differences in continence?

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Regular Member

Date Joined Nov 2008
Total Posts : 123
   Posted 12/6/2008 5:59 PM (GMT -6)   
I am a newer member and have posted several incontinence topics since that is my cross to bear at the moment. This one is just an observation. How can there be such a difference in how men respond to the surgery regarding incontinence? Some are dry from day one, others take a year ,etc. If the healing of the bladder area is a main factor and all good surgeons make sure of that connection being tight, whats the deal. My surgeon is the head of uro and had done over 1,000 prostate removals, his record is impeccable. It seems like I have less leakage on weekends then during work time. I go though 4-5 pads a day plus I were depends as a backup to support pads. That might be overkill but I feel secure that way. On weekends it is about a third of that many.
I got word of this site though a post on Web MD cancer message board. Much more activity and comparisons on this site. I have been reassured about my situation by seeing it on average is normal. I am at 9 weeks , got my 1st 0.00 psa test this week.
Any other Bruce Springsteen fans out there?

Rich man in a poor man's shirt

Veteran Member

Date Joined Apr 2008
Total Posts : 847
   Posted 12/6/2008 6:57 PM (GMT -6)   
Who's Bruce Springsteen? smilewinkgrin
To answer your main question, I think the difference is anatomy. I remember seeing a study somewhere that said that the length of your bottom sphincter was related to how continent you would be. Think of a hosepipe -- a narrow blockage can still let something through, but the escape is less for a wider blockage.
Another factor would be how effective the muscles controlling that sphincter are -- possibly that is determined in part by how fit you are.
One factor I have never seen mentioned is damage to the nerves controlling that sphincter. They must be near the prostate -- can they be damaged during surgery, just like the erectile nerves?
Age 63. Other than cancer, in good health; BMI 20
Pre-op: No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores
7 March 2008, RRP, non nerve sparing
Two nights in hospital; catheter and staples out after 7 days
Continent, no pads needed from the get-go
Post Op: Stage pT2 M- N-; clear margins and lymph nodes; Gleason 4+4=8; prostate weight: 37gm
6-week and 7-month PSAs: 0
Bimix injections working well 

New Member

Date Joined Jun 2008
Total Posts : 19
   Posted 12/6/2008 7:49 PM (GMT -6)   
Today it the one year anniversary of my surgery with the guy at Johns Hopkins who invented the nerve-sparing surgery. He did Bob Dole, John Kerry and other big names. His first words to me was that I was a "perfect case." He tells of patients who have erections the day after the tubes come out. Well, guess what? I still leak. There is no way that one standard can be set. They are all guessing.
And yes, Bruce rules. XM radio station 58 is all Bruce all the time.
Diagnosis 7/07
open radical 12/07
PSA pre-op 1.4 gleason 3+3 clean margins
First psa post-op 3/08 0.006
Second psa post-op 6/08 >0.01

Regular Member

Date Joined Apr 2008
Total Posts : 270
   Posted 12/6/2008 9:47 PM (GMT -6)   
I think you raise a good question that all of us have considered. I too know several people operated on by the same outstanding doctor with various degrees of incontinence dry-up timing, and ED improvement. Obviously, it is not all contributed to the doctors skill, even though that must play a huge factor - all the doctors effort being equal, it must be associated with our individual anatomy, cancer status, age, and physical condition.

Reference the continence roller coaster. I think stress, physical activity, fatigue, diet, and surprises all lend to it. I have more propensity to leak late in the day, and if I drink sodas. I also have to concentrate harder on prevention when doing a lot of bending and physical exercise. One other thing that gets me is any surprises: Let's say I step off the sidewalk unexpectantly - that is a squirt, or if someone sneaks up behind me and suddenly slaps me on the back - that's a squirt. Distractions make it harder, because to some degree either consciously, or unconsciously there is a learning curve of focus on re-establishing total continence that we took for granted prior to surgery - at least with me.
Age 61 (now 62)
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04
2nd Post PSA <.1 10/30/2008

New Member

Date Joined Jun 2008
Total Posts : 19
   Posted 12/7/2008 11:30 AM (GMT -6)   
Thanks for this new suggestion. I'm now officially off Diet Sunkist orange soda starting now.
Diagnosis 7/07
open radical 12/07
PSA pre-op 1.4 gleason 3+3 clean margins
First psa post-op 3/08 0.006
Second psa post-op 6/08 >0.01

Post Edited (Quincy3) : 12/7/2008 9:33:21 AM (GMT-7)

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