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Bladder seems to hold less urine than before surgery

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Ed C. (Old67)
Veteran Member
Joined : Jan 2009
Posts : 2543
Posted 8/3/2009 7:26 PM (GMT -8)
It seems that the urine volume in my bladder is less than it used to be. I also feel that I don't empty the bladder completely which causes more trips to the bathroom. My doctor said that the volume will increase over time but I feel that 6 months should have been enough. Any suggestions?
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Paul1959
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Joined : Nov 2007
Posts : 598
Posted 8/3/2009 7:33 PM (GMT -8)
Well, you're right. the reconstruction of a bladder neck DID make your bladder a bit smaller. Also, some of the natural elasticity is gone since there is now a lot of scar tissue at the bottom of your bladder. Now, I will tell you that 18 months out, it HAS gotten better. Sometimes I am surprised at how much I was holding. Other times, I'm desperate to go to the bathroom and I astonished at how little there was.
The end of urination is now an event. You have to really relax and give it a minute to all empty. take your time. I found that when I rushed things, I would end up with more than just the few proverbial drops down my pants. Stand there for a good ten seconds after you thing you've finished and give a few good contractions. Also shaking it a bit more helps empty the urethra...just don't have TOO much fun shaking it.
Paul
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Jeff M
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Joined : May 2009
Posts : 10
Posted 8/3/2009 7:35 PM (GMT -8)
You can have a quick "procedure' done in the doctor's office that measures how much urine is left in your bladder after you pee.  It's totally painless and takes about 2 minutes.

If the bladder is holding over a certain percentage then they may have to scope to see the problem.  If there is scar tissue causing blockage, they use a balloon to help open.  This is done with a local sedative and I hear it is also painless, if you are sedated enough.

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Tony Crispino
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Joined : Dec 2006
Posts : 8160
Posted 8/3/2009 7:41 PM (GMT -8)
I am not certain that it makes the bladder smaller necessarily. But it does reshape it. This can make it feel like you voided and actually didn't. Jeff's advice is good. Let the doctor know...

Tony
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CPA
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Joined : Feb 2008
Posts : 655
Posted 8/4/2009 1:35 AM (GMT -8)
Greetings, Ed. I told my doc the same thing a few months after surgery.  He said sometimes your prostate has been enlarged prior to surgery and it may have caused your bladder to have changed shape.  Now that the prostate is no longer there, it should eventually reshape, but he recommended a drug called Detrol LA that helps the bladder relax and thus move back to normal shape a bit quicker.  I would echo previous comments that sometimes the end of a good pee takes a while and you have to make sure that you stand there a bit longer.  Also - and I'll take all the comments this probably will generate - but I find if I sit down rather than stand I can do a much better job of getting my bladder completely empty.  So this is what I tend to do just prior to going to bed and also when I do get up (usually once a night) during the night.  David

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Ed C. (Old67)
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Joined : Jan 2009
Posts : 2543
Posted 8/4/2009 5:22 AM (GMT -8)
Thank you all for your comments and suggestions. When I'm at home I try to urinate sitting on the toilet rather than standing up. If this persists much longer I'll see my doctor to find out if I'm emptying the bladder and if not what could be done about it. Again Thanks
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geezer99
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Joined : Apr 2009
Posts : 990
Posted 8/4/2009 5:28 AM (GMT -8)
My doc said that the bladder is a very resilient muscle and that at four months I could still expect improvement.

Do raise the issue of emptying your bladder with your doc. The test is easy -- they have you pee and then rub an ultrasound probe over your belly. The reason that this is important is that if the bladder doesn't empty, the chances of urinary infection are increased.
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Purgatory
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Joined : Oct 2008
Posts : 25448
Posted 8/4/2009 5:48 AM (GMT -8)
My doctor said when I asked him the same question about bladder size, is that it isn't decreased, it's shaped somewhat different and has been re-located slightly to re-join the urethra. He said contrary to popular opinion the bladder is moved to fit the urethra, not the other way around.

Nine months out, I don't feel I can hold as much volume, and I have to go more often, and it is a strain to go. I often lean on the bathroom wall with both hands, it seems to make it go easy, and sometimes I have to make myself relax to get it all.

Now that I am on cath #6, doesn't matter, goes into the bag, and when I empty the bag, boy does that bag piss like a race horse!

I am hoping for a somewhat normal flow after what I am about to go through.

