Post surgery constipation problems

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 23847
   Posted 11/19/2008 12:28 PM (GMT -6)   
Prior to this pc surgery, never ever had constipation, regular as clockwork  The day before surgery, had a drink 40 oz of nasty tasting laxative.  made me go to toilet 22 times that day alone!  Have not passed bm since surgery, Nov. 1th.  One reason they kept me an extra day, but despite 3 suppositories, 3 liquid laxatives, and doses of warm prune juice (yuck), not a thing, not a sqiurt or even a baby turd, so the sent me home anyway.  Nothing is working here.  What else can we try or do?  At some point this might turn into a big problem.  Cant do enema, too dangerous  according to my sugeon  Other than minor gas, nothing is happening.
 
David in SC
Age 56, 56 at DX
 
PSA 2007 5.8
PSA 7-2008 12.3
PSA 9-2008 14.9
 
Biopsy 9-2008 Positive
7 of 7 cores positive, ranging from 40 - 90%
2 tumours noted, Gleason 4+3 and 3+4
Periunual Invasion noted
Additonal High Grade PIN noted
 
Open RP surgery completed on Friday, November 14, 2008 at
St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon,
Nerve bundles not able to be spared, awaiting pathology report, Cath scheduled to be removed on 12-15-2008,


M. Kat
Veteran Member


Date Joined Jul 2006
Total Posts : 715
   Posted 11/19/2008 1:04 PM (GMT -6)   
David, it sounds like you are doing the right things. be sure you're walking, too. I assume you passed gas since that was the requirement for Jeff before he could leave the hospital. Jeff did not have a BM for several days either (and had to drink some liquid laxative to get things moving) and it was somewhat painful, but once that first one was done, things moved along well. (sorry, I just had to say that! tongue) Check with your doctor if it gets to be too long a period. how long is too long? I don't know.... kat
Husband Jeff 56 years old diagnosed July 27, 2006
PSA 6.5, 2 positive areas in biopsy, Gleason 3+3=6
Radical Retropubic Prostatectomy August 30, 2006
pathology report - all clear - cancer gone
1st post-surgery PSA test <0.1, 2nd post-surgery PSA test <0.1, 3rd PSA <0.1
no more pads Oct 12, 2006
first "real" erection with use of pump 12/16/06
3/07 - occasional dribbles and erections with Cialis and pump
8/07 - 1 yr PSA <0.1
9/1/07 - achieved erection with Viagra - no pump!
3/08 - 18 mo PSA <0.1
switched to Levitra - works much better than Viagra & Cialis - fewer side affects
summer of 2008 - have had a few erections with no drugs! yeah!!
8/08 - 2 yr PSA <0.1


BillSD
Regular Member


Date Joined Sep 2008
Total Posts : 142
   Posted 11/19/2008 1:33 PM (GMT -6)   

David,

I had the same problem and almost freaked out when I didn't have a decent BM for several days after surgery (almost a week). But of course it FINALLY came. Just a word of warning. Do NOT try to force it. Take stool softeners and laxatives and let nature take its course. Hope that is a word of encouragement from one who has been there. And oh yes, if you are taking iron supplements, as I did, don't let the discoloration bother you.

BillSD


Age 59 at diagnosis (Now 60)
PSA 4.4
05/15/2008 – Biopsy
Gleason 3+3=6
Most cores positive 40% or more, some 100%
Bone scan and pelvic/abdomen CT show no visible metastasis
06/15/2008 – Began two months Casodex 50 mg
07/01/2008 – Trelstar shot (3 month dose)
09/15/2008 – Retropubic Radical Prostatectomy
Pathology: Staging pT2c pN0 MX
Gleason post op: 3+4=7
No discrete tumor mass
Bilateral involvement
No capsular penetration (carcinoma extends into but not through capsule bilaterally)
Perineural tumor invasion (PNI): present
Perineural margin: Free of carcinoma
Bladder neck: Free of carcinoma
Distal (Urethral) Margin: Carcinoma present
Seminal Vesical: None present
Lymph Nodes: 18 nodes free of metastatic carcinoma
10/13/2008 - PSA <0.1 - disclaimer: I had HT, so...
12/01/08 - Begin 35 treatments EBRT (adjuvant radiation because of concern for positive distal margin and PNI)
 
 
 


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 11/19/2008 1:39 PM (GMT -6)   
David...it took several days for me as well. I was really bothered by that because I didn't want to be constipated. The prune juice and other laxatives just didn't work. After several days of eating lots of solid food and with the build up of laxitives in my body, it finally worked. But yuck...it was that tar sticking goo stuff and with the little muscle control I had at the time, it was really a mess to clean afterwards. Don't worry though, soon you will be back to normal. If it persists, then call your doc for advice.
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base)
Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1,2008
Gleason 7 (4+3) Staged pT2c NO MX
Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA Oct 08 <.05


