Newbie with continence questions

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StuckInTraffic
New Member


Date Joined Mar 2008
Total Posts : 14
   Posted 3/13/2008 1:54 AM (GMT -7)   
Hello Everyone
 
Just had my prostate removed on 2/27/08 (surgery went well) and foley out on 3/10/08. I have few questions regarding leakage:
  • In general how soon do you start seeing improvement? weeks, months?
  • Since the removal of the catheter, I've noticed that I can hold it for short period during the night (awake) but none during the day time, is it normal? wonder why and if anyone experienced the same?
  • Other than kagel, any other execise that I can do to help speed up the continence recovery?

Thanks.

 


Age: 48
DRE normal, PSA 3.1
8/28/07: Diagnosed cancer, T1c, Gleason 3+3=6
2/27/08: Laparoscopic Rad. prostectomy @ Anaheim Kaiser, 4 hrs.
              Both nerve bundles spared
              Pathology Report: Tumor confined w/in prostate
              T2c, Gleason is 3+3=6
              Surgical margin: Focally involved by tumor in right apex
3/10/08: Catheter removed.
 


Jetman
Regular Member


Date Joined Oct 2007
Total Posts : 30
   Posted 3/13/2008 2:43 AM (GMT -7)   
Hi StuckinTraffic,

I had my catheter in for 45 days because of an infection, an things were not healing the way they should have. I was told when the catheter came out that I would have a hard time regaining my continence. But by the 12th week after catheter was removed, I was pad free. Just give it some time, things will improve in a few weeks and hopefully you will have the same results as me. Just keep doing the Kagels, I did 50 a day. If things don't improve in a few weeks ask your doctor about Pelvic Floor Muscle Rehab. I went for this and I think it helped me recover much faster. My doctors office did the rehab at the office once a week. I went for seven weeks and stopped because things had improved so much that I didn't need it anymore.
56 years old
Had 3 Prostate needle Biopsies done in the last 8 years all negative.  
Last Biopsy done on July 6th, 07 Positive in one sample.
March 2007 PSA 10
May 2007 PSA 12.1
Pre-surgery Gleason grade 3+3=6
Sept 4, 2007- Robotic Laparscopic prostatectomy Surgery Nerve-sparing right side, took half of the left side, 
                    took Seminal vesicles, and vas deferens, bilateral, and 
                    Lymph nodes left side, pelvic. NO Malignancy found out side of
                    the Prostate.
Post Surgery, Pathologic Stage: pT2(m) NO Mx
                   Gleason score: 4+4=8
                   Tumor volume: approximately 35%
 Oct 19, 2007 - Catheter removed after 45 days
 Oct 31, 2007 - Start Pelvic Floor Muscle Rehab, once a week for 6 to 12 weeks for incontinence.
 Dec 18, 2007 - 1st Post op PSA  0.0 (undetectable)


JCL
Regular Member


Date Joined Jul 2007
Total Posts : 242
   Posted 3/13/2008 4:51 AM (GMT -7)   

You will see in the responses you'll receive that everyone is different. In my case I was out of the pads at five weeks, although I would still have some stress incontinence that was inconsistent and eventually went away over time.

As far as recovery I would recommend walking every day, and if you have stairs in your home, or access to an elliptical machine at a gym that can imitate a set of stairs, I would highly recommended it. Looking back I can see now that once I started doing 75- 100 flights of stairs in my house, and then started on an elliptical machine, my incontinence improved tremendously. In my case I felt that a combination of Kegeling, stairs and walking strengthened the pelvic floor muscles enough to speed my recovery along. The main thing is stay active. I run about 30 miles a week now and can stay dry, and still do Kegels just for insurance. Get that sphincter and bladder used to activity so it will adapt. Be patient. It sounds like you’ll be just fine.

 



Diagnosed: March 25, 2007. Age 49
Biopsy: Gleason 6. Five of twelve samples positive with <5% each. No perineural invasion seen.
Surgery: May 21, 2007
Post-op Pathology: Upgraded to Gleason 7 (3+4), negative margins, negative capsular penetration, negative seminal vesicles, lymph nodes left intact, multifocal perinural invasion, 15% of prosate involving cancer in both lobes. T2c
Continence: Out of pads at five weeks. Seven months post-op I'm fully continent.
Erections: Yes! With the assistance of Cialis.
Post Surgery PSA: Three tests, all <0.1
Family history: Great-great grandfather died from PC. My Father had his prostate removed at age 67 in 1997 and has had an undetectable PSA ever since. I was diagnosed at a much earlier age and had a more agressive cancer than my father. Go figure.