David in SC
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dawgfan
Regular Member
Joined : Aug 2006
Posts : 148
Posted 8/4/2009 10:35 AM (GMT -8)
I'll agree that my bladder certainly seems smaller after the first RP surgery. I frequently joke that I have the bladder of a 5 year old. Recent sling installation did not change this situation either (not that I expected it to). I asked the doc yesterday at my 6 week checkup about the frequency and he said it will improve, but that my caffiene intake plays a part in the situation.
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Steve n Dallas
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Joined : Mar 2008
Posts : 5246
Posted 8/4/2009 12:18 PM (GMT -8)

Have you ever noticed that some nights you can drink 4 beers and not have to pee..Other nights you have to pee twice per beer...

Seven or eight months ago I was having one of those pee all the time evenings. My friend was driving me home ten miles....I almost didn't make it. Never had to pee so bad in my life. If it had been my car..I would have just done it right there in my pants...It really really hurt that I needed to go so bad. Even a gun shot to the head would have been better.

I asked my surgeon about it the next time I saw him..He was right - ut has gotten better.

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Cajun Jeff
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Joined : Mar 2009
Posts : 4175
Posted 8/4/2009 1:54 PM (GMT -8)
Have had he same situation here. At 6 months I decided to wait and hold off on uninating as long as possible to try to increase the size of rht bladder. I think is it working. I go less frequently and I seem to be able to hold longer. Just sometimes when the urge hits it is time to go and I mean NOW!!!

I do find with any alcahol consumption in have to go frequently and I tend to leak just a bit.


Hope this helps.
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goodlife
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Joined : May 2009
Posts : 2692
Posted 8/4/2009 7:41 PM (GMT -8)
I think a lot of it early on is training. After a couple or 3 weeks on the catheter, any accumulation makes you feel like you have to go. Post catheter, I was getting up 2 or 3 times a night, and didn't really go that much when I did.

Now when I am in final stages of incontinence resolution ( 1 pad a day), by habit if I am near a potty, I go so I don't tinkle in my pad. The fuller we are, the more we are apt to leak. Our bladders get used to emptying when they aren't full, and signal us to go.

At night, I hate to get up, always have. I found by not getting up as often, and in most cases I can go back to sleep, now I am able to go all night again. Only when it gets painful do I get up.

As to the residual, I think the posts recomending that urologist check it out is goof advice.
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kjoe1947
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Joined : Nov 2012
Posts : 1
Posted 1/3/2013 4:18 AM (GMT -8)
This is my first post. I had Davinci surgery Nov. 14, 2012. Catheter removed on 26th. Most days I go through 8+ pads. Haven't given up my one cup of coffee in the morning. I know I need to drink more water. I have been doing my Kegels.
My problem is I don't have the urge to pee during the days (nights I do OK). During the day I know I'm leaking and go to the toilet but only dribble (no stream). When I leave the toilet I began leaking again. So frustrating.
In the last couple of days I've found that when I go to try to pee if I just "slightly" strain (same type strain as if I were having a BM) while standing over the John, I can produce a good stream. My bladder doesn't hold as much yet as before surgery but I do get a good stream by using this slight strain method. I've also decreased the number of pads per day. You guys probably already know this, but I thought I would pass it on as it is helping me.
Age 65.
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142
Veteran Member
Joined : Jan 2010
Posts : 7298
Posted 1/3/2013 5:06 AM (GMT -8)
kjoe,

Welcome to HW.

Let me suggest that you post your comment as a new thread, so you can be properly welcomed by the crew here.

The pad story is familiar to us surgery guys. We should have a special stock option for Depends smilewinkgrin

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Bruze
New Member
Joined : Dec 2012
Posts : 14
Posted 1/3/2013 7:10 AM (GMT -8)

kjoe1947 said...
This is my first post. I had Davinci surgery Nov. 14, 2012. Catheter removed on 26th. Most days I go through 8+ pads. Haven't given up my one cup of coffee in the morning. I know I need to drink more water. I have been doing my Kegels.
My problem is I don't have the urge to pee during the days (nights I do OK). During the day I know I'm leaking and go to the toilet but only dribble (no stream). When I leave the toilet I began leaking again. So frustrating.
In the last couple of days I've found that when I go to try to pee if I just "slightly" strain (same type strain as if I were having a BM) while standing over the John, I can produce a good stream. My bladder doesn't hold as much yet as before surgery but I do get a good stream by using this slight strain method. I've also decreased the number of pads per day. You guys probably already know this, but I thought I would pass it on as it is helping me.
Age 65.

