A question about urinary frequency after PCa surgery

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Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 11/24/2009 11:05 AM (GMT -6)   
I averaged 4 or 5 nightly trips to the restroom for many years prior to my PCa surgery.  Now I am averaging 1or 2 trips a night.  This is a great improvement and can't really complain.  As with many older men, the problem is not so much having to go too often.  The real problem is that many of us have a devil of a time getting back to sleep. 
 
What is a normal urinary frequency?  Is this just a function of aging?  Can anything be done to improve it?
 
I know this is a minor problem compared to what many of you guys are going through.  Any thoughts would be appreciated.
 
Carlos
Diagnosed 2/2008 at age 71, PSA 9.1, Gleason 8 (5+3)and stage T1c.  CT and bone scan neg.
Robotic surgery 5/2008, nerves spared, bladder neck spared with pelvic floor reconstruction.
All margins, SV and lymph nodes were neg. 
Staged pT2c, Gleason sum 8 (5+3).
Continent at 6 weeks. 
PSA <0.1 at 18 months, Nov. 2009.


Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 314
   Posted 11/24/2009 11:38 AM (GMT -6)   
I'm 14 years younger than you, but I can give you a case history based on my grandfather (who did not have PC, or at least was never diagnosed as having PC) in the later years of the last century.
 
He used to get up to use the bathroom about twice a night during his '70's; 2-3 times a night in his 80's; and probably 3 times a night in his 90's (he died at age 96).  He began to experience minor-moderate incontinence at night in his very late '80's and in his '90's.  He wouldn't see a doctor, but at my suggestion he started religiously emptying his bladder right before going to bed, reduced his fluid intake for several hours before bed, and slept on a waterproof pad which was machine washable to protect the mattress.
 
As for getting back to sleep, he would lie quietly for 10 - 15 minutes, but if that didn't work he would read whenever he couldn't sleep.  He told me that he felt like he didn't need as much sleep as he had earlier in his life and that overall he got enough sleep between the several hours of sleep per night plus an hour long nap during the afternoon.  He said the nap really made a difference.
 
As for what's "normal," I don't really know.  I suspect that like so many things, everyone is different.
 
Zen9
 
  

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 11/24/2009 12:34 PM (GMT -6)   
Thanks for your comments. Your grandfather was certainly right about the afternoon nap. It is essential.

Carlos
Diagnosed 2/2008 at age 71, PSA 9.1, Gleason 8 (5+3)and stage T1c.  CT and bone scan neg.
Robotic surgery 5/2008, nerves spared, bladder neck spared with pelvic floor reconstruction.
All margins, SV and lymph nodes were neg. 
Staged pT2c, Gleason sum 8 (5+3).
Continent at 6 weeks. 
PSA <0.1 at 18 months, Nov. 2009.


English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2218
   Posted 11/24/2009 1:07 PM (GMT -6)   
Carlos,


Some questions spring to mind when thinking about not being able to bet back to sleep after peeing at night:



How far is it from your bed to the bathroom? A long walk there and back will wake you up more than a short one and thus make it harder to get back to sleep when you get back into bed.

I have a very short walk. (And after my father had a heart attack he used to have a bed-bottle so that he could pee without having to even get out of bed - as he also had to go upstairs to the bathrrom from his bedroom.)



Do you have to turn the lights on? Light will upset your body's rhythm. I leave a 7watt child's night light on on the landing and this is enough light to light my way from bed to bathroom without needing to turn any bright lights on, and I usually have my eyes half shut too.



Is the trip to and from the bathroom a cold one? Do you have to put on slippers and dressing gown? Doing things will also wake you up more.



Do you have any techniques to help you relax again when you lie back down? In the first weeks after my op I always grabbed my MP3 player and relaxed with a mixture of soothing music even if I did not manage to sleep.



I used to have to get up for a pee about twice a night before surgery and had done since my twenties, and I still have to get up about twice. BUT I made an interesting dicovery when I still had my catheter in. With the bag attached I was able to see how much pee I produced when and was amazed that I produced masses of pee between midnight and three every night, (which obviously explained my long term problem) so I have since tried to modified my intake to try and get the liquid into me earlier and thus out before midnight.

But at least I have not had any night time leaking since the first night after the catheter came out.



