Suggestions speeding RRP healing process and incontinence control? (Was No Subject)

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New Member

Date Joined Jun 2009
Total Posts : 5
   Posted 6/28/2009 11:16 PM (GMT -6)   
I had my da Vinci prostate surgery June 11,2009 and my catheter removed June 22nd. The process went excellent with virtually no pain or issues. At the time of this posting, now six days after the catheter removal, I am experiencing considerable leakage although I do appear to be getting better control over my urinary stream. What I am curious about and maybe someone out there could help me with is what can I expect to see going forward? Can I expect to see my leakage become less and less until it finally stops or will I experience an abrupt stop to the leakage. I understand from talking to my doctor as well as reading all the great posts here that everyone is different in terms of time needed to heal and working oneself back to normal. Coupled with my doctors very positive comments about how well he thought my surgery went as well as how good I feel I believe I am healing normally but it would be good to hear supportive statements from others who are experiencing the same as I am. Also any suggestions about what I can be doing to help speed the healing process along would be much appreciated?
added a Subject for archiving and because there is more than one No Subject subjects on the board  Also, duplicate post deleted...

Post Edited By Moderator (James C.) : 6/29/2009 12:59:18 PM (GMT-6)

Regular Member

Date Joined Sep 2008
Total Posts : 72
   Posted 6/28/2009 11:43 PM (GMT -6)   
Glad your surgery was successful! Welcome to our club of Prostate Cancer survivors! Not a club you want to join but we are here to help.
In my case I just gradually got better and better. Finally I just quit dripping.
So just be patient and do those kegels!!!!

Don't get discouraged!!
Diagnosed Feb 2008  54 years old
3+4=7 gleason
7.5 PSA
4 out of 20 biopsies were cancerous
daVinci Robotic surgery July 24, 2008  Univ of Calif San Francisco Med Center  Dr Peter Carroll
In hospital 2 nights altho I had option of leaving the next day but stayed due to distance home.
Contained in prostate, not spread
Six weeks post surgery PSA less than .01
Five month PSA less than 0.1  Lab did wrong type of PSA test so this test was not as accurate.
Eight Month PSA less than .01  Yeah!!!!1

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 6/29/2009 7:46 AM (GMT -6)   

You are but 18 days out of a very major surgery. You are doing very well, and sound like a normal path on incontinence. Most of the improvement for many is just slow and steady. Just keep telling yourself what you just have been through, and have reasonable expectations on the healing end, the incontinence, and eventual any ED issues. It's hard to swallow being told to be patient all the time, but it is still good advice. Listen to your body, it will tell you when too much is too much, when it needs to rest and chill. This is a good time to be very compliant to your dr's advice and suggestions. Wish you all the best now that you are on the other side.

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, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist

Regular Member

Date Joined Nov 2008
Total Posts : 299
   Posted 6/29/2009 9:56 AM (GMT -6)   
I found two things to be a big help. First cut out all soda, beer, coffee, etc until you have stopped leaking. Or at least cut back. Some guys have tried to continue their existing use of liquids that fill up your bladder quickly and it took longer to get dry. Second, is to walk alot while doing kegels. By the time the catheter was out, I was walking five miles a day. Within a week after catheter removal, I was down to "stress leaks" only. Such as lifting something, stepping off a sidewalk curb, etc.
Btw, I bought a 50 Pad bag of Male Depends, threw over half of them away as I never had to use them.
Good luck
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
ED Status- Currently using Trimix, Levitra daily for increased blood flow.
Noctural Erections have completely returned on a nightly basis, same hardness as before.

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 6/29/2009 11:02 AM (GMT -6)   
Welcome to HealingWell...We have had quite a few guys show up soon after surgery with leaking issues and almost all get better in short time. We do have some guys who also did not fare as well, and changing their fluid intake hapits did not help much. In fact, I have read, it's a dangerous recourse if over done. You need to drink normal water and fluid levels, water is best, and not let your flow issue prevent that. Do keep up on kegel exercizes, and walking helps as well. Some of our long standing members who has serious incontinence issues will be along to lend their advice as well. Stay positive. Do expect to see improvement with time...

