Anyone have experience using Ditropan to control incontinence?

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55 and healthy in NJ
Regular Member


Date Joined Apr 2009
Total Posts : 56
   Posted 6/15/2009 6:44 PM (GMT -7)   
My friend (who had a robot assisted laparoscopic radical prostatectomy back in 2001 at the Cleveland Clinic) tells me he has had success with Ditropan for his incontinence.  He suggests I ask my doctor about it if my incontinence doesn't improve, but I'm sure sphincter strengthening is preferred over medication.  Any comments?
 
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)


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/15/2009 7:50 PM (GMT -7)   
I cannot add much. I used ditropan briefly after the surgery to control the urges. It definetly helped. If your incontinence is urge related I would imagine it helps. If it is stress related, I am not sure it would, but as I said, I have no first hand experience other than a few days right after surgery a year ago.

In general, a month after the surgery is too early to start worrying about it. I went back to work about 5 weeks after surgery and I used 8 pads a day then. At 13 weeks, it just stopped and I went from 8 to almost nothing in a matter of a week or two.

I know it is hard to do, but be patient...

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

Gleason downgraded 4+3=7

  Duke: T2c N0MX, one positive margin

  Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

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 6/12/2009

IMRT to start mid-Aug


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25353
   Posted 6/16/2009 5:33 AM (GMT -7)   
I used it heavily for 2 months after surgery because of being on a catheter for so long, it generally worked well for bladder spasms. There was a former poster on this site, from my state of SC, that was on ditropan patch's long term for the reason you asked. I remember him saying how well that helped him with that problem. You may want to ask about the patch version, some people, men and women, are on them longterm, as in years.
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, 5/9 .10 doubled in 3 months, new test in six weeks, then possibly off for salvage radiation
 
 


SnowyLynne
Veteran Member


Date Joined Apr 2004
Total Posts : 1539
   Posted 6/16/2009 5:53 AM (GMT -7)   
I took Ditropan for several months & it did help some with incontinence but it's not good for anyone with Dementia,it can make the person seem worse at times so my Dr stopped it.....
SnowyLynne


Edgarone
New Member


Date Joined Jun 2009
Total Posts : 3
   Posted 6/16/2009 2:00 PM (GMT -7)   
I am new to this, so forgive me if I don't do this right yet.
My surgery for prostatectomy was Tuesday last...June 9. I'm home with the Catheter on place and a Dr's visit tomorrow to remove staples. I'm a bit of an inventor (Architect by training) and wondered about improving the results for incontinency. (My brother is incontinent after 10 years, same surgery).

Here's an idea....(too late for me, but maybe for others)....My image of the catheter is a solid tube which one's urinary sphincter isn't able to close upon fully, to zero orifice. The sphincter gets used to not closing fully, leading to incontinence. I have a design for a novel catheter which allows full sphincter closure. What do you think?

I hope your problem resolves itself, so keep kegelling.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 6/17/2009 7:59 AM (GMT -7)   
First, Welcome to HW and the other side. Your idea of a new catheter sounds like something that is used outside or after the sphincter. If so, then the purpose of the current catheter is to allow for healing of the various sliced and diced parts of the bladder floor, urether and sphincter that has all been stitched back together. I suppose the main purpose is to keep urine out of those stitches, and to relieve any stress/strain on them, resulting in tearing of the the stitches. don't know if anything outside the bladder neck would provide as much protection and isolation of the surgical stitching site as current technology. Shop it around after you have it fine tuned and see.
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
21 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


Edgarone
New Member


Date Joined Jun 2009
Total Posts : 3
   Posted 6/18/2009 5:11 PM (GMT -7)   
thanks James,
Yes this is all weird.
My design for a catheter is exactly like the foley catheter but soft so your muscles could work it. The hard part was trying to figure out how to thread a soft catheter in place, but that's not so hard after all.

I think you must be right anyway, that the sphincter should probably not be used a lot anyway as its all healing in there.

I have another week with the catheter in place, but each time now I bear down for a bowel movement, urine leaks fairly freely out around the outside of the catheter. I guess I will call my doctor, but so far I hear this is normal, what?

Thanks

I promise to post my info soon.

Edgarone
New Member


Date Joined Jun 2009
Total Posts : 3
   Posted 6/18/2009 7:20 PM (GMT -7)   
Also,
Urine is leaking more freely around the outside of my catheter, especially when I have a bowel movement. My doctor isn't concerned too much, but it seems to be getting worse. Any experience in this?

55 and healthy in NJ
Regular Member


Date Joined Apr 2009
Total Posts : 56
   Posted 6/18/2009 7:33 PM (GMT -7)   
Yes, it's quite normal, however, the amount of leakage is usually directly related to the amount of straining you are doing when you move your bowels.  What's happening is when you strain, the balloon inside your bladder (that's on the other end of the foley catheter) is moving slightly out of position, which allows some of the urine to flow through the urethra as opposed to through the catheter.  In my case (see my thread "Greg's RALP" for my day-by-day post-surgery report) this also led to a burning sensation as the urine leaked out during a bowel movement, which, although not unusual, made for some very discomforting days.
 
What you need to do is load up on fiber, like prunes, so that you keep your bowel movement straining to a minimum.  Your doctor may have also advised you to take stool softeners each day - this is extremely important, as it is very easy to strain during a bowel movement, and the faster you go through it the better.  Good luck.
 
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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