Frequent Urination after Robotic Prostatectomy

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Prostated
New Member


Date Joined Aug 2010
Total Posts : 1
   Posted 8/13/2010 6:25 PM (GMT -6)   
Hi All,

First of all, I would like to thank everyone on this forum. It has been a great asset during my whole journey through my prostate cancer treatment, and it is an incredible wealth of information.

I am 56 years old, and underwent a robotic radical prostatectomy with Dr. Tewari a little over a month ago (gleason 3+4, PSA 5.01, 10% gland involvement). Fortunately, I have been doing well as far as continence goes; however, I have to urinate almost every 2 hours. Prior to the surgery, I had also found myself running to the bathroom quite often. I was under the impression that once the prostate is removed, the urinary frequency should start to decrease. In addition, I find myself getting up in the middle of the night to urinate a few times.

Has anyone else experienced this, and if so, is there anything that I can do to help decrease the urinary frequency? Any help or guidance would be greatly appreciated!

P.S. I will soon be going for my first post-op PSA, I hope that I too can join the 0 PSA club! tongue

DS Can
Regular Member


Date Joined May 2009
Total Posts : 193
   Posted 8/13/2010 6:33 PM (GMT -6)   
Welcome Prostated,
I'm glad to hear that your recovery is going well.  If you have been following this forum for a while you have had a great benefit to preparing yourself for surgery and recovery.
I remember the frequency of urinating getting better over time after the catheter was removed.  I had some pain issues with the catheter in place that bothered me initially.  I didn't have any problem with frequency or urgency before surgery so I can't help you there. 
Best wishes for continued healing. 
Thanks for signing on,
 
Dan
PSA Jan'07:1.2,  Jan'08:1.9,  Jan'09:2.5
BIOPSY Feb'09  PCa DX, age 52
Right: 3+3=6, 3/6 cores 10% involved,PNI-Y
Left:  3+3=6, 1/7 cores <5% involved,PNI-N
LARP April 9,2009 nerve sparing. Final pathology:
GS 3+4=7, Margins uninvolved, 2 lymph nodes negative
Catheter 8 days, Last pad May 2,2009
latest PSA: April 8,2010 <0.1
 
 

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 5176
   Posted 8/13/2010 6:44 PM (GMT -6)   
Yes, I did have urgency issues. But it improved significantly
 
Mel

63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.  As of 3/12/10--completely continent! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week). As of 6/22/10, I would say I am 100% continent, but I do have (controllable) significant urgency.

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in mid-June.

Second post-op PSA on 6/21/10--0.02--Not too bad!


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 935
   Posted 8/13/2010 7:06 PM (GMT -6)   
Yes, I got up several times a night to go to the bathroom after surgery. I was continent during the day but had issues at night. I did get better after a couple of months. I did my kegels every day and I believe that helped.
 
Age 48 at diagnosis
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
22 month  PSA <.04
continent at 10 weeks (no pads!)
ED is still an issue

Timm
Regular Member


Date Joined Feb 2010
Total Posts : 83
   Posted 8/13/2010 7:06 PM (GMT -6)   
It takes a little time for your body to figure out what to do, sounds like your doing great, hang in there it gets alot better.-Tim
58 yrs.
PSA 6.94 12/10
Bio. 8 of 12 cores pos. 2/1
Gleason 3+4=7
Da Vinci 4/14
Tumor volume 9%
Extraprostatic extension- within margins
Margins clear
T2c NO Mx
PSA. 6wks. surgery .01
PSA. 5 1/2 months .01

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24007
   Posted 8/13/2010 7:08 PM (GMT -6)   
Sounds like you are having a pretty good recovery period, good luck on that, and your first upcoming PSA test
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7/7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy, on Catheter #20

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 2676
   Posted 8/13/2010 7:59 PM (GMT -6)   
Your recovery curve is normal and you will likely have a lot of "abnormal " feelings in the whole area for the next at least 3 , more likely 6 mos.
age 67 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of Washington Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci, extensive PNI, That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
Dec 14,2009 psa 0.0 May 10 2010, psa 0.0

" Hypocrisy is vice's homage to Virtue " Francois de la Rochefoucauld, source courtesy of Tatt2

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2602
   Posted 8/13/2010 8:18 PM (GMT -6)   
I like to think we can "train" our bladders a little too. Post catheter, we tend to go every time we feel the urge so that we don't wet our pants. Our bladder becomes used to that, and so it tells us to go now.

