incontinence question

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compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 2/19/2010 2:19 PM (GMT -6)   

I was wondering if any of you have this strange type of incontinence (actually, probably not strange). I am now dispensing with the pad at night; I am dry then. I can dispense with the pad during the day when I am at home. What happens is I go to the bathroom and soon after urinating (within a minute) I am struggling to keep from squirting. Basically it is akin to urinating and just not being able to get those last drops out. The pressure will build and in order to relieve the discomfort I just go to the bathroom and urinate just a few drops. It is really a strange kind of urgency. I know I am emptying my bladder fairly well. The pressure is just those last few drops in the penis. But then, if I don’t relieve myself again and again the drops just accumulate (I guess in the urethra?) and I am uncomfortable. I might actually urinate like this ( a few drops) 7 times in 45 minutes. Then I might be okay for awhile.

If I go anywhere, I absolutely still need a pad as I do have some leakage. I don’t think it’s really too bad. I’ll know more when I go back to work. But does anyone have that kind of incontinence. Perhaps what I am describing is the norm?

I’m also wondering if the constant few-drops urination is counterproductive. I don’t want to mess up the holding capacity of my bladder. I suspect it is okay, at least based on the first urination of the day.

Your thoughts?

Mel


63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: 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: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights.

Next Event: First post-op PSA on 3/1/10


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/19/2010 2:56 PM (GMT -6)   
I remember someone who discovered the techniques of getting those last few drops out. Something about using the index and next finger to press up just behind the scrotum, up into the abdomen and this action would lift the dropped down portion of the urethea, draining out the few drops that has remained in the drop down loop. Something like that. Maybe they, or someone else will come back with a better description.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
32 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 2/19/2010 3:36 PM (GMT -6)   
Mel,
I get some of that even after one year. I often sit on the toilet after emptying my bladder but can feel that there are few drops left. Sometimes I feel like I leaked only to find out that nothing has come out.
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


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 2/19/2010 4:48 PM (GMT -6)   

I might also add that sometimes I urinate and then it takes another few minutes as plenty of drop...drop...drops are forthcoming. It's annoying.

Mel

 


63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: 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: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights.

Next Event: First post-op PSA on 3/1/10


Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 2/20/2010 1:19 PM (GMT -6)   
compiler said...

I might also add that sometimes I urinate and then it takes another few minutes as plenty of drop...drop...drops are forthcoming. It's annoying.

Mel

 


You are not even a month after major urinary surgery...

coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 2/20/2010 8:06 PM (GMT -6)   
Compiler, I have attached the link to a Tip that James C referenced. I can't remember how to post the link so that it will actually work so you'll have to copy it to your browser.

http://www.continence-foundation.org.uk/symptoms-and-treatments/overflow-incontinence.php#3
Age 51 @ DX
Pre - Op PSA, 4.3
Gleason 3+4=7
Stage T1C
da Vinci Prostatectomy 8/1/08
No issues with incontinence since day 1 after catheter removal
Mild ED for about 10 months. Levitra worked well for me. No ED at one year.
PSA 0.00 at 18 month post op


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/20/2010 8:58 PM (GMT -6)   
I agree, Casey, I think our friend Mel has very unrealistic expectations this soon out of a complex and major surgery. One's recovery doesn't go on schedule and by the book for many, if any one. Some well needed lesssons in patience are needed in my opinion.

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, 1/19 - Corr Surgery #4,  Caths #11 and #12 in at the same time, 2/8-Cath #11 out - 21 days


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 2/20/2010 9:25 PM (GMT -6)   
I won't begrudge Mel a good, possibly spectacular, recovery, but at +17 weeks, I still need a pad at night (if I cough or sneeze in the night, I leak, and not just drops). And, although I had gotten down to 1 pad a day a few weeks ago, I am back to 3-4 a day now for no apparent reason.

I wish my only problem was a slow drip after.

Mel - the guy in the song says "don't worry, be happy". I've always hated that song, but trust me, buddy, it applies to you.

DS Can
Regular Member


Date Joined May 2009
Total Posts : 195
   Posted 2/20/2010 9:57 PM (GMT -6)   
Mel,
I have been using James' technique for 30 years.  After having back surgery I no longer had the muscle control necessary to fully empty the urethra.  I'm not sure if this will help your situation or if you are just having other urgency issues. 
I am amazed at how little I do leak, seeing how easy it is to sit on the toilet and just keep going more and again some more and then more.
I wish you good healing and a great checkup in March.
Dan
 
PSA 01/07 1.2, PSA 01/08 1.9, PSA 01/09 2.5
BIOPSY 02/24/09  PCa DX age 52
Right: 3+3=6, 3/6 cores 10% involved,PNI-Y
Left:  3+3=6, 1/7 cores <5% involved,PNI-N
LARP 04/09/09 nerve sparing. Final pathology:
GS 3+4=7, Margins uninvolved, 2 lymph nodes negative
Catheter out 04/17,1st no-pad day 05/03
Followup PSA 05/28/09,08/20/09,12/08/09 <0.1
 
 


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 2/20/2010 10:02 PM (GMT -6)   
Thanks for all your suggestions.
 
I fully realize it takes time. You are misreading some of my questions as constituting unreal expectations. Frankly, I am doing better than I expected/feared.
 
Mel

63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: 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: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights.

Next Event: First post-op PSA on 3/1/10


Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 2/20/2010 10:28 PM (GMT -6)   
compiler said...

I might also add that sometimes I urinate and then it takes another few minutes as plenty of drop...drop...drops are forthcoming. It's annoying.

Mel

 


If you thought that after only one month it wouldn't be annoying, then you had unreal expectations.

Keep up the good work...you are doing fine.

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