Bladder control - how?

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Regular Member

Date Joined Sep 2008
Total Posts : 56
   Posted 2/9/2009 6:37 AM (GMT -6)   
I had surgery ~2.5 weeks ago, catheter came out last Wednesday (4 days ago). As I presume is normal, I have little to no bladder control. I'm going through 10 to 12 pads a day at this time.

How does bladder control come back? Is it something that just "happens"? Will I use my keagals to control my bladder? I try exercising my keagals now and it's still a bit too sore (#20 catheter) to do anything realistic at this time. Is there anything else I should be doing to promote bladder control?

To clarify: I'm not expecting things to work now - I'm just trying to understand this process as it happens to me...
cheers & beers,

Diagnosed on 9.23.08, age 47
Gleason 6, T1a
da Vinci LRP performed 1.22.09 at Moffitt Cancer Center by Dr. Pow-Sang
Catheter out on 2.4.09!!!!
Pathology: Gleason 7 (3+4), T2c. Tumor 15%, fully contained, margins clear, lymph clear.

Veteran Member

Date Joined Nov 2007
Total Posts : 598
   Posted 2/9/2009 9:34 AM (GMT -6)   
10-12 pads a day is not unusual at this point. Also, how full are the pads? damp? wet? boated? The normal dripping when walking or even erect is normal. Can you make yourself urinate at all? Is there anything left to urinate? It's WAY to early to panic. So relieve the stress and be kind to yourself. You are fine.

Keep trying to do the kegels. Those muscles are controlling the one and only sphincter you have left. It gradually gets better over several months. Keep walking. That is great abdominal exercise. The stories that you hear of guys being dry in days are extremely rare. Most guys are beginning to dry out after 12 weeks.

Also, you asked how it happens. slowly and gradually. First you will notice morning pads when you wake up are dryer, then dry. Then dry till noon, then it gradually gets later and later. The last to go is the evening, before bed.

feel better? Keep asking
46 at Diagnosis.
Father died of Pca 4/07 at 86.
1/06 PSA 3.15
1/07 PSA 4.6 (Biopsy 3/07 just suspicious)
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
-totally contained to prostate,
-10% involvement in L & R Mid lobes
PSA 0 at nine months.
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - Took 100mg viagra every night. for several months
Totally usable erections at 10 weeks, which disappeared over the course of a month or two.
ED bounce is what they call it. Now, at one year, ED is fine with viagra.

Regular Member

Date Joined May 2008
Total Posts : 240
   Posted 2/9/2009 9:45 AM (GMT -6)   
AstroNerd -

Bladder control is different for everybody, but IN GENERAL, time and patience seem to be the most important factors, followed possibly by exercise. Some guys say kegels help, some guys say lots of walking helps, some guys get back to general exercise as soon as possible (be careful - don't push too hard, too soon), some guys don't do ANYTHING and achieve good results.

You have internal swelling after surgery. Some guys have reported good control at first, and then heavy leakage a couple weeks later after the swelling goes down. What seems to happen frequently is, sometime between 10 and 20 weeks, you will have a sudden and dramatic improvement - sometimes all the way to dry. At that point, I think kegels and exercise help - but once again, everybody is different. I went from 5-7 heavy pads a day down to 2-3 light pads a day right around the 15-16 week mark, and I'm down to one very light pad a day now.

Pain down there (for me it was butt pain) is a problem in the early days. I probably lost 6 weeks of doing any exercise at all due to butt pain.

All you can do now is to try to stay "tight" as you stand up, walk around, go through your normal routines. "Tight" generally means squeezing your pelvic floor (kegel) as much as you can. Many guys, including me, experienced the frustration of sqeezing as hard as we could and still leaking as you walk down the hall in the early weeks. Then you have sensations of really needing to go, and you get there and just dribble.

Some people recommend staying away from alcohol, spicey foods, acidic foods like tomatoes - anything that might irritate your bladder.

All of that is normal. Time and patience are the most important factors. Sometimes the frustration is overwhelming - but you WILL get there.

Good luck,
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.

Regular Member

Date Joined Nov 2008
Total Posts : 299
   Posted 2/9/2009 11:10 AM (GMT -6)   
I seem to be one of the lucky ones in that I was totally dry at 8 weeks. However, I was walking 5 miles a day every day while I was off work for 6 weeks. Doing kegels the whole time that I was walking. I would leak sometimes when I went over a curb so I learned to prep for the long steps.
Age 60
PSA 2007 4.1
PSA 2008 10.0
Diagnosed April 2008
Biopsy: 6 of 12 cores positive
Gleason 4 + 5 = 9
CT and Bone Scan negative
Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared
Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th
lymph nodes negative
PSA Sept 28, 2008 0.00
PSA Jan 22, 2009 0.00

New Member

Date Joined Jun 2008
Total Posts : 12
   Posted 2/9/2009 8:28 PM (GMT -6)   


I had da Vinci surgery Oct.31, '08; catheter out on 11th day and dry every night since...with the exception of dreaming one night I was using the bathroom and dribble a couple of drops before waking up.  To be on the safe side, at night, I wore the jockey type Depend Extra underware for abt 4 weeks and during the day I wore the regular Depend Guards(pads)for men, normally one pad p/day.  In the 5th week I switched to the regular Depend Guards (pads) for men at night and day time, still normally one pad p/day; then abt at 10 weeks, I switched to an ultra thin pad. 

