Enlarged prostate and (post-surgery) incontinence

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phillysub
Regular Member


Date Joined Nov 2007
Total Posts : 64
   Posted 12/29/2007 9:25 PM (GMT -6)   
Hi folks,
 
I was wondering if there is any correlation between someone who had an enlarged prostate (BPH) and the success rate of continence after surgery. I've had BPH for 10 years without any PC. Then due to an elevated PSA, I had the biopsy and was "diagnosed".
During my experience of BPH there was the usual frequent and urgent need to urinate. I'm guessing that holding back that "urgency" is the same set of muscles that is dependent on for controlling continence.
 
So............my question is for the guys that have had surgery (open or robotic) AND had BPH.....what has been your success with continence post-surgery?
 
I'm curious to read your replies (I'm scheduled for robotic surgery on Jan 23).
 
Thanks.

kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 12/29/2007 9:32 PM (GMT -6)   
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
    43
    PSA 5.7 - Discovered during Annual Physical with Family Practice Dr.
        Biopsy Sept. 27, 2006 - Diagnosis Sept. 29 - 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
        RRP on Oct. 17, - Nerves on right side saved.
    All Lab's clear.  No Cancer outside prostate
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00
    Office visit on Jan. 19th due to continued excessive urine leakage.
    Feb.20th Cystoscope and 2nd Post Op PSA. Another 0.00.....:)
    Dr. said everything looks fine.  Continue to work Kegeal's. Leaking appears to have improved  after Cystoscope?!?!?!  Down to 3-4 pads per day!
    March 1st  Leaking has crept back up to 6 - 8 pads a day ??????? 
    March 29th Collagen injection into sphincter / bladder neck area to control excessive leaking.  Worked for a couple of days then back to leaking.
    April 17th (Six Months Post Op) 2nd Collagen Injection to control excessive leaking.  Leaking started back next day at work!
    May 14th Second Opinion about my leaking and Options at OU Medical Center.  After reviewing my records the Dr. feels I will probably need some surgical intervention to stop my leaking.  But did agree to try Bio-Feedback and work hard on the Kegeal's first!
    May 30th Follow up with my Dr. and 3rd Post Op PSA 0.00 agian!!!
    June 1st Start Bio-Feedback to try to control my leaking.
    Oct 17, 2007 1 year Post Op - Still fighting moderate / Severe incontenance. Using 4-6 pads a day.  Erections usable....sometimes!  Almost like before with 100mg Viagra!
    December 5th, 4th post op PSA 0.01!?!?!?   Is that still a 0?  Still leaking!!!!
   


Berb
Regular Member


Date Joined Mar 2007
Total Posts : 93
   Posted 12/30/2007 5:07 AM (GMT -6)   
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
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


aus
Regular Member


Date Joined Sep 2006
Total Posts : 211
   Posted 12/30/2007 5:21 AM (GMT -6)   

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.


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4453
   Posted 12/30/2007 12:53 PM (GMT -6)   

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.


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 584
   Posted 12/31/2007 4:35 PM (GMT -6)   

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.


 
Biopsy 10/16/06
T2A,  PSA 4.7
Gleason 4+4=8 right side
adrenocarcinoma of prostate
DaVinci Surgery 01/16/07
Post op report,confirms Gleason4+4=8
no extra extension/invasion identified
age 65
no continence problems
Back on the golf course...
90 day PSA  less than 0.01 (undetectable)
Six Month PSA still undetectable
Dealing with ED problems with Caverject/Viagra
nine month psa slightly elevated + .02
 
 
 


puget
Regular Member


Date Joined Mar 2007
Total Posts : 237
   Posted 12/31/2007 4:41 PM (GMT -6)   
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.
Puget
60 years old
Dx March 2007
Pre-Surgery Gleason 3+3 = 6
Clinical Stage: T1c
Biopsy: 1 in 10 positive
Da Vinci: June 7, 2007 
Post-Surgery Gleason 3+3 = 6
   Clear at margins
First Post-PSA Sept 07 = <.01 (Hooray!!)


middledaughter
New Member


Date Joined Nov 2007
Total Posts : 6
   Posted 1/4/2008 8:23 PM (GMT -6)   
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.
 
