incontinence after laparoscopic prostatectomy

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IsleofGough
New Member


Date Joined Jul 2008
Total Posts : 12
   Posted 8/4/2008 8:27 PM (GMT -6)   
I am a surgeon but not a urologist and had a laparoscopic prostectomy about a month ago. I am dry at night but have to go quickly to the bathroom 5 times or so nightly. I have almost no bladder control after sitting or walking more than 15-20 minutes. I heard about the Afex system here on this forum. My urologist didn't mention it to me. I had been going through about 8 depens per day and didn't like the chafing. I ordered the Afex starter pack and everything is much better: no daytime wetness. It isn't totally comfortable but is a lot better than wet depens. I don't work for the company (didn't even know it existed until about two weeks ago). But for others like myself, you can order it by phone (no internet ordering) from http://www.arcusmedical.com/afex_catalog.htm. The telephone number is on their site. I hope this helps someone else. I'm looking forward to eventual continence, but realize that can take months.

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 8/4/2008 9:27 PM (GMT -6)   
Your family must be proud of you. Is this the second coming of Rapids.?
www.healingwell.com/community/default.aspx?f=35&m=239259&g=621885#m621885
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07----4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable
PSA August 08 <.001 undetectable

Post Edited (BillyMac) : 8/4/2008 11:39:23 PM (GMT-6)


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 8/4/2008 10:01 PM (GMT -6)   
I wish you luck.

KW
    43 at Dx and Surgery
    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).
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
     


IsleofGough
New Member


Date Joined Jul 2008
Total Posts : 12
   Posted 8/5/2008 9:51 PM (GMT -6)   
Thank you. Except for the incontinence, I am lucky. At age 53, I went in to see my doctor for a routine PE. He initially was not going to do a rectal exam, but I reminded him that this is normally done annually after the age of 50. He found a nodule. An ultrasound bx x 12 showed cancer in 1 mm of one sample only (missed by initial pathologists but picked up by reviewer). My path was T2c, so I am lucky.

kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 8/5/2008 9:59 PM (GMT -6)   
Hey Doc. Your only a month out. I would not worry about the leaking quite yet. Be glad you persisted and got the exam you needed.

KW
    43 at Dx and Surgery
    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).
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
     


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 8/6/2008 9:51 AM (GMT -6)   
                                                        tongue    Hi ~IsleOfGouge and Loved Ones,

 

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Welcome ~ New Friend from all the members here... on HealingWell.com 

 

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alex1
Regular Member


Date Joined May 2008
Total Posts : 29
   Posted 8/6/2008 3:14 PM (GMT -6)   
IlseofGough:

I had mine in February, and initial incontinence seemed much like yours (now non-existent). An outfit called Timm Medical makes a product called an "acticuff" to helps a lot with the urgency issues, but is not really very comfortable to wear for long periods. However, it really helped me on exericise periods, etc for a time. Website is www.timmmedical.com. Check it out.
58-year old attorney, no family history of PCa
Biopsy 12/29/2007 with 1 of thirteen samples positive; estimated 5% involvement
3+3=6 Gleason
TR2C Stage
RRLP on 2/21/2008 with excellent prognosis (no evidence;margins and other tissue clear) on cancer clearance and sparing of both nerve bundles
Post-OP:Actual involvement 15%, one lobe only; PCa fully contained in prostate-no involvement with other tissues and margins clear
Catheter out on 3/2/2008; fully continent by 3/31/2008
Undetectable PSA on 3/31/2008
Working on ED: 20MG Levitra every other day; Vacuum pump almost daily; some improvement, but not there yet
2d undectable PSA on 7/21/2008


IsleofGough
New Member


Date Joined Jul 2008
Total Posts : 12
   Posted 8/6/2008 3:29 PM (GMT -6)   
Kw: yours is a horror story. Good luck with your surgery. Alex1: thank you for the information. I see you were fully continent by one month. I'm not continent at all during the day. How long is reasonable to expect "mostly" continent (except for sneezes, overfilled bladder, etc.)?

