nighttime incontinence

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New Member

Date Joined Feb 2009
Total Posts : 3
   Posted 3/23/2009 10:56 AM (GMT -6)   
I am now 46 days from my prostrate surgery removal and I am feeling much better. But while my urine control during the day is okay (I use pads and any leakage is from stress incontinence) at night I am getting up every 2 hours to go or more; ironically I am getting up more now that before the surgery. Consequently I am only getting 3-5 hours sleep of interrupted sleep at night. Not the best way to get full healing.
I did try a sleep aid and finally slept through the the night (first time in 2 and 1/2 months). But I leaked pretty much through my protection.
Any suggestions on how to get the necessary sleep while keeping as dry as possible?

Regular Member

Date Joined Oct 2005
Total Posts : 489
   Posted 3/23/2009 12:53 PM (GMT -6)   
Hey cease,

I am right with you at day 48 and I have also noticed I will get up twice at night now too. Not so much a real urgency like when I had BPH symptoms, but when I wake up i think , "Well it woke me up so bladder must be filled". And it might even be 8-10 ounces (what is a full bladder volume anyways?? -- ok 420-620 ml = 14-21 oz!!!). Is there such a thing as a Lazy Bladder where it signals "full" too soon?? Since I had BPH before prostate surgery I kind of think the bladder had gotten to a non-rubbery state (due to thickening of the muscle walls). I will ask my uro when I go in next week if this is normal (I am sure he will say yes) and what to do about it (I am sure he will say it will subside with time). Maybe we need to resist the urge to go every time the urge hits and make the bladder work for a living for that extra hour?? Good question though.

(Update: I did a quick google on this and this one comment sizes it up (for me at least)):

"The muscles that surround the bladder that squeeze it to get the water out get thick and tough from having to squeeze so hard to start the flow of water from the bladder. After the surgery they no longer have to strain to empty the bladder but because they have had to work so hard over the preceding months or years, it takes a long time for them to return to normal and get used to relaxing for a change. So that's another part of the recovery which takes a while. Hope this helps shed a little light on the matter."
Age 58, 192lbs, 6'4", 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
Biopsy Nov2008 1 of 12 cores 5%, Gleason 3+3 - Sona showed 140+ cc (110 grams post op) prostate size.
open RP surgery 02/03/9, Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
Post-surgery Pathlogy Report - All margins clear - No Invasive spread - no change in Gleason score.
Cath out on 2/18/9, passed a STONE within hours. To be analyzed by doc.
Using pump (encore) daily since catheter out -- Viagra and Levitra samples now and then (no effect).
03/06/09 Started Levitra 20mg rehabbing.

Post Edited (JimStars) : 3/23/2009 12:22:19 PM (GMT-6)

Regular Member

Date Joined May 2008
Total Posts : 240
   Posted 3/23/2009 2:29 PM (GMT -6)   
Hi guys -

I have posted this before. I was told that if you sleep on your back, your bladder will naturally hold a certain amount of urine - up to the level of your urethra. At that point you start to feel pressure. The time it takes your bladder to fill to that point, plus the unconscious control you have built up, determines how much sleep you get. If you hold off on the fluids for a couple hours before bedtime, and you have built up some control, you should be able to get a reasonable amount of sleep - but we are all different.

After more than 30 years of sleeping on my stomach, I learned to sleep on my back pretty quickly after surgery - and I was dry at night almost from day one. I would wake up and go to the bathroom about twice a night at first, but I was dry in bed. I hope this helps.

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.
Feb 2009: PSA at 9 months was undetectable.

Elite Member

Date Joined Oct 2008
Total Posts : 25380
   Posted 3/23/2009 2:49 PM (GMT -6)   
Hello Guys, I agree with what kragman just posted. Sleeping on your back helps. Most, not all, or always, men start to go dry at night first. Lay off caffine, soda pop, fruit juices even during the day, this is what my doctor said. I always wore a pull-up type depends at night as opposed to a pad, it convinced me that even if I didn't wake up, I wouldn't wet the bed. I did this for about 3 weeks after I went dry at night, even though the pull ups were bone dry, just to ease my mind and it did help me sleep better at night. I stopped doing that two weeks ago, and still no problem. We are all different on the incontinence part, so I hope you guys will be drying up soon, the losing sleep bit is rough, I went through 2 weeks of that until things started to stablize.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 6 month on 5/9

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2458
   Posted 3/23/2009 3:17 PM (GMT -6)   
Hi guys,
I sleep on my back and avoid caffeine. I was dry at night from the second day but I do wake up once to urinate. During the day I ware one pad. If I exercise, work in the yard or play golf, I tend to leak more and require a second pad. It had been 6 weeks since my surgery. I'm going to therapy to improve my bladder control and hope that this will not go on for too long.
Age: 67
Retired in 2001 and living in Austin TX.
PSA 3.5 free PSA 11%
Dx 12/30/08
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
Post op Pathology report:
Prostate weighed 57 grams
size:5.2 x 5.0 x 4.9 cm
10-20% involved
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
Lymph nodes: not dissected
seminal vesicles clean

Regular Member

Date Joined Dec 2008
Total Posts : 194
   Posted 3/23/2009 3:39 PM (GMT -6)   
Hay cease,

I'm 10 weeks out from RP now and was always a stomach sleeper. Had to relearn sleeping on the back and it made quite a difference. I'm dry enough now that I sleep on the stomach again without a leak, but I do have to head straight to the bathroom on wakeing up in the morning.
Age at DX 57
5-18-07 PSA 7.7
5-06-08 PSA 4.6  8% free psa, but stable
10-23-08 PSA 5.65 4% free psa
11-04-08 biopsy
11-11-08 2 of 12 cores positive
Gleason 3+3  6  stage t1c / post-op 3+4  7  stage t2c
CT and Bone scan negative
Da Vinci RRP 01-09-09
Catheter removed 1-15-09
Pathology Report says it's gone!
First Post-op PSA 2-17-09   0.00

Regular Member

Date Joined Jan 2009
Total Posts : 47
   Posted 3/24/2009 7:48 PM (GMT -6)   
I am now at week 11 since surgery. I am dry during the night. I have very little leakage until about 5 pm. From 5 pm until about 9 pm I leak a lot. Its getting better but I stll need to use pads. I look forward to the time when pads will be a distant memory.

Elite Member

Date Joined Oct 2008
Total Posts : 25380
   Posted 3/24/2009 9:12 PM (GMT -6)   
I hope that time comes real soon for you, spisam
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 6 month on 5/9

Veteran Member

Date Joined Apr 2008
Total Posts : 1131
   Posted 3/25/2009 6:27 AM (GMT -6)   
I had the same condition as you. I was pretty dry during the day but let loose at night time. I also got up about every two hours (more than before surgery). It gradually gets better. I did not drink fluids after 6:00 p.m. and did my kegels twice a day. I believe that helped a lot. Sounds like you are on your way to continence. I am appraoching a year an leak a little when my bladder is full but do not get up during the night.... and have been pad free for some time.
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
decision - surgery (robotic)
Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8
margins clear
9 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue

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