Post cath. urine stream

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Regular Member

Date Joined Nov 2009
Total Posts : 47
   Posted 2/3/2010 11:32 PM (GMT -6)   
I had the cath. removed this morning and also had a chance to visit with the doctor about my pathology report.  I have added the updated information to my signature.  My question for the folks who have walked the mile with this is:  How long after cath. removel did it take to get the "strong stream" that I have been reading about?  I know it has only been a day, but all I am getting is a "fair" stream, with spray and dribble thown in.  This is worse than what I had before surgery.  Hope it impoves as we are heading home ( 8 hour drive) in a couple of days. 
I have been through 4 sets of pullups with an extra pad thrown in so far and still have to make it through the night!  Hope it slows a little in a few days.
I have had little pain and walked about a mile a day while the cath. was in.  I walked a half mile after the cath was out today and found that that really caused the leak to get after it. 
age 59
2007 psa .6
Oct 2008 psa 9.4
Dec 2008 psa 11
Bio done 12 core, no cancer
July 2009 psa 16
Sept 2009 psa 20
All DRE were normal
Made appoinment at Mayo
Bio, 18 core 2 positive, gleason 3+3 =6
doctor said T2
Bone scan neg, CT neg, MRI with coil indicated cancer still in prostate
Robotic on 1/27/10
postop Pathology report:
prostite size 43g
adenocarcinoma involving left side from apex to base
nothing on right side
gleason up graded to 4+4=8
stage T2b no mo
largest area of cancer 1.4 cm in dia.
no involvement of periurethral glands
cancer does not extend into the posterior capsule
no extraprostatic extension and cancer does not extend to the external surface
distal and proximal periruethral margins are negative for cancer
high grade prostatic intraepithelial neoplasia found on both sides 
right and left side seminal vesicles are uninvolved
right and left pelvic nodes negative for cancer

Regular Member

Date Joined Dec 2009
Total Posts : 97
   Posted 2/4/2010 12:18 AM (GMT -6)   
Hello Twotall,

Getting that Cath out is real progress! I hated that thing. I was dry at night from the get go and had a pretty good stream when i got up to pee (about 4 times a night), but during the day when I was up and about, everything leaked out a drip at a time. That went on for about 4 weeks. 6-7 pads a day. Kind of a mess. I thought it would never end. Then over the next 3 weeks I dried up and didn't need any pads. Now I only leak a drop or 2 infrequently. Have a strong stream and only get up once during night.
They say everyone is different....Be patient, keep doing the Kegels, and keep up the walking.. I was up to 5 miles a day.

Good luck to you!
Age 70

PSA 5/2008- 3.6, PSA 7/2009- 6.1, retested 9/2009-5.1.
Biopsy 9/2009. 4 of 12 positive. Gleason 3+4=7
CT and bone scan negative.
Robotic De Vince Surgery 10/29/2009. 1 night in hospital. No pain. Cath out on 11/6
Pathology Report: Gleason score 3+4. Margins slightly involved <.1mm to .25mm. Perineural invasion present, stage pT2c. Tumor 18%. Seminal Vesicle - absent, Lymph Nodes 0 of 6.
Continence- first 4 weeks after cath out Dry at night, rest of time, bladder held nothing. 6-7 pads per day. as of 12/30 no pads most of time. almost dry except for a few drips. I keep doing Kegels.
ED. Started VED on 12/17. 15 min every other day. 20mm cilias twice a week. No sign of life yet.

Veteran Member

Date Joined Aug 2009
Total Posts : 670
   Posted 2/4/2010 1:04 AM (GMT -6)   
It sounds to me like with the amount of leaking you are doing, a strong stream may be a lot to hope for right now. You may still have swelling and irritation from the catheter -- don't make any judgments for at least a few days to a week. Although I'm fully continent now, it took a couple of months of frustration - you might have to be patient (everyone is different in their recovery).
Best Regards
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

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4849
   Posted 2/4/2010 9:16 AM (GMT -6)   
Give it a few more days to heal....But you might be a canidate for the roto rooter treatment...
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.

Elite Member

Date Joined Oct 2008
Total Posts : 25394
   Posted 2/4/2010 9:47 AM (GMT -6)   
Sorry to read about your Gleason upgrade from a Gleason 6 to a Glesaon 8. That will warrant keeping a close eye on your future PSA numbers closely. The rest of your pathology report looked pretty decent though.

On the incontinence part, there is no normal, and as advised by others, it will take some patience on your part. Make sure you keep yourself properly hydrated, your body still needs liquids as much as ever. Stay away from sodas, booze, juices, and anything with caffine (other words: all the good stuff), drink lots of water, and walk as much as you feel comfortable while in recovery mode.

Good luck.

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: 1/10 .12
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 43 days, 1/10 - Corrective Surgery #4, and Caths #11 and #12 in at the same time

Veteran Member

Date Joined Nov 2007
Total Posts : 598
   Posted 2/4/2010 2:04 PM (GMT -6)   
Give it some time. Your urethra is irritated and swollen from the cath. You should see improvement over the next week.

As long as you are peeing, you are fine.
Paul 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
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!

Veteran Member

Date Joined Nov 2009
Total Posts : 7270
   Posted 2/4/2010 3:08 PM (GMT -6)   

Excellent question. I had my catheter removed Tuesday. My stream is not strong at all, but I guess good enough. I had BPH before surgery and had a decent stream with flomax but lousy without. My current stream is between the two. I, too, was hoping for a better stream.


OTOH, I am at 1 pad/day and 1 pad/nite (probably don't need the night one). So, I have to be pleased, although I hate this dribbling crap



63 years old
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro! DREs have always been normal.  
History of BPH/prostatitis. PCA-3 test: 75.9 (bad news, guaranteeing I have to do....): Biopsy on 11/30/09. Result of biopsy:

5 out of 12 cores positive. Gleason 4+3. More specifically: 2 cores were 3+3 (one 5% and the other 30%) on one side. On the other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C

REVISED BIOPSY REPORT: The previous was read by Umich. Slides were then sent to Dr. Menon at Ford Hospital. Here is their report (much better) -- changes in bold print below:

5 out of 12 cores positive. Gleason 3+4. More specifically: 2 cores were 3+3 (one 5% and the other 20%) on one side. On the other side, 3 cores were 3+4 (5%, 5%, 20%)

 Surgery with Dr. Menon at Ford Hospital,  1/26/10. He says all looked good. Spared nerves. Awaiting pathology report, set for 2/2/10.

Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland.

Lymph Nodes: Clear

Perineural Invasion: yes. Seminal Vessical Involvement: No

Extraprostatic Extension: yes

Positive Margin: Yes-- focal-- 1 spot .5mm

Final Weight is 52.7 gms

Incontinence: just joined that club-- definite leaks-- my guess is 1 pad during the day -- at night??? First night tonight!




Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 2/4/2010 4:40 PM (GMT -6)   
At cath out my stream was about 20% of pre surgery. My doc explained that he sutures the bladder neck rather small because it will expand as it heals. It took 4-5 months to get back to 60% and now at 9 months I am still at about 70% but that is an amount I can live with.

So, as long as you flow, patience is called for.
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

Veteran Member

Date Joined May 2009
Total Posts : 2692
   Posted 2/4/2010 5:06 PM (GMT -6)   
Part of full stream is also full (fuller) bladder. With all the leakage, your blasser never gets real full. I can blister the porcelain when my bladder is full.

The post surgical swelling is also a real thing . Give it a few weeks.
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 injection
No pads, 1/1/10,  9 month PSA < .01

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