Post Edited (JCL) : 3/13/2008 6:04:33 AM (GMT-6)


Mike A
Regular Member


Date Joined Feb 2007
Total Posts : 213
   Posted 3/13/2008 5:49 AM (GMT -7)   
Hi S.I.T.
Welcome to the forum nobody wants to join. JCL is right, everybody heals at a different rate. I was certain after four weeks that having the surgery was a mistake, and that I would never be dry again. It was a few months before I saw any real improvement, and that was when I started to kegel during urination. Starting and stopping the stream, seemed to isolate the muscles that I needed to strengthen. I'm now 14 months post-surgery, and while I still wear a pad a day, it is mostly to catch a few drops. Don't give up or get discouraged. Give yourself plenty of time to heal!
Best,
Mike
June 2005 - Age 53 PSA 4.8 at regular physical October 2005 - After several rounds of anti-biotics, PSA 5.2 at Urlogist November 2005 - Biopsy negative July 2006 - PSA 5.9 at regular Physical October 2006 - After several more rounds of anti-biotics PSA 8.1 November 2006 - Second biopsy - Positive December 2006 - Gleason (3+4=7), Tumor T1c, CT Scan and Bone Scan Negative
January 2, 2007 Robotic Prostatectomy, University of Rochester Medical Center - Tumor confined but larger than thought, only one nerve able to be spared. Margins clear. February 2007 - Three to fo ur pads a day, no erection with viagara. April 2007 - First Post-Surgical PSA 0.02. Down to one pad a day.July, 2007 - Six Month Post-op: PSA 0.04 No change in ED. October, 2007 - Nine Month Post-op: PSA back down to 0.02!Almost totally dry! Only slight improvement in ED - Will try injections if not improved by next appointment. January 2008: One Year Post-OP PSA 0.02 still dripping, but improving. Tried 500 dose of MUSE for ED, no luck. Will try 1000.


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 3/13/2008 6:52 AM (GMT -7)   
Dear Stuck in traffic,
I'm about 4 weeks since catheter removal. My Doc told me that the first phase of regaining incontinence was staying dry at night. I get up about twice to go with no leakage in the pad. Daytime is a different story (about 3 to 4). I walk about 3 miles a day and do the Kegels. My Doc also said to measure my progress in weeks, not days. I drink a lot of water every day. It keeps my urine clear and minimizes stinging. I'm sure it contributes to the leaking. I am able to hold it longer each day without leaking so there is improvement. Be patient and hang in there. Everyone is different.

Joe
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C 


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 3/13/2008 6:54 AM (GMT -7)   

Everyone's situation is different.

I started out with 12 pads a day.....got up hourly during the night to change a pad.

12 quickly turned to 10, then to 6-8, then 5-6, then 3-5.....now 1 a day.

My incontinence recovery was hampered by an infected left testicle and a left groin hernia/hernia surgery, both of which were very painful and in the same general area as the muscles I was trying to retrain.

During most of this period, I have done several hundred kegel exercises a day, other than a month or so when my hernia pain was significant.

I recently found out about walking/ellyptical exercises as a means of helping, and am starting to do more of that.

I have been on 1 pad for almost 3 weeks.....not much flow, but even a little flow each day requires some sort of protection.

Be patient.....it is frustrating but it does generally get better with time.

Bob


Danman Bob
Age 57
Prostate removal November 2007
Gleason score 9, PSA 14
Biopsy result - 9 of 12 sticks showed cancer
Despite high Gleason score, cancer was confined to the prostate
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (1 to 2 pads a day)
Began using Osbon Erec-Aid Esteem manual pump for therapy mid-February 2008
Begain using Viagra 3 times a week December 2007 to stimulate blood flow


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 3/13/2008 9:22 AM (GMT -7)   
 
As mentioned before, we're all a little different in the healing process. As you can see by my signature, it took me about 2-3 month before throwing my pads away, but then, I'm a lot older than you. The fact that you can control your leakage at night has to be a good sign. The right kind of muscles are there and just have to learn to do their job all the time. It's important to be patient. Do as much walking as you can (but don't over do it). I also found that stair climbing and doing my kegel exercises really helped. Don't forget to rest and give your body a chance to heal as well.
Wishing you a complete and speedy recovery.
 
Magaboo



Born Sept., 1936
PSA 7.9
Stage T1C
-ve DRE
Gleason's Score 3+4=7
2 of 8 positive
Open RP 28 Nov 06
Post op staging T3
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06
Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA test Mar., 08 =.04 
 
 


StuckInTraffic
New Member


Date Joined Mar 2008
Total Posts : 14
   Posted 3/13/2008 9:34 AM (GMT -7)   
It is nice to hear encouraging words from everyone and thank you.

Currently at night I only have to get up once to empty the bladder but during day time it's non stop dripping...

