need some info.and experience with some post op questions

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buckeye42
New Member


Date Joined May 2009
Total Posts : 12
   Posted 6/11/2009 8:47 AM (GMT -6)   
good morning all.need some info.and experience with some post op questions.I am 4 weeks post op devinci surgery.I am dry during the night,get up about 3 to 4 times can make it to the bath without leakage. During the day i seem to leak all the times when standing or moving about.Is the normal?

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 6/11/2009 9:09 AM (GMT -6)   
Can't say what "normal" is, but many guys have same experience. The kegal guys say it takes 6 weeks to see a change in pelvic muscles. I am 7 weeks post op, and somewhat better, but I still leak throughout the day. I find that i can retain more and more urine, but it leaks once I reach that certain amount.

I have resorted to a Zimmerman clamp during the day while I am working. I Kegal every chance I get, and then in the evening, i work on walking and doing normal activity as I attempt to train my muscles to stay shut.

Good luck, it will get better.
Age 58
PSA 4.47
Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09
Nerves spared
0/23 lymph nodes involved
pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.
Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Thankful for early diagnosis, and U.S. healthcare
Living the Good Life, cancer free
6 week PSA undetectable. 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 6/11/2009 9:47 AM (GMT -6)   
You seem to be well within the range of what people report here. During my pre-surgical counseling the nurse taught me kegals and hooked me up to a computer (let’s not discuss where the electrodes were) that measured my contraction strength. She said that this would give baseline data so that if I were still having troubles 3 months post-op they could see how my muscle strength was developing. I take that to mean that up until three months most incontinence is not all that interesting.

But that doesn’t change your situation which is stressful and pretty darn annoying. All I can say is that there are a lot of us here who can sympathize with what you are going through and encourage you that things will improve.

Oh, as an after thought, some guys find that caffeine increases their leakage -- that includes soft drinks like Coke as well as coffee and tea.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.

Post Edited (geezer99) : 6/11/2009 8:50:05 AM (GMT-6)


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 6/11/2009 11:07 AM (GMT -6)   
Buckeye...did you have some urination issues before surgery...like urgent frequency? I know that prior issues with the urinary tract can complicate recovery slightly. Even issues as smoking, caffine from tea or coffee (and soft drinks), and certain medications will make the recovery process longer for some.

There isn't any thing as normal, but average time is anywhere from 3 months to a couple of years. If you are seeing any improvement (dry at night is a start), then I would be encouraged and just give it more time and not get too frustrated.

With this disease..we wait for our PSA, we wait for the continence to return, and wait very impatiently for the ED to go away.

Give it some time...all will be fine.
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
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month April 2009 .06


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/11/2009 12:21 PM (GMT -6)   
I was leaking a lot (8 pads a day) during the first 3 months with little signs of improvement. Was very frustrated. Then like someone just turned off the faucet - just a few drops.

Previous 5 biopsies over 4 years negative

PSA going from 3.8 to 28

Father died from PCa @ 78 - normal PSA and DRE

Dx Nov 2007, age 46

PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke

6 rounds of chemo (Taxotere+Avastin)

1/8/2008

33.90

1/11/2008

29.50

1/31/2008

38.20

2/21/2008

32.00

3/13/2008

26.20

4/3/2008

26.60

4/24/2008

20.60

followed by RRP at Duke (Dr. Moul) on 6/16/2008

Pathology

  Duke: Gleason downgraded 4+3=7, T2c N0MX, one small positive margin

  Sloan Kettering: results coming soon, T3a N0MX

PSA undetectable for 8 months, then

2/6/2009

0.10

4/26/2009

0.17

5/22/2009

0.20

6 Months ADT starting 6/15/2009

IMRT to start mid-Aug


hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 6/11/2009 12:56 PM (GMT -6)   
My incontinence stopped within a month after the catheter removal but I was walking 3 to 5 miles a day while recovering. I also stopped drinking coffee, soda, beer, etc., until I was dry. Water and milk were it.

Things got better day by day, to the point where I would leak only with stress. Such as lifting things, taking a big step off the curb while walking, etc.
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
pT2c
lymph nodes negative
PSA Sept 28, 2008 0.00
PSA Jan 22, 2009 0.00
ED Status- Currently using Trimix, Levitra daily for increased blood flow.
Noctural Erections have completely returned on a nightly basis, same hardness as before.


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 6/11/2009 1:45 PM (GMT -6)   
Greetings, Buckeye.  What you are describing is fairly normal.  Most guys tend to be dry at night before being dry in the day.  I remember that even though I was mostly dry fairly quickly, when I leaded it was when I stood up and when I lifted something that weighted much of anything at all.  It gets better all the time - hardly ever leak now.  I, too, was getting up 3 or 4 times.  Doc prescribed Detrol LA and am down to usually once a night - sometimes twice.  Better but still not what I would like.  Very seldom sleep through the night.  Hang in there - it does get better. David
Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


donte
New Member


Date Joined May 2009
Total Posts : 6
   Posted 6/11/2009 7:03 PM (GMT -6)   
I'm right there with you 24 days since surgery, dry during the night.  I'll wakeup 4 times during the night with urges and able to find the toilet. But through-out day leakage, but starting to catch urges to go.  I find myself getting better everyday, yes it is fustrating, but be positive, be patient it will work out.
 
