Gaining Continence after Surgery

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LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 1/2/2009 3:39 PM (GMT -6)   
I had the cath removed 3 months ago and I was so disappointed (and sometimes discouraged) in the amount of leakage I had...all the way up until last week.  Last week with the warm weather, I did some outdoor maintenance to the landscaping and I noticed that I hardly leaked at all...all day long.  Since then, I don't think I leak at all (except for maybe an occassional stress leak), although I am still wearing a liner for security as some how I don't have the full confidence yet that this is really for real and that I have finally started getting some control.
 
Question now for the veterans here, is this really possible to go from several pads a day to nearly dry in a matter of just a day or so?  Don't get me wrong, I am counting my blessings here, but I am having difficulty thinking that in just one day I wake up and I am continent again.  I thought it was more of a gradual process.  Or is this just a temporary fluke and I will still need more time to recover.
 
I am really hoping that this is going to be the start of a very good 2009 along with a ZERO on my PSA test next week.
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base)
Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1,2008
Gleason 7 (4+3) Staged pT2c NO MX
Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA Oct 08 <.05


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25372
   Posted 1/2/2009 4:40 PM (GMT -6)   
Les, I hope that is a big turn for you on the continence issue, and best of luck on your upcoming PSA test. In less then a month, I am suppose to have my first post surgery psa, and hoping to make it in the zero club tool.

David in SC
Age 56, 56 at DX
 
PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
 
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, ranging from 40 - 90%, G 4+3 & 3+4
 
Open RP surgery  November 14, 2008 at St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon, Non-nerve sparing, 4 days in hospital, staples removed 11/24/8, Catheter out on 12/15/8 on day 32.  Day 33, urine stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08.  After 7 hours, complete stoppage again, emergency room put in Catheter #3 early evening of day 45, still 12/29/08. New appt. to see dr. on 1/5/9 as result.
 
Post-surgery Pathlogy Report:
Gleason 3+4=7, pT2c pN0 pMx, Prostate 42 grams, tumor 20% cancer
Contained in capsular, neg. margins apex, bladder neck, right lobe, neg. in seminal vessels and lymph nodes.
 
First PSA Post Surgery  Scheduled now for 2/9/9
 
 


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 1/2/2009 11:21 PM (GMT -6)   
LV-TX, You will find on here that many men will have a "overnight" improvement at some point. It seems that the body and brain finally just connects to relearn how things work. But in my case I was just not a good Learner!!!.
I wish you luck with your continued improvement.
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
     


hawkfan75
Regular Member


Date Joined Jan 2007
Total Posts : 165
   Posted 1/3/2009 12:29 AM (GMT -6)   

LV-TX

I hope that you are doing Kegals!  I started them prior to surgery and still occasionally do them now.  I was fortunate to not have a lot of incontinence.  Still, to this day, if I suddenly make a strange move, I'll get a "drop dribble".  Annoying, but I'll live with it.  I referee high school sports, actually doing three basketball games in a high school tournament today.  I find that when I'm exercising strongly and concentrating on the game, I have no problem.  Perhaps this is like your work today.  My suggestion is to do the Kegals and all the exercise you can.  Good luck.


Age 57 at diagnosis (2006),  PSA 4.7 (up from 3.2 one year previous)
Biopsy November 8, 2006 1 of 10 cores positive 5% LEFT Side Gleason 3+3
Robotic surgery January 19, 2007
Post Surgery Pathology Stage T3a, Gleason 3+4, positive margins and capsular penetration RIGHT Side
Post Surgery PSA:  March 5, 2007:  0.01    5 month PSA  0.08
Adjuvant therapy began June 26, 2007 with Zoladex injection
Radiation began August 23, 2007, ended October 8
First post radiation PSA, December 18, 2007:  0;  March 2008 - still 0;  July 2008 - 0; Sept. 2008 - 0;
 
 


RBinCountry
Regular Member


Date Joined Apr 2008
Total Posts : 270
   Posted 1/3/2009 11:50 AM (GMT -6)   
I am 7 months post DiVinci. With me it seemed at 3 months I was nearing dry, and improvement has been very gradual since. I bragged a while back that I was dry - well perhaps that is in degrees. Compared to where I was before surgery I am not dry. On the other hand, I have found that much of my little bit of continued dribble lies in post urination. It seems once I go, it is hard to find a stopping point and my valve system seems to want to remain slightly open thereby causing some little bit of post urination dribble. In addition, I too have the ocassional stress squirt.

Most recently I took a terrible cold. For a couple of days my body was wrenched with no energy - I had a hard time getting out of chair. During that two days I squirted more than I have in months. Incontinence is a humbling thing. For me it seems about the time I believe I have it licked I don't. I do believe I will eventually become entirely dry, but from my experience patience is key. Good luck.

RB
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


anglophile
Regular Member


Date Joined Apr 2008
Total Posts : 82
   Posted 1/4/2009 7:35 AM (GMT -6)   
Kegals are the key to continence, IMO. I practiced them before surgery, and after.

