Leak Volume vs. Pads

I have found that having a pad count is not definitive so, I have started weighing my leakage. I am currently using 1 pad/day w/15 gms. of urine. This can certainly increase with activity and hydration, but is beginning to be somewhat standard. I am interested if anyone else measures their leakage, this way, so that I can get an idea of where I stand. I am approximately 9 months out from DiVinci at MD Anderson.

I don't understand what value there is in going through the trouble of weighing the pads - even if you could do that effectively (and if you're out and about and/or working it's not going to be easy to do).  When the leaking stops, you're better.  That's how I'm going to judge the incontenence issue.  My Urologist told me in a follow-up meeting this week that most of his patients leak for at least the first three months, after which most of them see a substantial improvement.  Some don't see the improvement until 6-months, he said.  At work yesterday - 8 hours (plus an hour each way in transit - for a total of 10) I used about 5 pads.  Today I took the day off and was running lots of errands - and in 3 hours I used 6 pads.  Some days are obviously better than others and activity level plays an important role in the number of pads used - from what I'm experiencing.

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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 (19 days post-op)

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

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

 

For most men who post on this site, 15 grams/day is practically dry.

I've just passed my 2nd anniversary from DaVinci. After the first year, I started weighing every day hoping I could see a downward trend. Despite using exotic curve smoothing techniques, the daily weighing was all over the chart from a low of 11 grams to a high of 500 grams/ day if I exercised a lot and then had a large, spicy meal.

As you can see from my signature, I did kegels, bio-feedback and had two collagen infusions. After all was said and done, I was still averaging 180 grams/day.

I had sling surgery on Sept 5.2008 and am now dry.

As to your question, I have an old chart I downloaded from a site which no longer exists showing weeks since surgery vs pad weight.

(Done by Anna Smithers in 2007. You can find more current work by Googling her)

It shows that at 35 weeks, 98% of men were < 50 grams, 92% < 10 grams and 84% < 1 gram.

This is in line with what my Uro said, that 95% of men are dry after one year (My personal opinion is that this is overstated, but that's just me).

You don't say what you've done to try to improve. Are you doing Kegels? Are you sure you're doing them correctly? Bio-feedback can help that. Collagen infusions will help for a sort time, but is rarely a permanent fix.

I'm very encougaged with the AdVance Male Sling procedure I had 5 weeks ago.(See my previous posts). For men under 200 grams/day it's a good solution.

Ed

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Ed from Rochester, NY 66 years old

PSA 6/06 1.9

4/06 Biopsy 1 core cancerous Gleason 3 + 3 = 6

8/06 Da Vinci Dr. Joseph, Strong Memorial, Rochester, NY

Gleason 3 + 4 = 7, negative margins

3 month PSA .01

6 month PSA .01

9 month PSA .02

1 yr PSA .01

1 1/2 yr PSA .02

2 yr PSA .03

1st collagen 12/07

2nd collagen 3/08

Imiprimine 7/08

still leaking about 120 ml/day 2 - 4 pad

AdVance Male sling procedure 9-05-08

Unable to void, catheter in for 11 days, then self-catheterization

Dry after Catheter removed, no exercise for six weeks from procedure date

My Doctor recommended weighing the pads too.  If nothing else it gives your Doctor a reference point of how you are doing.

I was using 4-6 pads /day when I went to see Dr. Webster about fixing the incontinence. Part of the pre-visit routine was to keep a log of how much I was voiding for three days, and to save one day's worth of pads for them to weigh at the visit. Being of a computer geek technical background, and knowing that some days were perceptibly dryer than others, the idea of a single day's volume as a measure of my leakage was a bother to me.

I started logging the actual volume, since I could have a 'dry' 6 pad day, and a 'wet' 4 pad day. I kept the volume data in an spreadsheet, and used a statistical analysis program at work to run a locally weighted statistical smoothing to see what the moving average was.

I did improve from a high of over 400ml/day at about 3 months out, to about 100ml/day when I decided to go ahead with the AdVance Sling.

My experience with that has been (finally) good, with 0 pads, and only the occasional urge leak. No more stress leaks at all.

https://www.healingwell.com/community/default.aspx?f=35&m=1221982

15 grams/day? I would have killed for that this summer!

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51 yrs old at diagnosis & surgery
Biopsy 6/20/2007, 2 of 10 cores positive, 9%, Gleason 3+3, PSA 2.5, up from 2.0 previous year.
DaVinci robotic at Duke Univ. Medical Center 10/3/2007 both nerves spared
post surgical PSA tests all < 0.1
AdVance Male Sling 08/25/2008 at Duke Univ. Medical Center