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 11/19/2008 1:43 PM (GMT -6)   
Oh and a suggestion...while sitting on the bathroom comode, get a foot stool to bring your knees slightly above your waist line...helps open the passages a little and relax the muscles. Just a tibit of info from having been in your shoes.
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base)
Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1,2008
Gleason 7 (4+3) Staged pT2c NO MX
Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA Oct 08 <.05


RBinCountry
Regular Member


Date Joined Apr 2008
Total Posts : 270
   Posted 11/19/2008 2:20 PM (GMT -6)   
This is obviously a problem that all of us had to varying degrees - I had it as well. I followed the same routine as the rest of you. I can only say that having had the good ole enema before surgery, and eating nothing but liquids before and after - part of it is there is not a lot there. It is not like you just ate two plates of enchiladas. I worried about this also, but it came about when it came about. "This too shall pass!" (pun). Take some stool softener so that when it does happen you will be able to handle it. It will happen!

RB
Age 61 (now 62)
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04
2nd Post PSA <.1 10/30/2008

6071
Regular Member


Date Joined Jul 2008
Total Posts : 108
   Posted 11/19/2008 4:08 PM (GMT -6)   
yes i had the same problem i got milk of magnesia on day 4 and it worked for me
Age 61 at DX
PSA 2/2007 5.71
PSA 4/2008 7.23
Biopsy 5/2007 Negative
Biopsy 7/2008 Positive 1 of 12 cores positive 3+4 5% To 10%
Open Radical Prostatectomy 15/10/2008
Stage pt2c
Post op staging Gleason's Score 3+4=7
apical margin is focally positive
no extraprostatic extension
Seminal vesicles and lymph nodes clear
the vas and the bladder base clear
Catheter out on the 13/11/2008
 
 




Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 23847
   Posted 11/19/2008 6:56 PM (GMT -6)   
So happy to report, no longer having a BM problem, resolved itself around 630 PM this evening, just as several of you and my doctor said it would. Gee, this is some club we are in when we are happy to report something this mundane to the world. But thankful to have the pressure relieved inside, and one less thing to worry about.

David in SC
Age 56, 56 at DX
 
PSA 2007 5.8
PSA 7-2008 12.3
PSA 9-2008 14.9
 
Biopsy 9-2008 Positive
7 of 7 cores positive, ranging from 40 - 90%
2 tumours noted, Gleason 4+3 and 3+4
Periunual Invasion noted
Additonal High Grade PIN noted
 
Open RP surgery completed on Friday, November 14, 2008 at
St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon,
Nerve bundles not able to be spared, awaiting pathology report, Cath scheduled to be removed on 12-15-2008,


SebringR
Regular Member


Date Joined Oct 2008
Total Posts : 29
   Posted 11/19/2008 10:00 PM (GMT -6)   
Dont be surprised if that problem comes and goes for awhile.  I kept the stool softner around for the first 6 weeks.  Whenever I had gone a day or two I would have one of my grandsons applesauces with a sponge bob cup of prune juice.  seemed to work.
 
Keep up the regular walking it helps a lot.
Age 51
Father died of prostate cancer at 73
Yearly PSA testing.
Biopsy after PSA went up .75 in one year
6 of 12 in needle biopsy where cancerous
DaVinci surgery 4/15/2008
Last PSA .008
 


Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 374
   Posted 11/20/2008 5:38 PM (GMT -6)   
I didn't have my first post-op BM for about 3 days. For the first month, my Urologist recommended twice-daily dosages of Senokot to help soften the stools and keep things flowing; it worked well and I've experienced no constipation problems.

Age:  59 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (getting better, though)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0

 


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 11/20/2008 7:21 PM (GMT -6)   
I don't recall how long it took me for my first BM....but I remember wanting a SSN for it cause I was sure I had just delivered a baby!!!!...OOOOUUUCCCHHHHH!!!
Good Luck,
KW
    43 at Dx and Surgery (RRP)
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - Nerves on right side saved. All Lab's clear. 
    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.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second Opinion Consultation for Incontinance at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 22nd, 2008 - Surgery to install the AMS AdVance Male Sling.
    March 27th, 2008 - Sling not working, Little or no improvement.
    April 18, 2008 - Collagen injection.  Back to using 4-6 full pads a day within a week.
    May 14, 2008 - Another collagen injection to try to Band-Aid the leaking for our June cruise.  Will start making conusultation appiontments for AUS after we return.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    July 30, PSA 0.00.
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
    Oct. 6th, 2008 - AUS Activation by Dr. Morey
     


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 1362
   Posted 11/21/2008 1:38 AM (GMT -6)   
Stool softeners work eventually, but the wait can be anxiety-producing. For me it was 4 day before sweet relief!
PSA quadrupled in 1 yr (0.6 to 2.5)  
DRE neg  1 of 12 biopsies pos (< 5%) 
Open surgery June 06 at age 57
Organ confined to one small area Gleason 5   
PSA's undetectable  < 0.1  


Lungman
Regular Member


Date Joined Jan 2008
Total Posts : 276
   Posted 11/21/2008 9:22 AM (GMT -6)   
I also think this is an almost universal problem, primarily to the anesthesia and pain meds slowing down the intestinal movement. You are right KW, I think that is the closest I have came to giving birth!! I used stool softeners for about 3 mos, 100 mg colace. Occasionally, I would need a mild laxative. I also was aware of increasing my fiber intake to help. The single packet All Bran works nicely, and since it mixes with bottled water, takes care of helping to increase fluid intake as well. Purgatory, this is indeed a special club, where BM's and erections can share space, never thought I would discuss the two together, but at least we are not alone, and we all understand.