You might spot something helpful



Alfred

dogbot
Regular Member


Date Joined Aug 2009
Total Posts : 147
   Posted 11/24/2009 1:59 PM (GMT -6)   

Carlos, I experienced a different set of circumstances. Before my op I did not go for a pee during the night, after the op I started with perhaps twice a night, following that I tried to limit liquid intake before bed and gradually it decreased to once a night. Now 6 months out I can usually go all night again unless I have a few beers and then I only go once. I have been lucky that I can drop off to sleep again within minutes of a pee.

All the best from England.


Diagnosed February 2009. Gleason 6, Psa 7.2, 12 core biopsy, and then Mri scan, which showed organ specific.
DaVinci at Addenbrookes, Cambridge, England 18th May 2009.  Nerves removed one side.
Catheter in for 8 days, no pain, no post op problems apart from an infection, cleared with antibiotics.
Some aching around the penis, which still occurs.
6 week psa 0.1, post op pathology all good, confirming pre op tests. Ed a problem, no treatment as yet.
Light ladies pad during the day, just to control a slight dampness and a Tena for  men pad at night for occassional leakage.
Awaiting 3 month consultation at the moment.
Sept 09 - still awaiting consultation. 99% dry during the day, tena pad at night just in case.
Sept 18th 09. PSA less than 0.1
Sept 29th follow up consultation at Addenbrookes. Staff happy with progress.
Nov 11th update. One small stress dribble in the last 2 months. Still some muscle stiffness in pelvic area.
 


kodiak
Regular Member


Date Joined Nov 2009
Total Posts : 27
   Posted 11/24/2009 5:36 PM (GMT -6)   

Carlos,

          When you get back in bed try as hard as you can to stay awake that usually puts my right to sleep. smilewinkgrin

                                Charlie


Age 52
PSA4.5
Gleason 6
Robotic surgery Oct29, 2009
Pathology margins good
1 week off cath 1 pad per day
St Clairs hospital, Denville NJ
Dr Colton
Flash up date! Nov 21,2009 50%hydralics back useable erection 1st time woo hoo!


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 11/24/2009 5:46 PM (GMT -6)   
Alfred and dogbot, Thanks for commenting. I have tendency to worry about things over which I have no control. That tends to do a job on me.

kodiak, Thanks, you may be on to something. I will give it a try tonight.

Carlos
Diagnosed 2/2008 at age 71, PSA 9.1, Gleason 8 (5+3)and stage T1c.  CT and bone scan neg.
Robotic surgery 5/2008, nerves spared, bladder neck spared with pelvic floor reconstruction.
All margins, SV and lymph nodes were neg. 
Staged pT2c, Gleason sum 8 (5+3).
Continent at 6 weeks. 
PSA <0.1 at 18 months, Nov. 2009.


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 11/24/2009 5:50 PM (GMT -6)   
I am a lazy sob. I cannot stand to get up in the nigtht. Prior to surgery, i virtually never got up.

Post surgery, I would get up 2 or 3 times because I was afraid of peeing the bed. As time progresses, I will lay in bed for at least an hour if I feel the need to get up. I lay on my side in the fetal position. Many times, I fall back asleep and don't get up at all.

I believe that by not getting up, I am able to train my mind and my bladder to just hold it. Now I rarely get up. As was mentioned, limiting fluids after 9 does help also,
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injections


kodiak
Regular Member


Date Joined Nov 2009
Total Posts : 27
   Posted 11/24/2009 6:05 PM (GMT -6)   

Carlos,

          The harder you try to get back to sleep , the harder it is to accomplish sleep .I use my method all the time as I think I have a sleep disorder.I have never had a night of constant sleep as long as I can remember.

                                                  Charlie  

       


Age 52
PSA4.5
Gleason 6
Robotic surgery Oct29, 2009
Pathology margins good
1 week off cath 1 pad per day
St Clairs hospital, Denville NJ
Dr Colton
Flash up date! Nov 21,2009 50%hydralics back useable erection 1st time woo hoo!


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 11/24/2009 7:25 PM (GMT -6)   
Goodlife, I think you are right about being able to train your mind and bladder. Some of my problem might just be fear of loosing control. I do know that the years of BPH may have caused my bladder walls to thicken and also some bladder muscle problems. But on rare occasion I can make it overnight. I have to laugh a liitle when you young guys say no fluids after 9. At 73, maybe no fluids after 7.

