Cath Out and Path looks good

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Bedelia
New Member


Date Joined Nov 2009
Total Posts : 18
   Posted 12/21/2009 7:59 PM (GMT -6)   
My husband had the cath out today - didn't care for the experience much though.  I think his anxiety made it worse than it was.
 
The pathology report was good.  The tumor was confined to the prostate (10%) and the gc remained at 3+3.  The lymph nodes and tissues were all negative.  He was so relieved he had tears of joy. 
 
Now, for the incontinence.   So far, he has not felt the "urge" to pee.  Basically, he's just leaking.  He wants to know (asked me to find out from you guys) when does that urge come back?  He's panicked.  The PA said it may take up to 2 wks, and everyone is different.  I know this is a constant topic; I've read about the control issue, but what about the feeling of having to go?
 
Also, what is the purpose of drinking lots of fluids at this point?
 
I have told him this is day one, be patient, but he's quite grumpy. 
 
Any advice?

Age 60, no symptoms
Hardness found in DRE during physical
PSA 1.84 (up from 1.5 last year)
Diagnosed 10/27/09
Left Mid and Apex: Adenocarcinoma, GS 3+3,
cancer in 2 of 10 cores occupying 40%
daVinci 12/11/09
Strong Memorial Hospital, Rochester NY
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 12/21/2009 8:05 PM (GMT -6)   
Excellent news on the pathology report, glad it stayed a Gleason 6 and 10% not bad.

I have had 9 caths removed so far, none of them hurt, all just feel weird coming out.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA:
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 12/21/2009 8:53 PM (GMT -6)   
Hi Bedelia & Hubby,

Sorry to hear that hubby is so grumpy. He should be jumping up and down for joy having received such a great pathology report. Unfortunately, we are all a little different in the getting dry department. I have read on this site about a couple of lucky guys that were dry from the get go. Most of us however, will go for several weeks or even month before abandoning the pads. So patience is an absolute MUST with this disease. The urge to go will return once he health a bit and starts to get a little drier.
Enjoy your early Christmas present and the holiday season.

Magaboo
Born Sept 1936
PSA 7.9
-ve DRE
Gleason's Score 3+4=7, 2 of 8 positive
open RP 28 Nov 06 (nerve sparing), Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; 3 days before Rad Start=0.1
Salvage RT completed (33 sessions - 66 Grays) on the 19th Dec., 08.
PSA in Jan., 09, = 0.05; July 09, <0.04


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 12/21/2009 8:55 PM (GMT -6)   
Relax. All of his plumbing has been re-arranged and it is going to take a while for his body to sort it out. For the first week expect nothing. Then gradually going from wet pads every two hours to wet pads every two hours BUT with some left in the bladder to be controlled. For most guys, night time continence comes first (even if you get up several times a night.) The last control to return is late in the day when you are tired.

For a month at least he is going to be very conscious of where to find the next bathroom. But it will get better. Today, We spent the entire day 9:30am to 9:00 pm visiting friends, hitting outlets, and driving in between. I'm 8 months post surgery and did it all on one light pad, although I restricted my fluid intake on the three hour drive home.
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


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 12/22/2009 6:02 AM (GMT -6)   
Bedelia, congratulations on a very good path report! As to the reason for drinking lots of fluids...your husband needs to flush out his urinary systems. There will likely still be little bits and pieces coming out. This will keep his system working and prevent blockage and infection. I understand his grumpiness as my husband was that way shortly after the surgery. In our case, John just wanted things to go back to the way they were before the surgery. I think that in his mind he felt that once the catheter was out, the recovery was over. Kind of like the old Archie Bunker response to Edith's menopause - "if you're going to change, then change already." Like all things worth having, continence takes time and patience.

Congratulations again to you and your husband - the path report is something to celebrate.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009- 0.1, September 0.3, October back to 0.0, December 0.0. Thank you God!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 12/22/2009 8:10 AM (GMT -6)   
Sephie, that one part amused me. Once the catheter is out, that is really just the beginning of recovery. I think that some men either have the wrong idea about the scope of their surgeries, or they are told the wrong thing. It is a complex serious surgery, with a longer recovery curve then many are led to believe. And that's assuming they don't have any set backs along the way. For most men, you are not all recovered in the 4-6 weeks that some are told. I know there are exceptions to that of course. My own uro/surgeon told me ahead of time to look at it as a full year recovery. He was much closer to being right.

David
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA:
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 12/22/2009 8:46 AM (GMT -6)   
He should be doing his exercises ( lightly) at this time. Whenever he goes to urinate he should practice stopping the stream, then restarting ( this will be tough at first)

Walking is a great exercise, start slowly, 10 minutes, then gradually get up to 20, 30, etc

Each week will be better than the past, till he gets down to a few drips when bending, lifting, laughing

He will get there, good luck, its great that you are assisting, he is a lucky guy
Stats:
Age: 52
PSA (2008)=1.9
Biopsy on Jan 09, 2009
One (1) out of twelve (12) cores was positive, plus external nodule found
Gleason Score = 3+3
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 12/22/2009 9:13 AM (GMT -6)   
Hi Bedelia,
First day of winter and everything is covered in white. Fortunately for your husband, you were considerate and got a plow service. Nice. All he has to do is look out and enjoy it.