I particularly do not like to get up in the night. Pre PCa, I would not get up to go.

After surgery, I would get up once or twice so I wouldn't wet the bed. I found that each time I felt the urge to go, I would wait until the last possible minute, and each time it seemed I could go a little longer.

Now I am back to sleeping all night, unless I drink too much before I go to bed.

I think you will be able to do the same.

Good luck.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 3607
   Posted 8/13/2010 8:41 PM (GMT -6)   
I will chime in here and say yep it looks like all of us that have had the surgery had the same issue of seeming to have to go too frequently. I can also agree with the others here it does get better with time. Part of the issue is we are haveing to learn how to hold longer and with time we start to feel almost like new. Im to years out and when I get the urge I know it is time to find a place. I am one of the lucky ones that have been dry sence removal of Cath.

I really sounds like you are doing great at this time.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1 pre cancer core
10/08 Nerve-Sparing open radical
Surgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clear

3 month: PSA <0.1
6 month: PSA <0.1
10 month:PSA <0.1
1 year: PSA <0.1
16 month:PSA <0.1

ED - Started Cialis at 3 months, tried all 3, 6 months added pump, 9 months Tried MUSE (YUCK) Bad experience.
1 year mark Found new Urologist visit was at 14th month post surgery
Started Injections, Caverject! (Success)
17 month: ED making improvements : Oral Meds gets me 85%

April6th
Regular Member


Date Joined May 2010
Total Posts : 263
   Posted 8/13/2010 9:58 PM (GMT -6)   
I concur with the group.

My surgery was June 1st and right after the catheter was out, I was getting up at night 4-5 times that first week and was pretty concerned but my Uro said it was in the normal range. Now 2.5 months later it has dropped to getting up 1x each night.

Prior to surgery I got up an average of twice a night and had a real weak stream so now that I get up just once a night and pee like a teenager, I am pretty pleased.

Hope your recovery continues to go well!

Dan
Here are some of my stats:
Age:54
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean
PSA tested on 7/15/10: Zero Club membership card issued (trial membership with 90 day renewal)

unhappycramper
Regular Member


Date Joined Nov 2005
Total Posts : 113
   Posted 8/23/2010 12:31 PM (GMT -6)   
Hey Prostated,
My username should be 'Frustrated'. I am nineteen months post my Robotic Radical Prostatectomy and here is my story. After surgery and nine days post surgery because of bladder leakage problems, they sent me home with both the JP bag (Jackson-Pratt fluid collection) and my trusty ol' catheter for seven weeks post-Op. Now I feel I have scar tissue from the catheter being in so long and it hurts to pee. I had to place those big blue square pads on my bed in case I would lose control at night. I was also using two to three depends daily because of leakage. Then after about a year, it went down to one a day, none at night. Then after a recent CT, it showed a 6.5x7.2 mass lesion on the outside of the bladder where he sutures
d the urethra back to the bladder and is now putting added pressure on the bladder which in turn makes me go more than before. I may have to have that fluid lesion removed.

Right after Surgery, My Uro put me on 25mg Viagra daily to help (he says) rejuvenate and stimulate any of the nerves left, and getting the blood flow active again. I did this for six months post-Op, then he put me on 100MG of the blue pill, but after a few more months, because of the cost, and insurance does not cover it, so I had to quit. I can still orgasm, but it's always a very frustrating for me and my GF the amount of time it takes to get me there, with a limpy, very flaccid, non-responsive member. (anywhere from 10-25 minutes) I want my stiffness back, but I no longer have (at this time) prostate cancer, so the best of both evils, will have to do. I guess I can't have it all! I do have a VacPump and should be using it everyday..ED doc says “use it or lose it”, it does help a little, but only a small increase of chubbiness, but not enough for penetration, then vac goes off, I lose it. Everyone id different, so don’t give up, your recent surgery is just that, recent, give it some time to heal. Doc also told me it could take up to three or four years to heal and get something back, if anything, so I may have to resort to trimax injections, then worry about accidentally hitting a blood vessel by mistake…Ahhhh, what we go through to get a decent erection, post Op. I may never get anything back naturally again, one could only hope, and also having a patient loving, non selfish GF also helps in the tension release department.