Randy
46 you when diagnosed, now 48
Pre-Op PSA 9.9
1 of 12 cores positive, Gleason 3+3
DaVinci on 9/5/2007
Post-Op Gleason 3+6, Negative Nodes and Margins
Less than 1% of prostate involved with CA
3 Month PSA 0.01, 6 Month PSA 0.01, 9 Month PSA 0.01
One Year PSA 0.01
Incontinence resolved 9/15/2007, one day after cath removal
ED showing significant improvement.
Occasional Success with Oral Meds
Success with BiMix


wallypm
Regular Member


Date Joined Apr 2008
Total Posts : 48
   Posted 11/21/2008 10:15 AM (GMT -6)   
I also had the same problem and experienced continued problems for a while. My best success was stool softeners and walking. After a while I got offf the stool softeners and started taking Dannon Activa on a daily basis.
Age 70 -  Diagnosed late March
PSA 5.52 - stage T2b,T2c
Gleason 7 (4+3)
quad heart bipass 4/06/06
surgery on 4/28/2008, Greensboro NC by David Grapey
path report showed  lymph nodes clear cancer has spread to the margins gleason (4+3)
catheter removed 5/8
Post surgery PSA 0  at 4 weeks


55 and healthy in NJ
Regular Member


Date Joined Apr 2009
Total Posts : 56
   Posted 5/22/2009 3:10 AM (GMT -6)   
Once again you guys have come to my rescue.  Here it is at 4 in the morning on Day 4 after surgery, and my stomach pains have awoken me from my sleep, making me question whether I've done anything wrong, since my doctor told me to make sure I'm having BMs by now.  Started slowly with the solid foods due to blood in the urine (see my report at "Greg's RALP" http://www.healingwell.com/community/default.aspx?f=35&p=1&m=1475616), and based on your posts here it sounds like I've been expecting too much too soon.  I'll continue with the colace and the milk of magnesia, and concentrate on high fiber intake.  I'll send the wife back to the store later today for some All Bran to go with my Weetabix.
 
I do have two questions regarding the posts:  when/why is too much liquid is a bad thing?  What/how exactly does walking help the constipation?
 
Greg

Age 55
Physical exam (01/22/2009): blood pressure 130/85, good EKG; basically all-around healthy
PSA 4.9 (02/05/2009)
Urologist DRE observed slightly hardened left lobe (02/19/2009)
Chest X-ray normal (02/23/2009)
Biopsy (03/03/2009)
PCa present in all sextants, <5% to 50%
Prostate gland 37 grams
Gleason score 7 (in two sextants, scored 6 elsewhere)
Cystoscopy (05/08/2009), showed clear
MRI (05/08/2009), "No findings are present to suggest extracapsular tumor."
Robot-assisted (daVinci) laparoscopic radical prostatectomy (05/18/2009) by Michael Esposito, M.D. and Vincent Lanteri, M.D.  Both nerve bundles spared.  Awaiting final pathology report to verify that PCa was contained within the capsule.
 
 
Research:
Surgery (daVinci robotic) consult with Michael Esposito, M.D., http://www.roboticurology.com/ (03/30/2009)
Radiation oncology (Varian IMRT/IGRT RapidArc) consult with Mark Macher, M.D., http://www.njneuro.org/fp/gammateam.asp (04/08/2009)
Other resources: Dr. Peter Scardino's Prostate Book (Peter Scardino (Sloan-Kettering), 2005); Urologic Robotic Surgery (Michael Esposito, Vincent Lanteri & Jeffrey Stock, 2007)


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 5/22/2009 7:57 AM (GMT -6)   
When you have surgery there are at least three things that contribute to constipation. The anesthetic, the pain killers, and physical inactivity. The total effect is dependent on your dose and physiology. Drinking lots of fluid helps with the first two because it gets your kidneys to filter out the residual drugs. It also helps keep your stools softer. Short of forcing yourself to drink, I have not heard of too much water although I suppose you could upset your blood electrolyte balance. Walking gets the pelvic muscles active – not just the walking ones but all the associated ones as well. Remember that your body actually moves food through the digestive tract it is not just gravity.

Follow your doctor’s directions on laxative and stool softeners and if things aren’t moving along call the office. They would rather deal with you on the phone rather than in a more serious situation
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.

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