I did not get the urge to pee for a long time. I still only get it when my bladder is full in the morning or after a nap. It makes sense to me if the bladder is leaking all day there is never a chance for the volume to build up and trip the switch on a the sump pump.

When the day finally comes and the signal begins, make sure to never be standing between him and the path to the toilet.

Amelia- For 30 some years it has been his job to put the seat down Starting today it is your job to put it up when you are done.

Stay warm,
Jeff
DX Age 56. First routine PSA test on April 8th: 17.8. Start 2 weeks of Cipro to rule out protatitis.
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.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next?
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 months: Still 3 pads per day. 420ml/day, 91 um leak.
12/11 5 months: Still 3 pads per day. 400-450ml/day Experimenting with Nyquil for 10 days: Can sleep through the night but withdrawal is bad. Stopped 12/20.
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04 undetectable.


STW
Regular Member


Date Joined Jun 2009
Total Posts : 292
   Posted 12/22/2009 12:35 PM (GMT -6)   
Even when things start to work more normally it'll seem like taking two steps forward then one step back. In my case, first I was dry at night. However, the door to the bathroom better be open and not too steps away because once I was up, oh boy. Still two steps forward. Then I'd leak a bit while taking a shower. The warm water couldn't be resisted. One step back. Next I'd be just fine up but sitting around the house. Again forward. The walk to the bathroom was a challenge and not always successful. Not as forward as I'd thought. Last was control while walking around. It was almost as if my legs acted likes pumps making sure my bladder was empty. It was weeks before I could finish a walk around the neighborhood with anything left in my bladder. There was no defining moment when that wasn't a problem any longer. Even after I thought the pads were staying dry and stopped wearing them I added an extra pair of under shorts to take care of little leaks. A good stretch still can bring a surprise now.
Of course your husbands mileage will vary.
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 PSA 9/10/09 <0.1


cocrgolfer
Regular Member


Date Joined Oct 2009
Total Posts : 171
   Posted 12/22/2009 1:33 PM (GMT -6)   
Bedelia,

During the last two months since my catheter came out I have researched the web, read everything I could get my hands on, and even have gone back 130 pages in HW reading every single thread about incontinence. Here's what I can tell you. Your husband might dry up tomorrow. He will possibly be dry in 3 months, and will probably be dry in 6 months. If none of those occur, his chances are 90% of being dry at 12 months. I have personally read stories of men who have done all of the above, including drying up slowly or practically going dry overnight. Until he regains the ability of retain urine he will not feel the urge to go. Incontinence is maddening and the doctors don't really understand exactly why it is so capricious. You can council him to be patient, do his Kegel exercises, and let the drips fall where they may. If there is anything else to be done I believe I would have found out about it by now.

Happy Holidays and the best of luck,

Steve

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 12/22/2009 1:49 PM (GMT -6)   
Bedelia, Like your husband, I didn't have any urge to pee. I was using about 7 or 8 pads a day and never had much in my bladder. I believe I started to feel the urge when my pad usage dropped down below 3 or 4 a day. Please keep encouraging your husband. Most of my friends that had surgery were continent by 3 months. Jeff (worried guy) had good advice about the toilet seat. Just bending over to raise the seat pretty much eliminated any need to use it. The thing that helped me the most was learning to squeeze my pelvic floor muscles before I did anything; before bending, before standing up, before getting out of the car or before moving anything. You have a good start - stay optimistic.

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.


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 12/22/2009 2:41 PM (GMT -6)   
Bedelia,
Like what others have said, what it comes to incontinence everyone is different. I was dry at night on the second day and mostly dry when lying down. I started out with 2 pads a day for over 2 months, down to one pad after 3 months and 99% dry after 5 months. I still dribble a couple of drops when I play golf. I use a thin liner on those days otherwise I don't use any pads.
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


skeener
Regular Member


Date Joined Dec 2009
Total Posts : 214
   Posted 12/22/2009 2:48 PM (GMT -6)   
Lots of good advice here.  Your husband's patience is being and will be tested.  He is lucky to have you rooting in his corner for him.  Have a nice Christmas!!
 
Skeener
 
Age:  63
 
Biopsy May 09 showed 2 of 12 cores positive for prostate cancer -- 1 at 5% and 1 at 25%.  Cancer indicated as non aggressive.  Gleason score 3+3.
 
Considering all the controversy about whether action is needed or not (I could die with prostate cancer not from it), gave consideration to active surveillance.
 
Had open RRP on Oct 23/09 in London, Ontario.  Excellent surgeon.
 
7 Weeks Post Op -  The fears I had about bad things about the operation and recovery did not materialise except of course ED!!.  Otherwise, everything went very smoothly.  Incontinence not a problem.  Wear a pad when out just in case. Pain was never a problem.  Forum tells me can't do anything about ED right now.  Give it a rest!!
 
Nothing of concern in the pathology report. 
 
