Visit with Urologist, Next step with incontinence

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JessTac
Regular Member


Date Joined Sep 2014
Total Posts : 57
   Posted 5/2/2015 3:54 PM (GMT -6)   
Hello fellow travelers,

I had my 14 month post surgery PSA drawn yesterday. Won't know for a week
to 10 days about that. Always a little nerve racking.
I still am incontinent on standing,walking, exercising, etc to the tune of 200ml a day
if I exercise. 80 ml/day if I sit most of the day.
I agreed to have the bulking agent Coaptite injected around my sphincter to help
with this. This is a first step in the march to an artificial urinary sphincter or sling if this doesn't work.
Has anyone had any experience with this?
Thanks,
Jess

Robotic Prostatic Surgery 3/14
3 PSA tests so far < 0.008
Pathology: Gleeson 3+3, Tumor had microscopic extension outside capsule but short of surgical margin
Seminal vesicle, bladder neck negative

Aussie Amnesia
Regular Member


Date Joined May 2014
Total Posts : 87
   Posted 5/2/2015 6:57 PM (GMT -6)   
I trust you did your kegels regularly throughout...as I did but still dribbled at times after 15 months. What finally helped was stream stopping at least 3 times each time i pee, this it seems gave me more control til now I'm virtually dry.
PSA @ diagnosis 6.2 nil symptoms.@ age 65
Robotic Prostacectomy & Pelvic Lymphnode dissection 07/13 Surgeon: Geoff Coughlin, Brisbane
Gleeson 7 (4+3)
Surgical margins negative, LV: present
PV: present
Tumour stage: pT2pNO Lymph node: 29 negative nodes
PSA Post Op:.02 @3mths:.01 @6mths:.02 @9mths:.05 @10mths .06 @12mths:.08 @15mths .14 retest @16mths .12 @18mths .16 No ED SRT started

JessTac
Regular Member


Date Joined Sep 2014
Total Posts : 57
   Posted 5/3/2015 7:01 AM (GMT -6)   
AA,
I did do the kegels and still do regularly. There is some conflicting info about stopping in midstream.
My uro said not to do it on a regular basis. Just do it to evaluate your ability to do kegels properly.
I think I am simply one who is in the incontinent group.
Thanks for your comment,
Jess
Biopsy 12/13 1 core positive G 3+3
Robotic Prostatectomy 3/14, G 3+3, pT3a : a microscopic focus of adenocarcinoma is seen to
extend beyond the prostate capsule into periprostatic connective tissue-block 4) ; Margin : R0
distance of tumor from closest margin less than 1 mm) . Neg Seminal Vesicle, Neg Bladder Neck.
Perineural invasion present within but not outside the prostate.
Incontinent,Impoten

Jazzman1
Veteran Member


Date Joined Sep 2010
Total Posts : 1152
   Posted 5/3/2015 1:27 PM (GMT -6)   
Hi Jess,

I'm sorry to hear about your problems, and I think it's good that you want to do something about it. Incontinence is maddening, and life is too short to live with it. After 14 months, I think it's time to act.

Between the sling and the AUS, the sling is the more conservative approach. You want to try to find a urologist who's really experienced with this. They'll do urodynamics testing to see if you're a good candidate for the sling and that will give you much better information on which to make a decisions. The tests are easy, but leave your modesty at home when you go in.

I have the AdVance sling, which has worked really well for a lot of guys here. It didn't completely solve my problem, but things are much better since I had the sling surgery. It was certainly worth it.

Whatever you decide, I wish you dryness. Only somebody who's been through it can understand how utterly frustrating incontinence really is. I'm always glad to see guys like you who want to act on it. I hope you get some relief.

Best,

Jonathan
Age 59

Biopsy 8/10
Three of 14 cores positive: 10%, 60% & 80%
Stage T1C; Gleason 6
---------------------------------------------------------
open RP at Cleveland Clinic 11/10
Post-surgical pathology: Gleason 7 (3+4)
Three positive margins; Stage T2c(+)
PSA since surgery: <.03
----------------------------------------------------
AdVance sling: 12/11 -- Drier than before

JessTac
Regular Member


Date Joined Sep 2014
Total Posts : 57
   Posted 5/4/2015 7:59 AM (GMT -6)   
Jazz,
Thanks for the encouragement. I have just retired and I am ready get something going on this because I
try to stay active.
The plan is for the bulking agent 1st and then to look at the sling or AUS if that doesn't work. I'm all in now
that I am retired
I appreciate your comments.
Jess

teddydog
Regular Member


Date Joined Feb 2013
Total Posts : 94
   Posted 5/4/2015 11:13 AM (GMT -6)   
Ask your doc about Imipramine.  It's an antidepressant, but helps with incontinence issues. My boyfriend was having issues 2 years after.  Starting taking and it worked wonders.  Still a dribble with heavy exertion but all in all, 90% better.  Was at 2-3 pads a day. Now, down to 1 for safety reasons.

Jazzman1
Veteran Member


Date Joined Sep 2010
Total Posts : 1152
   Posted 5/4/2015 5:57 PM (GMT -6)   
Jess,

Let us know how the bulking agent works out. I'm curious about it.

Thanks,

Jazz
Age 59

Biopsy 8/10
Three of 14 cores positive: 10%, 60% & 80%
Stage T1C; Gleason 6
---------------------------------------------------------
open RP at Cleveland Clinic 11/10
Post-surgical pathology: Gleason 7 (3+4)
Three positive margins; Stage T2c(+)
PSA since surgery: <.03
----------------------------------------------------
AdVance sling: 12/11 -- Drier than before

JessTac
Regular Member


Date Joined Sep 2014
Total Posts : 57
   Posted 5/7/2015 7:25 AM (GMT -6)   
Jazz,
Will do. My "surgery" is scheduled for June 5. I just received a good PSA: <0.008 14 months post
robotic prostatectomy .
Jess
Biopsy 12/13 1 core positive G 3+3
Robotic Prostatectomy 3/14, G 3+3, pT3a : a microscopic focus of adenocarcinoma is seen to
extend beyond the prostate capsule into periprostatic connective tissue-block 4) ; Margin : R0
distance of tumor from closest margin less than 1 mm) . Neg Seminal Vesicle, Neg Bladder Neck.
Perineural invasion present within but not outside the prostate.
Incontinent,Impoten

JessTac
Regular Member


Date Joined Sep 2014
Total Posts : 57
   Posted 5/7/2015 7:29 AM (GMT -6)   
Teddydog,
Thanks for the suggestion. I may consider that at some point.
Jess
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