It appears the kegel and other excercises all have upsides but I think I should start slowly to make sure I don't put too much stress on the surgery areas and allow it to heal completely. Occationally still see tinted of blood in the urine if I do too much activities.

yes, I shall be patient...don't have a choice :)
Age: 48
DRE normal, PSA 3.1
8/28/07: Diagnosed cancer, T1c, Gleason 3+3=6
2/27/08: Laparoscopic Rad. prostectomy @ Anaheim Kaiser, 4 hrs.
              Both nerve bundles spared
              Pathology Report: Tumor confined w/in prostate
              T2c, Gleason is 3+3=6
              Surgical margin: Focally involved by tumor in right apex
3/10/08: Catheter removed.
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 3/13/2008 10:46 AM (GMT -7)   

:-)    Hi ~ StuckInTraffic & Loved Ones ,

 

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Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 3/13/2008 10:53 AM (GMT -7)   
Hi StuckInTraffic,
First I bet that screen name has something to do with the 91 freeway. I went to high school at Esparanza just around the corner from that Kaiser facility. Lived there for about twelve years. My Step mother retired from that building over 15 years ago. I was driving past that hospital on the 10th this month, cooincidentally. (Always get off at Lakeview when visiting friends in the area).

Welcome to the best site on the web for patient to patient interaction for prostate cancer. I searched quite well for a place to say my frustrations only to be picked up by the folks here. Stay with us and stay positive. There are many that have had similar results that have improved dramatically. In time you will be one of them. You are very fresh from the surgery. I was lucky in that way and have had very little issues with continence. I might have traded that for a better pathology, but things are as they are. I wish you well. I also lend you prayer that you are now free of this disease. God Bless you and be well.

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (1/08): <0.1
I will continue HT until May '09. 
Visit my Journey at:
 
STAY POSITIVE!
 
Prostate Cancer Forum Moderator


StuckInTraffic
New Member


Date Joined Mar 2008
Total Posts : 14
   Posted 3/13/2008 11:38 AM (GMT -7)   
Hi Tony

Yes the screen name has something to do with all the traffic around here and fwy 91 is one of the worst. In addition, my professional work also involves traffic so I am actually stuck in traffic.

My mind is at ease somewhat after I found and read the posts and the support one's get on this forum.
Age: 48
DRE normal, PSA 3.1
8/28/07: Diagnosed cancer, T1c, Gleason 3+3=6
2/27/08: Laparoscopic Rad. prostectomy @ Anaheim Kaiser, 4 hrs.
              Both nerve bundles spared
              Pathology Report: Tumor confined w/in prostate
              T2c, Gleason is 3+3=6
              Surgical margin: Focally involved by tumor in right apex
3/10/08: Catheter removed.
 


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 3/13/2008 3:12 PM (GMT -7)   

Stuck-in-Traffic,

Only a few weeks since surgery?  Yes, take it easy.
But do walk a little more each day.

Do some kegels even now.  Probably 3 sets of 10 / 3 times a day until the urine is no longer pink, then ramp up a bit.  (Click on my incontinence thread in my signature for a few dialogues on the topic of kegels & types of kegels such as elevator kegels.)
The stop the stream pelvic-floor-muscle-identifying-exercise, the stairs, the elliptical - all good ideas.
Your recovery sounds better than average and you will likely be pad free by week 12 or 16.
Perhaps much sooner.  Patients seem to slowly get down to a few pads a day and then it tends to just happen very quickly.
A humbling exercise that will REALLY focus your consciousness on the muscles invovled is to:
   stand over the toilette with a full bladder, "kegel down" and cough....
       ...or walk up and down the stairs (nude, with an old t-shirt for a catch rag)
       with a full bladder and cough.
Letting your bladder fill up completely while reclined and/or sitting will help with the "settling" that must occur between the displaced bladder and the shortened urethra.
I would rehydrate after work, knowing that my bladder would fill as i sat and reclined for the evening.
Exercising (without over-doing it) also helps this process.

Your Friend,

CCedar
ICTHUS!


2 Years of PSA between 4 and 5.5  + Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.  +  Gleeson 3+3=6
OPEN R P 16FEB07 at age 54. 1+" tumor - touching inside edge of gland.  + Confined:)
Pad Free @ 14 weeks.  PSA: 6 mths <.003  :)   9mths <.008
:)  1 Yr <.008 :)
At 1 yr, ED treated with 100mg Viagra Often -  5 Year Colonoscopy 19FEB08:  Clear!

kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 3/13/2008 7:59 PM (GMT -7)   
Wish I could be some help but nothing has worked for me. I do not mean to scare you but a rare few of us continue to have problems many months (16 so far and counting) after surgery. The only thing good out of this is all my psa's have come back 0.00's!
Hope things dry up for you soon but you are not alone if it does not.

Good Luck,
KW
    43
    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. 4th, 2008 - Appointment with Original Dr. to discuss options and recomendation for surgical fix for incontinance.
    Feb. 22nd, 2008 - Surgery to install the AMS AdVance Male Sling.
 
     

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