It seems the surgeon makes a lot of difference with research indicating that the learning curve flattens out after 250 surgeries.
 
Best wishes
 
Middledaughter

cowboy bob
Regular Member


Date Joined Sep 2007
Total Posts : 107
   Posted 1/4/2008 11:56 PM (GMT -6)   
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.

kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 1/5/2008 12:14 AM (GMT -6)   
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
    43
    PSA 5.7 - Discovered during Annual Physical with Family Practice Dr.
        Biopsy Sept. 27, 2006 - Diagnosis Sept. 29 - 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
        RRP on Oct. 17, - Nerves on right side saved.
    All Lab's clear.  No Cancer outside prostate
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00
    Office visit on Jan. 19th due to continued excessive urine leakage.
    Feb.20th Cystoscope and 2nd Post Op PSA. Another 0.00.....:)
    Dr. said everything looks fine.  Continue to work Kegeal's. Leaking appears to have improved  after Cystoscope?!?!?!  Down to 3-4 pads per day!
    March 1st  Leaking has crept back up to 6 - 8 pads a day ??????? 
    March 29th Collagen injection into sphincter / bladder neck area to control excessive leaking.  Worked for a couple of days then back to leaking.
    April 17th (Six Months Post Op) 2nd Collagen Injection to control excessive leaking.  Leaking started back next day at work!
    May 14th Second Opinion about my leaking and Options at OU Medical Center.  After reviewing my records the Dr. feels I will probably need some surgical intervention to stop my leaking.  But did agree to try Bio-Feedback and work hard on the Kegeal's first!
    May 30th Follow up with my Dr. and 3rd Post Op PSA 0.00 agian!!!
    June 1st Start Bio-Feedback to try to control my leaking.
    Oct 17, 2007 1 year Post Op - Still fighting moderate / Severe incontenance. Using 4-6 pads a day.  Erections usable....sometimes!  Almost like before with 100mg Viagra!
    December 5th, 4th post op PSA 0.01!?!?!?   Is that still a 0?  Still leaking!!!!
   


cowboy bob
Regular Member


Date Joined Sep 2007
Total Posts : 107
   Posted 1/11/2008 9:57 AM (GMT -6)   
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!

CEC
New Member


Date Joined Jan 2008
Total Posts : 4
   Posted 1/11/2008 6:53 PM (GMT -6)   
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
 

Post edited to mask last name for security… : )

 

Post Edited By Moderator (bluebird) : 1/20/2008 1:32:27 PM (GMT-7)


Grover
Regular Member


Date Joined Jun 2007
Total Posts : 29
   Posted 1/17/2008 2:33 PM (GMT -6)   
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.
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.


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 1/20/2008 3:46 PM (GMT -6)   

Quote from 1st posting above ~  12-19-07 phillysub said:


Hi folks,

I was wondering if there is any correlation between someone who had an enlarged prostate (BPH) and the success rate of continence after surgery. I've had BPH for 10 years without any PC. Then due to an elevated PSA, I had the biopsy and was "diagnosed".

During my experience of BPH there was the usual frequent and urgent need to urinate. I'm guessing that holding back that "urgency" is the same set of muscles that is dependent on for controlling continence.

So............my question is for the guys that have had surgery (open or robotic) AND had BPH.....what has been your success with continence post-surgery?

 

I'm curious to read your replies (I'm scheduled for robotic surgery on Jan 23).

 

Thanks.

 

tongue    Hi ~  Phillysub & Loved Ones,

 

Thinking of you and sending special thoughts your way as you move toward surgery day… 

 

We hope  “Our Journey” helps to guide you over at least one stepping-stone on your path.  Keeping you close… in thoughts and prayers. 

 

“Our hands will be on your shoulders”

special words borrowed from hamala

 

In Friendship,

 

~~*~~*~~*~~~)*&^%  Group Hug %^&*(~~~*~~*~~*~~

 

From the 3 of us...

Lee, Buddy, & Murphy

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