Just last week, 13th week, I stayed dry all day and now today I'm trying it with "NO PAD", and so far...DRY!  What most of the guys and gals are saying here on the forum, the average is 8 - 12 weeks and I fell right in line with those times.  Very very thankful for the dryness and healing process I have had and I hope and pray the same for all.  

In addition, I also feel as if the old "ED" is on the wane and some degree of yesteryear is returing.

MY prayers to each and everyone of you...



Born Aug. 14, 1940; dx 6-3-08
Oct. '05 PSA 3.7; Free PSA 14.3
1st Bio July '06 - negative; PSA 5; DRE Negative
2nd Bio Mar '07 - negative; PSA 6.68; DRE Negative
Feb. '08 PSA 7
Mar. '08 PSA 10.8;  Free PSA 24.1
April '08 PSA 8.2; Free PSA 14.6
3rd Bio June 3'08, one core of 10 (LMid 20% cancer)other 9 cores negative
Stage T1c, Gleason 3+3=6; DRE Negative
Scheduled surgery, da Vinci, Aug. 7, '08. Canceled due to failed pre-opt stress test. Had cardiac stent put in August 1. da Vinci surgery Oct. 31, '08.  Cath. out Nov. 11.  Nerves sparred. No incontinance at night and only 1 pad per day, more for precaution. 
1st Quarter PSA report on Jan. 11, 2009 was ZERO (0.0).

Veteran Member

Date Joined Nov 2006
Total Posts : 883
   Posted 2/10/2009 8:41 PM (GMT -6)   

    I'd like to order a doctor to get out of pads!!!!   It's not like it is always a mental thing.  I tried everything I could to get out of the pads. 

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

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 2/11/2009 2:53 PM (GMT -6)   
I was using 10-12 pads for the first couple of months, maybe the first three.  It was very frustrating.  Then, about month 3 - the leakage dropped quite a bit.  My Urologist told me most of his patients don't see improvement until between 3 to 6 months post-op.  I'm now using, on average, 1 to 1.5 pads per day. I just came back from an agressively active - walking in heat, over tough terrain - vacation in Mexico and could have gotten by on 1 pad a day.  I have no leakage overnight.  2.5 weeks is a very short time post-op.  Give it some time, frustration and all.

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 (getting better, though)

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

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

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0


Regular Member

Date Joined Jan 2009
Total Posts : 180
   Posted 2/11/2009 4:11 PM (GMT -6)   
Hi Chris,

As you can see there is no pattern. In my case I had control almost at once but could not control the control. What I mean is I was dry until I had to go and if I was more than 20 steps away forget it, I was going. It sounds to me like you say you are continuously leaking, is that right? There are many forms of incontinence, please describe more fully what you are experiencing.

Best, 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

Veteran Member

Date Joined Jul 2008
Total Posts : 637
   Posted 2/11/2009 5:24 PM (GMT -6)   
Dear Chris,
Pete has been incontinent for two years, and in Sept had the AUS installed....It is finally beginning to work better. He uses two pads a day and two at night, What has really helped is a medication the Doctor ordered..called Detrol.....It seems to help the bladder spasms. Diane
Husband Pete
dx Jan 2001 gleason 4 + 3 PSA 16.5
Seed implant and conformal radiation and Lupron from Jan 2001 to Jan2002
2005 Dec PSA began to rise from .5 to 8 within 6 months
Salvage surgery at MSK 9/06 Dr. Eastham
Fistula operation 2/07 MSK Dr. Wong
Many cystoscopies and ER visits with strictures
Catheter for one year....Catheter taken out Sept 07..
Total Incontinence since then....
PSA .52 3/08
AUS Operation at MSK Sept 8 2008 Dr. Sandhu
Activated Oct 28th Dr. Sandhu..MSK
Some difficulty with AUS arising Nov 10 2008
Meeting with Dr. Sandhu to discuss AUS problems and new PSA test Dec 11, 2008
PSA .6 12/08
AUS improving..only 2 pads a day and one at night
Complete hip replacement surgery Dr. Waters Gainesville, FL 1/9/09
Forging ahead to health!

Regular Member

Date Joined Apr 2008
Total Posts : 82
   Posted 2/11/2009 10:07 PM (GMT -6)   

As someone said earlier, everybody is different.

I was pleased to get out of pads completely at 7 1/2 months. See my signature for more details.

It's little steps.
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)

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