"Incontinence" Definition

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Jetlagged
Regular Member


Date Joined Jul 2008
Total Posts : 29
   Posted 2/4/2009 1:37 PM (GMT -6)   
My son's Cub Scout Pinewood Derby is coming up soon, where the car can't weigh more than 5 oz, so I bought a sensitive scale so I don't have to run to the post office during construction. rolleyes It has several units, one of which is ml. So I got the "bright" idea of weighing my pads to see how much I'm actually leaking/seeping. Over a 24 hour period I (according to the scale) gained 6 ml, which clearly isn't much.

Does anyone know what the "threshold" is to be considered continent?

Clearly I have way too much time on my hands smilewinkgrin
Robotic RP 12/07
Age 46
Pre-surgical PSA 5.02
Bone scan/Chest X-ray clear
All margins, seminal vesicles, bladder resection margin, 17 lymphs clear
3+4=7
Three Post-surgical PSA's <0.01
Forth (one year) PSA 0.01 (not less than)
Re-test in March


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 2/4/2009 3:21 PM (GMT -6)   
Gotta love those Pinewood Derby races....ah and the old postage stamp scales... Don't have an answer except what my Uro said. I would most likely have some minimal (very minimal - his words) stress problems with the unexpected cough or sneeze etc. So I have no idea how to equate that into ml. I guess I figure that if I can get through an entire day with only the small teaspoon into a pad I would consider to be continent...others might think that is still too much. Good question hopefully someone else has a real answer.
You are beating back cancer, so hold your head up with dignity
 
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 5 week Oct 2008 <.05
       3 month Jan 2009 .06


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4828
   Posted 2/4/2009 3:26 PM (GMT -6)   

There are many guys here that have done a ton of measuring...(i'm not sure why)

Me, I didn't leak too much for the three months I wore pads..One in the morning and replaced it when I got home mainly for sanitary reasons.

 


Age 53   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
 
06/25/08 - Da Vinci robotic laparoscopy
Catheter in for five weeks.
Dry after 3 months.
 
10/03/08 - 1st Quarter PSA -> less then .01
01/16/09 - 2nd Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.
 


NV RTRD 2007
Regular Member


Date Joined Jan 2009
Total Posts : 75
   Posted 2/4/2009 5:30 PM (GMT -6)   
I had open surgery exactly 2 months today and I've been using only one pad for 24 hrs. I don't have any idea what is considered to be continence or incontinence. To me, as long as there's something (doesn't matter how much) in the pad when you change it, I considered it incontinence, until it's completely dry. It may take a while but we have to be patient. We know that this is one of the major (the other is ED) side effects of surgery. If I can't be fully continent, I still be glad and thankul that I went through the procedure. I am more at peace knowing that the PC is no longer exist. Likewise, as for the ED (though according to my DR both the nerve bundles were spared), if it will happen that I will not regain it, well there are other ways to enjoy sex life other than intercourse. Just be happy that we are cancer free and that's the most important thing. We will enjoy life longer.
Age 54; Age DX 53
PSA: May 07- 2.9; Dec 07-4.3; Jan 2008- 6.1; May 2008- 6.4; Sep 2008- 7.3 ; Sep 2008- 9.6
Bone Scan: Mar 2007- Normal without evidence of metastatic disease.
Biopsy Mar 2008: 6/6 core right gland- No evidence of malignancy; 5/6 core left gland- positive Gleason score 3+3=6 average tumor volume 5 mm.Clinical Stage II.
Transrectal ultrasound at UCSF Jun 2008: 7x14x10 mm hypoechoic lesion in left gland. DRE positive, PSA Density- 0.23 and Prostate volume - 27 CC.
RRP: 4 Dec 2008; Discharged - 8 Dec 2008; Cath removed- 18 Dec 08.
Pathology Report: Prostate- 33 grams; L/R pelvic lymph node -No evidence of malignancy; Right Lobe- No definite tumor; Adenocarcinoma, Gleason 3+4.
Post PSA: 7 Jan 2009 - <.05.


Tobmeister
Regular Member


Date Joined Jan 2009
Total Posts : 41
   Posted 2/5/2009 12:23 AM (GMT -6)   
From what I've read some doctors who claim high levels of continence fudge their stats by defining people that only have to wear 1 pad a day as not incontinent. I might have a small dribble come out every great once in awhile but I'm talking about no more than what maybe used to come out after urinating before surgery - not even enough to go thru underwear. In my opinion you are not incontinent if you do not need to wear any pads at all.

Something I think I have discovered that I have not seen mentioned anywhere - maybe I've just missed it - is psychological stress leak. You read about physical stress leaks (sneezing, passing gas, etc). I am convinced that some of the leakage is caused by psychological stresses and you can learn to control it. For instance when I first removed my pad I was at work by myself all day and no problem. But a couple days later when my employee was there I was more self conscience and the more I thought about it the more I felt like I needed a pad.

Anybody else have this weird feeling?
Tom, age 51
Diagnosed 11/12/2008
PSA 2006 - 2.8, 2007 3.06, 2008 4.6 (remember the rate of increase is as important as the level), PSA free 8.7%
Family history - brother and uncle (remember family history is very important)
Gleason score 7 (4+3); 6 out of 19 cores sampled positive for cancer; perineural invasion present
Bone scan and CT scan both negative
Prostate mildly enlarged, DRE negative
DaVinci radical prostatectomy 12/30/2008 - left side nerves spared
Catheter removed 1/15/09 - no pain!