Charlie, I appreciate your thoughts and I agree with you about your sleep method.

Carlos
Diagnosed 2/2008 at age 71, PSA 9.1, Gleason 8 (5+3)and stage T1c.  CT and bone scan neg.
Robotic surgery 5/2008, nerves spared, bladder neck spared with pelvic floor reconstruction.
All margins, SV and lymph nodes were neg. 
Staged pT2c, Gleason sum 8 (5+3).
Continent at 6 weeks. 
PSA <0.1 at 18 months, Nov. 2009.


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 11/24/2009 7:38 PM (GMT -6)   
Carlos,

If you really can't get to sleep, wake your wife up and ask her about her day. Puts me to sleep within seconds every time !
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injections


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 11/24/2009 7:51 PM (GMT -6)   
Goodlife,

You are wise beyond your years.

Carlos
Diagnosed 2/2008 at age 71, PSA 9.1, Gleason 8 (5+3)and stage T1c.  CT and bone scan neg.
Robotic surgery 5/2008, nerves spared, bladder neck spared with pelvic floor reconstruction.
All margins, SV and lymph nodes were neg. 
Staged pT2c, Gleason sum 8 (5+3).
Continent at 6 weeks. 
PSA <0.1 at 18 months, Nov. 2009.


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3743
   Posted 11/24/2009 9:32 PM (GMT -6)   
Carlos,
Before my surgery, I'd sleep through the night. Now (at 4 months) I get up 3x per night. I then start or stoke the fire in the wood burning stove so it will be warm when everyone else gets up. They think I am being considerate but in reality I figure I'm up anyway so I might as well.
about half the time I look in at this site without my glasses and the eye strain makes me sleepy.
Hey look! It's bed time already. I'm off...Good night.
Jeff
DX Age 56. First routine PSA test on April 8th: 17.8.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7 Tumor size: 2.5 x 1.8 cm location: both lobes and apex. No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Extraprostatic extension present; Perineural invasion: present, extensive
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 10/31 3 months, Still no activity, nada, zip
Incontinence - 8/20 4 full pads per day
. 9/7 3-4 full pads per day (I'm going to try cutting down on fluids. Bad idea. I know.)
9/27 2 months: Still 3 pads per day.
11/14 4 month: Still 3 pads per day. 420ml/day, 91 um leak. At this rate I'll be fine in 2012.
Post Surgery PSA - 9/3 6 weeks- 0.05, 10/13 3 months- 0.04 undetectable.


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 11/25/2009 1:48 PM (GMT -6)   
A nurse suggested to me that right after surgery we head for the bathroom at the slightest urge to beat leakage but that this is bad training for the bladder. She suggested that I keep a "pee log" during the day and try get the interval above 3 to 4 hours. The idea is not to hold to the point of discomfort, but to get the bladder used to being full.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day


kodiak
Regular Member


Date Joined Nov 2009
Total Posts : 27
   Posted 11/25/2009 2:02 PM (GMT -6)   

Thanks Geezer,

                     I have been having a hard time with that.I pee everytime I see a bathroom .I think I have to retrain the old bladder.I guess this is normal?

                                                   Charlie


Age 52
PSA4.5
Gleason 6
Robotic surgery Oct29, 2009
Pathology margins good
1 week off cath 1 pad per day
St Clairs hospital, Denville NJ
Dr Colton
Flash up date! Nov 21,2009 50%hydralics back useable erection 1st time woo hoo!


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 11/25/2009 2:11 PM (GMT -6)   
Geezer, Thanks. Prior to surgery my whole life was planned around the nearest restroom. I think this probably carried over after surgery. Now I can make it about 4 hrs. unless I've been into the coffee.

Carlos
Diagnosed 2/2008 at age 71, PSA 9.1, Gleason 8 (5+3)and stage T1c.  CT and bone scan neg.
Robotic surgery 5/2008, nerves spared, bladder neck spared with pelvic floor reconstruction.
All margins, SV and lymph nodes were neg. 
Staged pT2c, Gleason sum 8 (5+3).
Continent at 6 weeks. 
PSA <0.1 at 18 months, Nov. 2009.

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