Next, My URO suggested I see a ED Doctor, which prescribed testosterone injections to up my Libido and sex drive,(which I don’t think I have any problems wanted satisfying sex. Because of my Neuroendocrine Carcinoid Tumor cancer, my oncologist told me NOT to take those injections because of some risk factors.

Then the ED Doc suggested a Pump implant….I have a problem with that. (too mechanical, and maybe a turn-off for her too) The only other option is to take Trimax injections, which my URO told me in some cases, the erection will last longer than four hours and become a medical problem and cause more symptoms. Sooooo…here I am. I did do kegals religiously for eight months post Op, but stopped, thinking it did not help as much.

I don’t want to sound like a downer, but some guys are much luckier rebounding than others, when it comes to this surgery and dealing with both the incontinence and sexual function areas.

Good luck to you, and to any other recent radical prostatectomy patients on this site!

fertree
Regular Member


Date Joined Jun 2010
Total Posts : 118
   Posted 8/23/2010 4:33 PM (GMT -6)   
Greetings Prostrated,

You will hear a thousand times, and it is true, that everyone is different. That said, my experience was that before the RP, I would get up twice per night. Immediately after the catheter came out, it was once an hour for the first couple of weeks, then once every 2 hours for the next couple of weeks, and now, after 5 months, I'm back to twice a night, where I was before the whole thing started. The only difference is that before the surgery it was twice a night at 5 minutes a crack, and now it's more like 5 seconds! I can live with that.
PSA 2.1 on Avodart
Biopsy: 1 of 12 cores positive >5%, Gleason 8
open RP: 05/10/2010 Dr. Gary Steinhoff, Victoria BC
Pathology: pT2c Gleason 3 (80%) 4(20%)=7, no lymph invasion, no extraprostatic extension, negative margins, tumor 5% of tissue.
Nerve bundles removed (based on original Gleason 8)
Incontenence: 6+pads for 9 weeks, dropped to 3 pads in 1 day.
First PSA >.01
Urethral Stricture requiring additional surgery Aug 20 (darn! If I'd known I was 80% Gleason 3 I could have gone for the robot, saved the nerve bundles and bypassed the stricture issue! In my next life, I'm having that biopsy sample checked twice!)

freinds
Regular Member


Date Joined Jun 2010
Total Posts : 75
   Posted 8/24/2010 6:18 AM (GMT -6)   
I too had the frequency at night. Usually up 4-5 times per night. At my one month checkup I asked my URO about it and he insisted that is was normal and that it would deminish. Now I am at about 7 weeks and it has indeed gone down, I only get up about 2 times per night now. I read somewhere that Magnesium tablets help with this so I bought a bottle of 250 mg magnesium tablets and began taking them about 2 hours before bedtime. This is about the time that the night frequencys slowed down significantly. Was it the magnesium or just the natural deminishing as the uro said? Not sure, but hang in there - I'm sure it will get better for you in time.
age 50, diagnosed April 2010

pre-op PSA 3.7
One month post surgery PSA ZERO
Gleason 6 upped to 4+3=7 post surgery

post op. surgical margins clear

Bone scan clear

freinds
Regular Member


Date Joined Jun 2010
Total Posts : 75
   Posted 8/24/2010 6:24 AM (GMT -6)   
just to clarify, I only took ONE of the 250mg tablets at night.
age 50, diagnosed April 2010

pre-op PSA 3.7
One month post surgery PSA ZERO
Gleason 6 upped to 4+3=7 post surgery

post op. surgical margins clear

Bone scan clear

Arch
Regular Member


Date Joined Jun 2010
Total Posts : 177
   Posted 8/24/2010 8:33 PM (GMT -6)   
I'm 3 months out and started at 5-6 times per night after catheter removed, now down to 3 times per night.
PSA 5.5 Jan 2010
Biopsy, both lobes involved
Gleason 3/4=7
Radical prostatectomy May 18, 2010
Catheter out June 3
Pathology: 15% involved, lymph nodes and vas deferens clear, margins clear
June 3-10 10-12 pads/day
2 months 8 pads/day
Aug 1, 2010 5-6 pads/day
Aug 20, 2010 3-5 pads per day
Aug 16, 3 month PSA: undetectable...woohoo!
ED 95% with viagara but not firm enough

Post Edited (Arch) : 8/24/2010 7:45:38 PM (GMT-6)

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