You'll see my progress in my signature below. The first breakthrough was an all-night sleep without a pad, but I had to physically hold myself when running to the bathroom the next morning. I gradually was able to control myself and walk normally to the bathroom when I got up.

The next step was using one pad all day.

At 7 1/2 months, I finally went pad free. I do occasionally have a drop dribble, too, but I'm very happy to be off pads now.

I just have to remember to relieve myself before I do any heavy lifting.
Age 59 - diagnosed in Jan. 08 after biopsy
da Vinci Robotic Prostatectomy 4/11/08 - both nerves spared
Catheter removed 4/25/08
Prostate Pathology: Gleason Grade 6 (3+3)
5 wks post-op Continence: 1 pad night, 2 during day
7 wks post-op Continence: 2 pads every 24 hours
First post-op PSA at 7 wks: >0.1
14 wks post-op Continence: 1 pad days, no pad nights
Post-Op PSA at 5 months: >0.1
7 months post-op Continence: First pad-free day/night!
7 1/2 months post-op Continence: No more pads!
(ED is a different story)


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4828
   Posted 1/4/2009 7:44 AM (GMT -6)   

I had my three month visit on a Friday…Doc said he wanted me off the pads by January’s six month visit….He made it sound like I had a choice in the matter.

 

So next day on Saturday, I said what the heck. I didn’t use a pad and haven’t used one since.


Age 53   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Gleason - 6
(biopsy done March 4, 2008-> 2 of 12)
 
06/25/08 - Da Vinci robotic laparoscopy
10/03/08 - 1st Quarter PSA -> less then .01
 

Surgeon - Keith A. Waguespack, M.D.

Las Colinas and Plano Offices

 


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 1/4/2009 8:38 AM (GMT -6)   
I am exactly 7 months post op. The key phrase is - everybody is different. But there are many stories on this board of guys making no progress, and then sometime between about 3 and 6 months they have a burst of overnight improvement - sometimes all the way to dry.

Mine hit around 15 weeks. I went from 7 soggy pads a day to 5 light pads a day in about one weekend, and then down to 1 pad a day in the next few weeks. I have plateaued there. I've tried no pads from time to time, but I squirt at random times - for no distinct reason - once or twice a day and I hate the feel of damp underwear. I NEED to increase my general exercise, as I think that could be a real key. But obviously if it bothered me more I would work harder at it.

The thing that might finally drive me to make the final push is, due to the pad and the heat I seem to generate, I think I sweat a lot down there, and I am constantly damp and sticky - but not from leaking.

Steve n Dallas - Yeah, my doctor ordered me to get off pads by Feb - my 9 month check up. But if I am still squirting once or twice a day, screw that. I prefer comfort and safety (even if it is warm & sticky) to uncomfortable, cold dampness.

Life is good,
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.
Feb '08: PSA 3.7.
March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were
              cancerous and the 6th was suspect.  
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 node and nerve samples taken, and appeared to be cancer free.

July 2008: PSA at 7 weeks was undetectable.
August 2008: PSA at 14 weeks (3 months) was undetectable.
Nov 2008: PSA at 6 months was undetectable.


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 1/4/2009 1:43 PM (GMT -6)   
Kccragman, Let the Doctor that "ordered" you off the pads have a leakthrough in public! Then see how he feels about ordering you off the pads. If he is so confidant in your getting totally drip free how about asking for a Money Back Guarntee! I bet he won't put YOUR money where HIS mouth is.
Hope you continue to improve.
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
     


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 1/5/2009 8:40 AM (GMT -6)   
Well I got a little over zealous this weekend and tried going without at pad in public...big mistake. I stayed dry for nearly the entire day, and then it hit...I bent over to pick up something and wound up with a soggy pant leg. A moment of embarrassment for sure. Oh well...still overall it is better than before. I think I will wear a liner for the time being to be on the safe side. But in comparison from what it was, I can live with that.

For those that will soon face this issue, I can't say that I did the Kegals often, but I am physically active and I think that is the main key. Give it time and stay active in whatever you do, be it golf, bowling or as Tony mentioned the Wii Fitness. I think getting back to your normal routine in life after surgery as quickly as the doctor will allow you to, is the best advice I can offer. Then let time and nature heal and take the minor setbacks in stride...it will get better.

Stay positive and remember...you are beating back cancer, so hold your head up with dignity...even with a soggy pant leg.
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base)
Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1,2008
Gleason 7 (4+3) Staged pT2c NO MX
Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA Oct 08 <.05


Bluenose
Regular Member


Date Joined May 2008
Total Posts : 260
   Posted 1/5/2009 9:47 AM (GMT -6)   

 

..finally took the plunge today and worked up the confidence to come to work padless. Will hit the gym on the way home as well with out!  I've been going without of an evening when I get home and most of the weekends...soooo I figured it was time. I never really had a big problem with IC, still had those public accidents etc. Like Les I can't say I did the Kegals on a regular basis, just continued trying to get back to my normal routine on everyday life. 