Members: Thanks for the coffee tip...I'll layoff that immediately.
 
 
 

Age 57

PSA  4.6   2/2005   (not addressed by family doctor)

PSA  7.6   2/10/2009

PSA  7.9   2/17/2009

Biopsy: 3 of 12 cores positive 25% left side

Gleason 3+4=7

Stage T1c

 

Robotic Surgery  5/18/2009

Roswell Park Cancer Inst., Buffalo, NY

Dr. James Mohler

Upgrade Gleason 4+3=7

Tertiary grade 5

15% gland involved

Stage T3a

Focal extrprostatic extentension

High grade PIN

Perineural invasion identified

MARGINS of excision are NEGATIVE for tumor

Vascular/lymphatic invasion: NO

Seminal Vesicle invasion: NO

Lymph Nodes: None sampled 

Pathological Staging (pTNM):  T 3a  NX  MX

cather out  5/28/2009


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 6/11/2009 8:05 PM (GMT -6)   
Four weeks is a short time to expect continence for most people. There are some who are dry just after few days but in general it takes much longer for most. I'm 4 months since surgery. I started out dry at night and 2 pads during the day. I would leak a lot more if walking, getting up, or lifting. After one month I started using only one pad (some times 2 if very active). At 2 months I was down to one pad even if active and now I just use a liner (small and thin) just to protect me from the few drops that happen occasionally. My doctor thinks that the average is 6 months. I do recommend that you do Kegel exercise to build up and strengthen your pelvic floor muscles.
Age: 67
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 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 2/9/09
Surgeon: Dr. Randy Fagin, Austin TX.
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Bilateral 10-20% involved
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
seminal vesicles clean
Lymph nodes: not dissected
1st PSA test 4/7/09 result <0.1


55 and healthy in NJ
Regular Member


Date Joined Apr 2009
Total Posts : 58
   Posted 6/12/2009 12:17 AM (GMT -6)   
I guess I'm as normal as everyone else.  25 days after surgery and I'm basically dry overnight, but getting up during the night 2-3 times.  I believe the overnight dryness is related to being prostrate (HA - was wondering when I could sneak that word in!) such that there is less effect of gravity from the bladder.  Otherwise, it's not too bad during the day, if I remember to concentrate on the Kegels when I'm in motion or moving into or out of a seated position, otherwise it leaks on me.  What I'm finding is a difference between a dribble and an actual stream if I wait to long to visit the bathroom, so that tells me I need to be more aware of when my bladder starts to get full so as to not be caught off guard.
 
Greg

Age 55
10/15/2004 PSA 2.9
12/14/2005 PSA 3.7
11/20/2007 PSA 2.79
01/22/2009 Physical exam: blood pressure 130/85, EKG good, basically all-around healthy
01/23/2009 PSA 4.54
02/05/2009 PSA 4.9
02/19/2009 Urologist DRE observed slightly hardened left lobe
02/23/2009 Chest X-ray normal
03/03/2009 Biopsy: PCa present in all sextants, <5% to 50%, Prostate gland 37 grams,
    Gleason score 7 (in two sextants, 6 elsewhere)
05/08/2009 Cystoscopy, showed clear
05/08/2009 MRI, "No findings are present to suggest extracapsular tumor."
05/13/2009 pre-op EKG good
05/18/2009 Robot-assisted (daVinci) laparoscopic radical prostatectomy by Michael Esposito, M.D. and Vincent Lanteri, M.D. - both nerve bundles spared
05/19/2009 Surgical Pathology:
    Prostate gland 51.8 grams
    Gleason score 3+3=6
    Pathologic stage T2c, N0, Mx
    Left/Right Pelvic lymph nodes clear (no tumor present)
    No presence of extra-capsular invasion
    No margin involvement
05/26/2009 Catheter and incision staples removed
05/30/2009 Started Viagra .25mg 3x/week 
 
Research:
Surgery (daVinci robotic) consult with Michael Esposito, M.D., http://www.roboticurology.com/ (03/30/2009)
Radiation oncology (Varian IMRT/IGRT RapidArc) consult with Mark Macher, M.D., http://www.njneuro.org/fp/gammateam.asp (04/08/2009)
Other resources: Dr. Peter Scardino's Prostate Book (Peter Scardino (Sloan-Kettering), 2005); Urologic Robotic Surgery (Michael Esposito, Vincent Lanteri & Jeffrey Stock, 2007)

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