Post operative results:
Pathologic stage - T3aN0Mx
Post surgery biopsy - Bladder neck margin negative, lymph nodes negative, specimen confined, extracapsular extension positive, perineural invasion positive, seminal vesicle invasion negative, all margins negative, Gleason 3 + 3 = 6.

No incontinence problem within 1-2 weeks after catheter removal
1st post op PSA scheduled for 4/16/09

"Pick a good doctor and say your prayers"


gpg
Regular Member


Date Joined Jan 2009
Total Posts : 180
   Posted 2/5/2009 6:45 AM (GMT -6)   
Like the others have said it varies depending on whose ox is being gored by the description. To me it is simple, if you have to wear a pad or any other device you are not continent regardless of whether the incontinance is stress, urge, or otherwise.

Scott
Diagnosed @ 48yo 04/07
focal, low volume tumor gleason 6
RRP 07/30/07
Persistance of PSA
IMRT 11/07-01/08
Emerg, cysto obstructed bladder 01/08
Persistance of PSA
08/08 learned Dr. left significant amount of prostate
12/08 PCA3 negative
12/08 saturation biopsy 36 cores 24 having normal prostate tissue
12/08 referred whole to med malprac attorney


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/5/2009 10:25 AM (GMT -6)   
I agree with Scott. It's like being a little bit pregnant. Either you are or you aren't. My definition is if you are dry during your routine activites during an average day and night , then you are continent. I have a rare stress drip when sitting cross-legged and reaching to my right, but that's a special position and not a part of my everyday routine, so I don't count it. I would also venture to say if you are still wearing a pad 'just in case' then you aren't continent yet, as you probably don't mentally consider yourself dry forever. But that's just my semi-formed opinion... tongue
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 2/6/2009 11:15 AM (GMT -6)   
Jetlagged -

I agree with those above who say zero leakage means continence. My doctors at GW were doing a clinical trial on incontinence, and they said Walsh at Johns Hopkins considered incontinence to be 2 pads a day. Yuck.

Steve n Dallas - Weighing pads is a great way to see improvement if you are leaking heavily month after month. I was depressed at my leakage, and totally embarassed by delivering 6 or 7 HEAVY pads to my 3 month trial weigh-in (they were measuring the weight of pads used in the previous 24 hours). I was off the charts. I discovered I had a gram scale at home, and I started weighing pads. I determined that I was not nearly as bad as I thought - I just had a terrible day before the trial weigh-in.

Now I can report I am losing about 10 grams a day (about one third of an ounce) - due to random leakage. I just can't seem to get over that last little hump. And, as I've said before I can't stand the feel of damp underwear, so it's pads for me for a while longer.

kcragman
Age: 53; 52 at DX
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 2008: 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 2/6/2009 9:33 PM (GMT -6)   
Being a long term HEAVY leaker I would say incontinance is anything that makes you change your lifestyle!!! Since I have had my AUS activated I can go anywhere I want. Wear anything I want. Drink as much of what ever I want and I do not have to plan ahead for "facilities" to use. I do not have to carry extra cloths and and number of pads everywhere I go. Eventhough I still use a womans panty liner to catch some dribbles and squirts I would say the AUS has given me "social continance"
Hope this is about a clear as mud!
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.  Working Great, only light drips and dribbles.
    Jan, 31st, 2009 - PSA ????? Will post when I get the results!  


Salty_clark
Regular Member


Date Joined Apr 2008
Total Posts : 95
   Posted 2/7/2009 9:54 AM (GMT -6)   

Very nicely said KW.  I, too, was and, am at this point in time, a heavy leaker.  Continence is a very personal matter. Continence for one is, relatively speaking, incontinence for another. Ocassionally, I hear of a guy who goes for years in a state of incontinence and just puts up with it or reconciles himself to living with it...whether it be drips and dribbles or full fleged rivers.  I just simply cannot stand even the slightest amount.  That is the reason I have undergone AUS surgery in the hope of getting completely dry...I may be deluding myself into thinking that I will be dry dry dry...but I am hoping.  Right at this point I would probably accept wearing a panti-liner.  I'll find out in about another month when the AUS is activated.

Salty


Age 75 at DX 76 on 9 May 08
DRE positive with nodule 15 Jan 08
PSA 3.8 18 Jan 08
Biopsy 11 Mar 08 Gleason 8 (4+4) on the right 3 out of 12 positive <5%. Gleason 7 (4+3) on the left 1 out of 11 positive <5%.
Bone scan and CT scan Negative 12 Mar 08
Robot Assisted da Vinci prostectomy with Dr Fagin in Austin scheduled for 30 April 08.
- - - - - - - -
da Vinci successfully completed by Dr Fagin as scheduled.
Path Report:
Gleason downgraded to 3+4=7
Tumors confined to the prostate.
Bilateral tumor on right side 5 of 10 levels and on left side tumor present in 9 of 10 levels.
Margins Negative.
Extraprostatic Extension Negative
Seminal Vesicle Invasion Negative
Stage pT2c
As far as it goes between you, me and the fence post I am cured. 
06-24-08 <0.1 Undetectable.
09-23-08 <0.1 Undetectable.
01-10-09 <0.01 Undetectable. 
AUS/IPP installed by Dr Morey 1/21/09 Activation to be 03/09/09 


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 2/7/2009 9:20 PM (GMT -6)   

    Salty,  Please be aware that a few drips and dribbles are probably expected.  Do not be discouraged if you do have them.  It is a world apart from the flooding I had.

    Good Luck with the Activation.

    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.  Working Great, only light drips and dribbles.
    Jan, 31st, 2009 - PSA ????? Will post when I get the results!  

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