  So  far go good!!   Keep those heads held high gentleman..not just anyone can do this!


 
   age: 53
   Pre-0p PSA  Feb. 08, 5.0
      4.22.08, 4.1
      PSA  spiked once about 8yrs ago to 5.0 three months later
      back to 2.9...then into the 1.2 range until my re-scheduled 
      "missed" appointment this past Feb.
      Biopsy 5.1.08 
      Gleason-3+4=7
      T2a
      5 of 15 cores positive
      Da Vinci scheduled..7.29.08..as I read somewhere on this 
      site....."the first show of the day"
       DaVinci completed 7.29.08,
       Bladder Sling installed, umbilical hernia repair  
       completed during surgery.    
        Sent home 30hrs,  JP drain in place 7days,
       Path report "cancer fully contained"....Margins clear
        Cath removed 8.8.08(ten days)...one lightly used pad 24 hours
        ED therapy begins 8.9.08. 100mg viagra three times a week,
        pump everyday and hold for ten minutes.
        8.16.08 switched to Levitra 20mg.......whahoo, got lucky...
        immediate results..... 
        9.15.08 pad free at night, one thin (light) pad during the daytime
        hours. Just because I'm chicken..!
         9.18.08 1st post-0p-PSA-Undetectable...Zero's!  Yes!
         12.22.08 2nd post-op PSA-Zeros still...  
           .
         .."just tryin' to reason with hurricane season"..
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
       


masterguns
New Member


Date Joined Nov 2008
Total Posts : 16
   Posted 1/6/2009 2:53 PM (GMT -6)   
My update concerning PSA, IC and ED.  Tomorrow will be 8 weeks since my surgery.  I had that darn catheter in for 8 very, very long days and it finally was removed on 19 November.  I immediately was using 5 to 7 very soggy pads a day.  I am currently down to 2 or 3 depending on how active I am.  I would have to say that I am have more symptoms of stress IC than any other form.  I did Kegals religiously months before surgery and made an honest effort afterwards, but performing kegals hurt and still do, so I simply don't do them.  I, however, spend 30 plus minutes on one of my treadmills every evening and I think that is what is doing the trick for me.  As long as I am horizontal, no leakage at all.  I hit the rack with a new pad and wake up completely dry.  But once vertical, I had best be in front of the toilet asap, no delaying that or else.  My first PSA, two weeks ago, was "non-detectable".  I have had a lot of activity in terms of ED but not 100% in that area either.  I would trade no erections for total continence any day but hope to be 100% in both categories at some point this year.  I just consider myself blessed that at this point I am free of cancer, am back at work where I belong, again riding my new Harley Ultra Classic, and have a wonder supporting family. 
 
May God bless all you guy (and gals) and stay safe and confident things will work out.
 
MasterGuns
AGE: 59 DIAGNOSES: 5/27/08
PSA ONE WEEK PRIOR TO DAVINCI ROBOTIC: .84
ROBOTIC ASSISTED LAPAROSCOPIC PROSTATECTOMY):11/11/08 
TOTAL GLEASON SCORE: 7
PRIMARY PATTERN:   GRADE 3
SECONDARY PATTERN: GRADE 4
CONFINED TO PROSTATE:  BILATERAL INVOLVEMENT OF PROSTATE - pT2c
REGIONAL LYMPH NODE STATUS:  CANNOT BE ASSESSED - pNX
MARGINS UNINVOLVED BY INVASIVE CARCINOMA, THE TUMOR IS <1.0 MM.TO RIGHT
ANTERIOR LATERAL MARGIN.
EXTRAPROSTATIC EXTENSION:  ABSENT
SEMINAL VESICLE INVASION:  ABSENT
DISTANT METASTASIS:  CANNOT BE ASSESSED - pMX
PERINEURAL INVASION: NOT IDENTIFIED
HIGH-GRADE PROSTATIC INTRAEPITHELIAL NEOPLASIA (PIN):  NOT IDENTIFIED
PROPORTION (PERCENT) OF PROSTATIC TISSUE INVOLVED BY TUMOR: APPROXIMATELY 8%
ADDITIONAL PATHOLOGIC FINDINGS:
-NON-NEOPLASTIC PROSTATE WITH GLANDULAR AND STROMAL HYPERPLASIA.
-CALCIFIC ATHEROSCLEROSIS


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 1/6/2009 3:18 PM (GMT -6)   
I don't think it is uncommon for some of us to go from three or four pads a day to one pad overnight. I did that about 7 months out. I only wear a pad now if I leave home for the day. The kegels helped me I'm sure.
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
4/16/08- Started Bi-mix injections 
5/15/08- 1st Post-Op PSA 0.07 Undetectable
8/11/08 -2nd Post-OP PSA 0.02 Undetectable
8/15/08- No more pads as of today  Whoopee!!!
11/13/08- 3rd post-op PSA 0.02 Undetectable


IsleofGough
New Member


Date Joined Jul 2008
Total Posts : 12
   Posted 1/6/2009 10:12 PM (GMT -6)   
Yes, that is how it happened to me, and my urologist said it is common.
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