarged prostate and (post-surgery) incontinence

Hi folks,

I know there are guys here that had both positive cancer biopsies and enlarged prostates. I think Contenance return depends on how your Surgery went and how your body adjust to all the changes.

Hope all goes well with your surgery and recovery.
KW

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Hi Phillysub,

I had BPH for around 5 years, with frequent and difficult urination in the evening (5-10 times a night). I had Da Vinci done nearly 12 months ago. Unfortunately I am still going through around 9 pads a day, and according to the various experts, little chance of recovering continence.

Berb

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59 years old
Da Vinci surgery Jan 10, 2007, nerves spared, no cancer detected outside prostate
Pre surgery PSA 8, Gleeson 3+4=7, T1C, 3 out of 12 biopsies had cancer
Complication 1: urine favoured drain tube over catheter, extra time in hospital, catheter in for 2 weeks
Complication 2 - urinary tract infection - Citrobacter (hospital bug), 6 weeks antibiotics cleared up
Complication 3 - fungal growth on genitals (candida albicans) probably from antibiotics
Aug'07 Urodynamic study for continuing incontinence 8 pads per day; diagnosed bladder neck stenosis
Oct'07 CT scan indicated nothing abnormal; cystoscopy showed narrowing at anastimosis - dialated
Dec 07 averaging 9 pads a day, started acupuncture
Post surgery PSA tests: all undetectable

Main factors which influence surgery side effects and prognosis are selection of a very good surgeon, and whether it is possible for him to spare one or both nerves.

Surgeons at Cornell have recently published details of greatly reduced post surgery side effects due to new surgical techniques.

I have an enlarged prostate, weighed 110 grams at removal, 4+ times normal size, and was continent within 2 days after catheter removal.  Continence is more a function of surgeons skill, proper kegals, and luck more than gland size, I think. 

James C.

This is an interesting question, that so far I have not seen answered.  I had no enlargment of my prostate and no continence problems.  (Few drips after two weeks)

What do the urologist say?

As far as I know it has nothing to do with nerve spareing for ed.

I, too, had a large prostate ("normal" for me, not due to BPH). I was down to 1 pad a day after 3 weeks and fully continent within 4 weeks. I have heard that the size of the prostate may affect whether the nerves can be damaged/spared, which affects possible ED. I've not heard of a link between the size and regaining continence.

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Puget

My dad had surgery on Dec 18, 2007 with Dr. Kowachi at the City of Hope Hospital in Duarte, CA.  Dr. Kowachi is a fantastic surgeon who has done over a 1,000 of the robotic prostatectomies.  He was extremely caring.  My father's prostate was 2 1/2 X the size of a normal prostate.  His catheter was out December 26th and he is down to two pads a day and feels he will have full control after another week.

I had an extremely large prostate before having it removed 6/27/07.  Now, 6+ months later I am very incontinent, going through about 10 to 12 pads per day in spite of doing daily pelvic floor muscle exercises.  about two months ago a specialist checked my bladder and determined that I will likely not get more continent and will likely end up needing a "sling" or an artificial urinary sphincter. Although I don't know for sure, I've assumed that my bad incontinence has been due to a very large prostate no longer being there to do the work of shutting off the flow. I am hoping to get a sphincter within the next few months.

I may be looking at the AUS soon myself. Getting tired of fighting the leaking. Let us know what you do and how it goes. I would be very interested....

Good Luck, KW

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KW,

Will do! You have fought a long hard journey. Don't feel bad if you have to get the AUS. From what I've heard, it will be a great relief!

I also have an enlarged prostate (90 cubic centimeters) and I am considering Da Vinci surgery. I am 72 years old and was diagnosed 2 years ago with
a Gleason score of (3+3) 6 and stage T1c. I have a consultation appointment with Dr Peter Carrol at University of California San Francisco (UCSF)
on March 6th, 2008 to discuss the possibility of Da Vinci surgery. As I look at it surgery would kill 2 birds with one stone, i. e. it would get rid of the BPH problem as well as the cancer.

Obviously, I am very interested in following your progress and would appreciate it if you would keep me informed.

Good luck on your surgery.

Thanks,

Charlie C

phillysub,
I also lived with BPH for about 10 yrs but when my PSA increased, I had the biopsy and the PCa diagnosis. My prostate was fairly large at 87grams. I had the robotic surgery and within 2 months post-op I was fully continent. I still urinate more often than I'd like, sometimes several times per nite. My surgeon had advised me before the surgery that I shouldnt expect that to change after surgery. He wasnt sure why, but guessed that the bladder gets used to emptying?? I'm not sure what to believe.
I had to wait 3 months for my surgery during which time I did the kegel exercises.. maybe that helped get me to continency post op? I'll never know but it sure cant hurt so I'd recommend you do them pre and post surgery.
good luck.

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Diagnosed Jan 07
PSA 5.79
Biopsy -12 samples, positive in 4, Gleason 3+3, T1c
Age 59
Surgery (robotic) June 1 2007
Final pathology - fully contained to prostate, <2% , Gleason 3+3
No leaking 2 months after surgery (Yahoo !)
6 month PSA <0.01 (Yahoo again !)
ED a work in progress. Taking 50mg Viagra daily.