 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
My Journal is at Tony's Blog  

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 6/29/2009 12:34 PM (GMT -6)   
As has been noted before, continence moves in stages and not always strictly forward. First comes nights -- I was able to hold for several hours and then wake up and void. Getting up so many times a pain but it was a sign of growing control. Days were hard at first--- I was using about five pads and it is awful to be standing up giving a presentation and realize that you are peeing your pants (well, just the pad, I was the only one who knew) about two weeks after cath out I could actually control myself enough that I was getting to the bathroom at work (at least every hour) -- still using about 3 pads a day. By the sixth week I was mostly dry at night and down to two pads a day

The hardest part was believing that I would get better. The thought of going the rest of my life the way I was in the first two weeks after cath out was frightening.
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.
At 10 weeks: no pad at night -- slight unpredictable leakage day/1 pad.

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 6/29/2009 1:01 PM (GMT -6)   
Tony, you are dead on right about not restricting normal needed liquids, with the thought that if you drink less, you will pee and leak less, that would not be healthy. My own dr. did stress, that during the incontinence period, to avoid all booze and beer, all fruit juices, all caffine, are carbonated beverages, because they all tend to aggervate the bladder area. He said to stick to plain water or milk. I followed his suggestion and hardly had a problem. Now, months later, I drink whatever I want without any issues.

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, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 6/29/2009 4:27 PM (GMT -6)   
Greetings, Chippers.  I would agree with others who have said it is not wise to cut out all liquids in hopes of cutting down on the volume you put out.  You need to drink plenty of liquids - my doc advised me to cut out as much caffiene as possible which I did for several weeks.  I found the best way to do my "kegels" was to stop the flow of urine several times when I was urinating.  I did this before surgery and continued it for several weeks after surgery.
You are doing great for only being out of surgery a few weeks - you are on the right path and will be dry before you know it. 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

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 6/29/2009 11:27 PM (GMT -6)   
I hope your recovery will go fast, but do be patient. It takes varying amount of time for everyone. I tossed pads this week - a year after the surgery (yeah!). I used about 8 pads a day for 13 weeks, then very quickly went down to one and very slowly improved to nothing over 9 months. It does happen for most people.

I think what helped me to finally loose the pads is loosing weight and a lot of walking.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

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)

PSA results:            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

RRP at Duke (Dr. Moul) on 6/16/2008

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

2nd opinion at 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, 6/11/2009-0.27

6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516

IMRT to start mid-Aug

Regular Member

Date Joined Jun 2009
Total Posts : 292
   Posted 6/30/2009 11:03 AM (GMT -6)   
All generalities are false.

I was leak free at night from the beginning. I was up an awful lot but at least going was my decision. Walking seemed to act like a pump for the first two weeks after the catheter was removed. I couldn't stroll around the yard without problems. I never had to void my bladder after a walk around the neighborhood. Walking emptied me out nicely. It all changed the third week and by the end I was pad free though I did wear two layers of underwear for a few days just to be sure any stress leaks didn't make their way to the outside. PC is can be humiliating enough without broadcasting leakage issues to colleagues and clients. The underwear at least allowed things to breathe.

Today, nine weeks post surgery, stress incontinence - occasionally, urge incontinence - nightly, walking not a problem. (Technically, the arthritic knee makes it a problem but that is for another forum.) I never considered fluid restrictions but I never drank coffee and 1-3 sodas a week didn't seem to be an issue.

My first night post catheter I was up at least six times. Four times a night is still not unusual. I'm looking forward to that decreasing as the muscles learn there is not an impediment to easy flow now. I know I was up less before surgery. Go figure.

Once again, you are and will be different.
Diagnosed at 54
PSA 8.7
Biopsy 1/7/09
4 of 6 cores positive, one at 90%
Gleason 3+4=7
Neg bone scan 1/15/09
One shot Lupron Depot 1/27/09
Tax Season
RP 4/29/09
Neg lymph nodes, postive seminal vesicle, 1 positive margin
Gleason 3+4=7 with tertiary 5
Catheter out at 2 weeks no nighttime incontinence
Pad free week 5
PSA 6/6/09 <0.1

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