First followup PSA and visit in Feb 09.      


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 12/22/2009 2:56 PM (GMT -6)   
Bedelia,

Patience my dear. Time will be needed to heal and relearning. Hope things dry up quickly. I was one of the lucky one that never had the problem after surgery. I think my walking had a lot to do with it. Everyone heals different with this surgery. All of us have different tales to tell with different hurdles to jump over before we got to what is called the new normal.

Merry Christmas from Cajun Land

Jeff T


Jeff T Age 57

9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable

10th month PSA <0.01
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.


Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 662
   Posted 12/22/2009 5:31 PM (GMT -6)   
Walk, walk, then walk some more.  That did more for me than anything.  I quickly got up to 4 miles a day 2 in the morning 2 in the afternoon. Really helped more than anything.  I did do the start and stop when I got to the point that I acutally had a stream. Never actually got anything from the Kegel so I stop that.   I'm currently working 10 hr's a day with no pads. Walking is my advice.  At least it worked for me.
 
jnm
Age 51, PSA 08/31/2009= 6.8, DRE Neg.
Biopsy 9/24/09 =10 of 12 positive. Gleason 6. 75% of one core.
da Vinci at Wash U, Barnes on 11/02/09
Pathology Changed Gleason to 4 + 3 = 7. Gleason 7 present in all 4 quadrants
All(4)periprostatic Lymph Nodes Negative, All(10)pelvic Lymph Nodes negative
Seminal Vesicles tumor free. No prostate extension


dogbot
Regular Member


Date Joined Aug 2009
Total Posts : 147
   Posted 12/23/2009 5:26 AM (GMT -6)   
Regarding the drinking of fluids, I had an infection after the catheter was pulled and the urine sample I supplied for testing was full of bits and pieces left over from the op. So a good fluid intake is needed to flush out all the rubbish. After about a month post op my urine was crystal clear once more. 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.
 


Bedelia
New Member


Date Joined Nov 2009
Total Posts : 18
   Posted 12/23/2009 8:01 AM (GMT -6)   
Thanks for the words of encouragement.  I know things will get better, just have to be patient.  He doesn't leak overnight which is good.
 
It's in the 20's but he has been getting out for walks.  Now we just have to find the right pad/brief.  We have 3 different types and none is as absorbent as they claim. 
 
I believe there is a light at the end of the tunnel - it's just a little blurry right now.
 


Age 60, no symptoms
Hardness found in DRE during physical
PSA 1.84 (up from 1.5 last year)
Diagnosed 10/27/09
Left Mid and Apex: Adenocarcinoma, GS 3+3,
cancer in 2 of 10 cores occupying 40%
daVinci 12/11/09
Strong Memorial Hospital, Rochester NY
 
 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 12/23/2009 11:11 AM (GMT -6)   
Dry at night is very good news indeed because it shows that some control is there. As far as pads, Depends Guards for Men seems to be a favorite. For them to work, they need to be inside rather tight fitting Jockey shorts. As far as capacity, some guys at your husband's stage go through 8-10 pads a day so perhaps you are expecting too much of them.

For a place to walk look into near by malls. Some open early just to accomodate walkers (I found out about this because my dad did it)

Get your husband moving and thinking about other things -- a positive attitude is good for healing.
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


English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2215
   Posted 12/24/2009 1:24 AM (GMT -6)   
The pathology report must have been welcome, especially with Xmas here.


Fluid intake is about several things.

The bladder needs to be encouraged to try and fill up, the urge to pee follows on from the bladder itself detecting that it is full.

The body needs to get rid of stuff left by the op and that means more than just blood clots etc that might be in the area near the operation site, it also means all the drugs etc injected or swallowed.

I was told it could take up to 4 weeks for my liver and kidneys to finish processing the anaesthetic. (The processing of the chemicals or the mixture of blood & urine may make the pee smelly, so drinking also helps dilute it.)



I also found it impossible to detect any change from one day to the next as the improvements come in such small steps, but after a week and especially after the first month the improvement was indeed obvious. And don't be worried by the odd step backwards. (Especially if say you get a cold that makes you cough and sneeze) I'm just coming up to five months post op and having been pad free since September I had a very leaky day yesterday for no apparent reason. And Kegel exercises are here to stay, it's not just an exercise to be done at the beginning.



If the walk from the bedroom to bathroom is too far at this stage consider having a wide-necked bottle by the bed.



Wear clothing where the zipper etc is easy to open very quickly.



If sitting tense the muscles before you stand up, in fact you'll find you need to tense the muscles before doing all manner of things. Over time you'll find yourself doing it automatically.



I loved Jeff's comment about "lift the seat" , but he might find it easier to sit to pee sometimes, especially when there are problems with the stream or the aim. (I sometimes produce two streams at rightangles at the same time now and if one goes the right way the other is sure to go the wrong way, and very often even when you think everything is going the right way you are actually dribbling on your shoes without realising it. A tiled bathroom floor is very useful and I have a little spray nearby containing dilute Dettol to make it easy to keep things clean.)



Must get to the stores now.

Happy holidays

Alfred
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