IsleofGough
New Member


Date Joined Jul 2008
Total Posts : 12
   Posted 9/14/2008 7:35 PM (GMT -6)   
Two days shy of two months post op I suddently went from eight pads per day to two to three. For the past five days it has been two pads per day. I post this for those who are depressed seeing no progress.

DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 9/14/2008 8:45 PM (GMT -6)   

Surgery 10 months ago yesterday.

Down to a pad in March.....then fraction of a pad since then......SLOWLY but SURELY a little better as time passes.

Now very slightly....and I mean slightly....incontinent.  Wear a very thin pad just to be cautious...but unless I am exerting myself a lot or coughing I do NOT leak now.  Have to shake it real well when I urinate, just like before surgery, but progress sometimes DOES happen many months down the road.

DanMan


Danman Bob, Born 1951
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14; Biopsy result - 9 of 12 sticks showed cancer
Post-op pathology stated that cancer was confined to the prostate
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of late April 2008)
100 MG Viagra 3 times a week beginning December 2007
Osbon Erec-Aid Esteem manual pump for therapy beginning mid-February 2008
30 MG papaverine/1 MG phentolamine bimix injections beginning late April 2008
Five week post-op PSA 0.2, five month post-op PSA 0.1, next test August 2008


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 9/15/2008 11:15 AM (GMT -6)   
19 weeks (almost 4 1/2 months) post op now. I had monster butt pain for 6 weeks, so I just figure I lost the first 6 weeks as far as fighting incontinence.

10 weeks after the first 6 weeks (or at the 2 1/2 month mark if you "normalize" my timeline) I suddenly shifted from 7 heavy pads a day to 5 thin pads a day - and sometimes less. That's where I am now. Still battling stress incontinence. I coach my daughter's soccer team and I am just a soggy mess after practice, but - I feel like I am making progress and I really feel like there is a light at the end of the tunnel.

kcragman
Age: 52
March 2006: PSA 2.5

Dec 2007: PSA taken for insurance application. I did not see the results until late Jan '08 - after I was rejected. Their lab said PSA 4.5. PSA again in Feb '08: 3.7.

March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were cancerous and the 6th did not look good.

May 5, 2008: Da Vinci robotic laparoscopy at GW Hospital, Washington DC.

Post op: Gleason 9 (4+5). 15% of prostate involved. Stage: pT3a. Negative margins. Lymph nodes and associated glands all appear to be cancer free.

July 2008: PSA at 7 weeks was undetectable.
August 2008: PSA at 14 weeks (3 months) was undetectable.


rvtraveler
New Member


Date Joined Dec 2008
Total Posts : 3
   Posted 12/29/2008 3:39 PM (GMT -6)   
I had my surgery on 11/21/08 and according to the posts that I have been reading I am just about where everyone else was at my time frame. I go to bed with a clean pad at about 9 PM and I am able to use that same pad throughout the night until I wake up at around 7 AM (a few drips on the pad during the night). When I get up during the night (2 or 3 times) I can start and stop. Once I get up in the morning I can control it by going to the bathroom about every hour (the pad just has a few drops on it). Once lunch time comes or I start getting active then it just has a mind of its own. Once the afternoon comes it just drips-I do not know if the muscle gets tired or somethings else is causing it. I also notice that if I take a trip in the car to the store-once i get out to a standing position it just runs.

So about it-HOW I AM I DOING?
PSA started out at 2.0 and ended up at 4.5
Biopsy showed one out of 8 samples positive
3+3=6 Gleason
Post Op biopsy showed all margins clean but a higher Gleason of 7
Surgery on 11/21/08


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 12/31/2008 1:22 AM (GMT -6)   
RT, Just hang in there and keep doing your Kegeals. I'm sure your body will adjust soon.
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
     

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