Can post RP continence progress backslide?

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Englishteacher
Regular Member


Date Joined Jan 2010
Total Posts : 28
   Posted 1/29/2010 3:49 PM (GMT -6)   
3 months out from surgery, continence was beginning to noticeably improve, far less leakage, better flow. The last few days it seems to have reverted some. Can it go back and forth or should it be heading in a consistently improving direction. Is there something I should be doing differently? Maybe more fluids, or fewer?
60 year old, sometimes happy, sometimes grumpy guy
Robotic RP 11/09
Otherwise good health
Gleason 8, T3a
Margins uninvolved
extraprostatic extension present,
Seminal vesticle invasion: absent
PSA 1/25/10 undetectable
Great support, wife, family, employer


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 1/29/2010 3:54 PM (GMT -6)   
I think most of use have some days that are better than others. In my case it has a lot to do with what I do during the Day. When I do ab workout at the gym I always get a squirt or two. Weight lifting the same. Most of the time dry as a bone. The good part is I don;t squirt enough to need a pad.

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.
15 months out injections Caveject (success)


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 1/29/2010 3:55 PM (GMT -6)   
I wouldn't throw gasoline on a fire that you would like to put out...
 
Meaning less fluids would be better then more.
 
What else has changed in the past few days...And did you go from 1 pad a day to 12? Or 1 pad to 2 pads a day?
Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


Englishteacher
Regular Member


Date Joined Jan 2010
Total Posts : 28
   Posted 1/29/2010 4:17 PM (GMT -6)   
Started out Depends and pads several a day got down to @one Depends a day, back up to two with a return of leaky faucet syndrome and annoying random squirts with different exertions. It's just been a day or so so there is no enduring trend yet.
60 year old, sometimes happy, sometimes grumpy guy
Robotic RP 11/09
Otherwise good health
Gleason 8, T3a
Margins uninvolved
extraprostatic extension present,
Seminal vesticle invasion: absent
PSA 1/25/10 undetectable
Great support, wife, family, employer


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6945
   Posted 1/29/2010 4:34 PM (GMT -6)   
English - I am two weeks further down the road from DaVinci than you, and have seen the same thing - weather got nice last week, and I kicked up the walking by a mile a day - leakage got immediately worse (+2 pads / day worth) the day I did that, then calmed down after several days. I suspect Kegels and walking need to be balanced to keep all the muscles strengthening together.

hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 2/1/2010 6:25 PM (GMT -6)   
Yes, kegels and walking need to be combined. I learned to do a kegel prior to stepping off a curb, or any kind of stress.

Have you started drinking more coffee, tea, soda, etc? I cut down on all liquids except for water while I was using pads. I did have some days that seemed to regress and then it would get back to normal.
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, pT2c, lymph nodes negative
PSA Sept 28, 2008 0.00, PSA Jan 22, 2009 0.00, PSA June 29, 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.


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 2/1/2010 9:13 PM (GMT -6)   
You're fine. Up to two pads a day is not a major setback. Sounds like you are also more active? It goes in plateaus - it's not a steady line of improvement. There will be some days that are much wetter than others. If you are down to one or two pads a day at 3 months, you will most likely be just fine. Don't sweat this stuff.
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!


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 2/2/2010 10:25 AM (GMT -6)   
I don't think that your condition is getting worse. We all have bad days especially if you are becoming more active. I find that being in the outdoor in cold weather increases my frequency of urination and may cause a stress leaking. I don't use a pad anymore but I still have an occasional drop or 2 when physically active.
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 in circumference.
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
11.5 months test 1/21/10 result 0.004


Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 310
   Posted 2/2/2010 10:41 AM (GMT -6)   
I have noticed that I sometimes leak a little (a very little) while I'm sleeping if I have more fluids than usual during the evening or if I am particularly stressed (which is happening a lot due to work recently).  Otherwise I'm dry.
 
So, sure, I think a lot of things can affect continency.  Look at the long-term trend and just accept that you will probably never reach the state of being absolutely bone dry for the rest of your life.
 
Zen9
No family history of PC.  PSA reading in 2000 was around 3.0 .  Annual PSA readings gradually rose; no one said anything to me until my PSA reached 4.0 in September 2007, at which point my internist advised me to see a urologist.   
Urologist advised a repeat PSA reading in six months = 4.0 .  Diagnosed May 2008 at age 56 as a result of 12 core biopsy.  Biopsy report by Bostwick Laboratories = Gleason 3 + 3. 
Interviewed two urologists - the one who did the biopsy and another - the latter had the biopsy slides re-examined = Gleason 3 + 3. 
Then went to M. D. Anderson Cancer Center in Houston in July 2008 and met with a urologist and a radiologist.  Biopsy slides re-examined yet again, this time by MDA's internal pathology department = Gleason 3 + 4.   
Chose da Vinci surgery over proton beam therapy; surgery performed at M. D. Anderson Cancer Center on August 15, 2008.  Post-operative pathology report = four tumors, carcinoma contained in prostate, clean (negative) margins, lymph nodes clear, seminal vesicles clear.  Gleason = 4 + 3. 
Minor temporary incontinence; current extent of ED uncertain due to lack of sexual partner; refused treatments for ED as being pointless under the circumstances. 
PSA readings: 
November 2008 = <0.1 ["undetectable"]
June 2009 = <0.1   
December 2009 = <0.1
 


Im_Patient
Veteran Member


Date Joined Aug 2009
Total Posts : 665
   Posted 2/2/2010 11:03 AM (GMT -6)   
Progress definitely has plateaus. It can be discouraging if you let it when you are in one. Just acknowledge that there are plateaus, and be patient - then you'll see some pronounced improvement and be surprised at the next plateau. Very typical. Keggles can help, but not necessarily in the short term - you might tire the muscles in the short term and backslide, but they strengthen in the longer term if you keep up on a regular regimen of them. That said, I think a lot of the progress just seems to come with time.
Gleason, 3+4; PSA, 7
Robotic Prostatectomy, March 2008 (Age 48 then), nerves both sides spared, post surgery analysis confirmed 3+4 Gleason,
cancer contained, no penetration, lymph nodes clear
PSA consistently <0.1 since surgery

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