This is very similar to what happened to me. The first 3 months after DaVinci (June '12) were pretty rough, although I started out with "only" 5 pads per day. I had little if any control. I quit coffee totally, and only drank liquid when I was really thirsty.

Whenever I felt the urge I would hit the toilet but nothing more than a dribble or two would come out, even though I felt like I had a full bladder. My bladder was not really acting as a reservoir; urine was coming out of me about as fast as my kidneys were producing it.

I was not working (thankfully) and got so tired of feeling urine coming out and not being able to stop it that I would just sit on the toilet and read. It was the only thing I could do where I could totally relax and not worry. I had been doing the max amount of Kegels, religiously, since the catheter came out (+8 days) but I still could not hold much back.

As I got towards 3 months I noticed pad use was down to 1-2 per 24 hour period. At my 3 month follow-up, my urologist suggested trying no pads. I had been toying with the idea for a couple weeks but didn't have the nerve to try it.

It was the right advice at the right time. At that point, much of my incontinence problem was in my head. Not wearing a pad forced me to concentrate on holding it. Now, at +7 months, holding it can still be a challenge especially when I'm on my feet, although sometimes it's a non-issue like the old days when I still had my prostate. I carry a pad in my truck, and carry a folded up paper towel in my back pocket.

Here's a tip, but I bet I'm not the first one to try it: In the evening if I leak I use a hair dryer to dry out my shorts. It only takes seconds and it beats the hell out of changing underwear all the time.
-----------------------------------------------------------------------------
EDIT to add: I never took "a healthy piss" until a couple of weeks after I got off the pads (surgery + 3.5 months). I never retained enough urine for that to happen, but once being forced to hold it I was taking the "racehorse" types again. And did it feel great! Those lucky racehorses.

Ah, the things we take for granted when young and healthy.

Post Edited (Bruze) : 1/4/2013 10:24:21 AM (GMT-7)

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Purgatory
Elite Member
Joined : Oct 2008
Posts : 25448
Posted 1/3/2013 4:13 PM (GMT -8)
the angle of the bladder can change greatly after the operation, my surgeon said, like tiling a can of water, obviously with enough tilt, the can wouldn't hold as much water as before, and may leave some in the bottom. depends of what difficulties encountered re-attaching the urethra to the bladder neck, as you now have lost one of the "mounting" points for your bladder. made sense when it was explained to me.

david
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hotrod58
Regular Member
Joined : Sep 2012
Posts : 36
Posted 1/3/2013 6:07 PM (GMT -8)
Greetings All:
After reading all the posts here on this subject I figure I must be really lucky. Had RPS in late October 2012, cath out 13 days later and have been continent since. As far as peeing?, I now can knock the cake hanging in the toilet off the hook if I try, LOL. Stream like a fire hose, like never before. As far as emptying my bladder fully, no problem. I do drink a lot of water and keep the plumbing working. Uro originally told me to try holding a bit longer to get bladder to hold more if I was having a problem but things working great on this end. Peeing like a thoroughbred after my RPS adventure!!! By the way, have not used a pad since two days after cath out and those were just a precaution at that time to see if needed. Glad I chose a URO that has done thousands of open RPS procedures.

Regards and Good Health,,,,,Hotrod58
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hawkgfr
Regular Member
Joined : Jul 2012
Posts : 98
Posted 1/3/2013 7:25 PM (GMT -8)
Mine seemed smaller as well. And after I stopped peeing on myself after about 6-9 months I would try and hold it longer when I was at home hoping to gain volume..I think that helped but you should wait until everything is healed up good before you do that...

I actully went back on the pads over Christmas due to a lengthy cold...sneeze peee/cough pee...hack pee...oh well...and I started kegals again too. lol

Hey look on the bright side though... When we go to the movies at least most of us no longer have to stand at the urinal looking at boogers on the wall or ceiling for two minutes waiting on a tiny trickle to start... Now it's more like, I hope I don't pee myself before I get there and fish tiny tim out of his little hole...;)
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Bohemond
Veteran Member
Joined : Apr 2012
Posts : 1438
Posted 1/3/2013 8:40 PM (GMT -8)
I'm 10 years since open RP and almost 3 years since SRT. My experience has been erratic. Sometimes I am pretty much normal, can go for hours and then pee a large volume. But other times I have extreme urinary urgency, but then am surprised to find out there is very little volume. Go figure. I think, at least in my case, there is something in the nervous system -- the signaling is sometimes wrong--even though the capacity of the bladder is probably pretty much the same as it always was.
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