Seem to be leaking more (urine) than before...

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unhappycramper
Regular Member


Date Joined Nov 2005
Total Posts : 113
   Posted 12/10/2009 9:56 PM (GMT -6)   
Hi all,
I had my robotic surgery last January 09, and I have heard that each patient is different as far as the healing time on the incontinence and the ED issues. It seems that nowadays, after I urinate, I have to sit on the pot for an additional 5 to 10 minutes until the trickling subsides. I hope there is no internal problem and just part of the timely healing process. To tell you the truth, I really hadn't notice the extra leakage until maybe the last month or so. I was most diligent on my kegel exercises for months post op. Anyone else with the leakage? Thanks, and Happy Holidays!

bunksbbq
New Member


Date Joined Jul 2009
Total Posts : 5
   Posted 12/10/2009 11:23 PM (GMT -6)   

I'm right there with you.  I have been dry since September, but lately I too have found that I have to push, shake, rattle and pull to get that last drop out.  A couple of times I wasn't very concientious, and looked down to see that I had wet myself pretty good.  I was getting worried that maybe I was regressing or that there might be something else going on.  Saw my uroligist this week and talked to him about it.  He did an ultrasound after I had gone and it showed an empty bladder.  His opinion is that I just have to be more diligent about getting that last drop.  Like you i find sitting down to be the best way to go. 

Hope this give you some comfort. 

Craig


Age 56
PSA 4.7 diag 4/09
DRE negative
Biopsy - 4 of 8 samples Gleason 3+3 - 6
DiVinci 7/22/09
Patholigy - Margins clear, Gleason 3+4 - 7, 40% involved
Both nerves spared
Cath removed 8/3/09
No Pads - basically dry by 9/09
ED - Still looking forward to that
PSA 8/31/09  0.0
PSA 12/8/09  0.0
 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 12/10/2009 11:32 PM (GMT -6)   
I have found this off and on as well. I am inclined to think that like the rest of the body things start to get a little slack as time and lack of exercise takes its toll. Probably ensuring a little kegeling (v?) wouldn't go astray with keeping on the straight and narrow.
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01
PSA August 09 (2 year mark), <0.01
PSA December 09 <0.01

My Journey: www.yananow.net/Mentors/BillM2.htm


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 12/11/2009 6:15 AM (GMT -6)   
Kegeling will help, but the main culprit is probably a sagging urethra. The urine is pooling in a dip in the urethra. When you start moving around, it pushes the last drops out - and down your pants. The technique - as awkward as it may be- is to reach behind your balls and push firmly up on your perineum. Some go from around back, others spread their legs and go in from the side, but make sure you have clearance for the half-teaspoon of urine that will come out.
The fun never stops.
Paul
www.franktalk.org ED website for PCa guys


46 at Diagnosis.
Father died of Pca 4/07 at 86.
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC www.roboticoncology.com
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - at one year, ED is fine with viagra.
Two year PSA - undetectable!


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 12/11/2009 8:18 AM (GMT -6)   
I gave up trying to piddle it all out. It is like Zeno's Paradox of Achilles and the Tortoise. I can pee 200 ml in one minute -Call that rate "Achilles". My body makes urine at a about 2000 ml per day - Call that rate "the Tortoise". If I sit on the toilet for 5 minutes, the Tortoise makes 1.4 ml - about 27 drops . If I manage to hold it for 5 minutes and let Achilles squirt it out in 0.42 sec., the Tortoise will make another 27 drops. While Achilles waits and squirts it out, the Tortoise makes more drops. You can never catch up.

The technique Paul recommends above works, and gives you a 20 minute edge on the Tortoise by squirting out about 5 ml more than either Achilles or you can.
Just don't let anyone see you doing it in a public restroom as a wide stance is required. ;-)

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.

Post Edited (Worried Guy) : 12/11/2009 12:28:40 PM (GMT-7)


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 12/11/2009 12:51 PM (GMT -6)   
Wow! This is the most amazing site for learning more about our disease. I never knew that Achilles had PCa. I guess that time he spent in his tent was for changing pads.
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


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 12/11/2009 1:38 PM (GMT -6)   
Geezer,
See? Some engineers do know something else besides numbers. Although, there were plenty of numbers in my analysis.
I could have answered the question with a limit equation and solved for the precise point where Achilles finally reaches the Tortoise and pees on his shell using Paul's Perineum Push Procedure.
I will leave that calculation for another mental case curious soul.
Jeff

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 12/11/2009 2:48 PM (GMT -6)   
Geezer and worried guy, you made me laugh so hard that I almost lost few drops. Sometimes we need a break and laugh at whar we go thru with PCa.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
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 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 12/11/2009 5:14 PM (GMT -6)   
Ed,
I'm hope you found the posting educational as well as humorous. The Tortoise produced at least 5 ml of pee while I ran through those calculations and did my fact checking. In fact he just made another 1 ml. Gotta run.
Jeff

cocrgolfer
Regular Member


Date Joined Oct 2009
Total Posts : 171
   Posted 12/12/2009 11:33 AM (GMT -6)   
The dangers of Paul1959's procedure. The area to which he refers is commonly called the "t'aint" which is an area that t'aint balls and t'aint a--.) A hard push and a slip would result in either turning oneslelf into a eunuch or giving oneself a self-administered DRE, the latter horrifying done without a glove.

Steve

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 12/12/2009 1:41 PM (GMT -6)   
Can't you guys decide whether you want to start ot stop ? We kegal for months, trying to stop the pee, then we can't seem to get it all out. Maybe we just did a too good of job of kegaling, and it is trying to put the brakes on.

Anatomically, probably standing is better to drain everyting out.

Even pre surgery, can't forget the little ditty on the bathroom wall, no matter how much you shake and dance, the last 2 drops go in your pants.

Well, now it's 20 drops.
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


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 12/12/2009 1:56 PM (GMT -6)   
...
And if it runs when 'ere you stand,
Then surely you are incontinent,

Kegel once, Kegel twice,
Kegel once again.

And the tortoise makes another 30 drops.

zachattack
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 12/13/2009 12:14 PM (GMT -6)   
Kinda reminds me of when I was young I loved to hunt.When it was real cold out and you had to pee real bad.You peed and then put it up and when it got warm it finished.

Zach
age 55dx 12-2008,psa at biopsy 8.6
biopsy 12/12 gleason 3+4=7
da vinci surgery 6-09 by DR. John W. Scott (my hero)
Hospital 3 days cath 7days still leaking from cough(bad lungs)
still have ed may be the hormones.
9-09 psa 2.2 hormone inj
10-09 nuclear bone scan no results yet I will have gold markers placed 12-29-09
start rad 1-10-09
organ confined
extracapsular seminal vesicle involvement
lymph node involvement


Modelshipwright
Regular Member


Date Joined May 2009
Total Posts : 215
   Posted 12/14/2009 7:53 AM (GMT -6)   
I too have experienced varying amounts of leakage at different times. It got better in a hurry after surgery and reached a plateau at about the 8th week. Then I noticed that I was needing to urinate more frequently and in smaller amounts and that leakage was a little more prevelant. I think some of it has to do with the colder weather that winter brings and that we relax a bit after getting through the worst part of the healing process.



I still remain positive and do my pelvic floor exercises every day. I think it will get better with time and that might mean months rather than days. Still, I am down to one pad per day and it is mostly dry.



Keep well,

Regards,

Bill

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 12/14/2009 1:50 PM (GMT -6)   
Bill,

You are doing very well. I am sure will reach total continence soon.

It has taken me 8 months, but I am at no pad to 1 pad a day. I mainly use one during the day for security, and I lift heavy things occasionally, and climb ladders, etc.

Keep the faith, and don't forget to pucker !
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

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