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compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 3/8/2010 2:28 AM (GMT -6)   

I'd like to revisit something I mentioned earlier.

I am having strange incontinence problems and maybe you guys could relate and have some advice. I am almost 6 weeks post-op. When my catheter was removed 5 weeks ago, I would get annoying squirt…squirt…squirt stuff, especially arising from sitting, sneezing, coughing, etc. I was doing better than most, I thought.

Soon after, I was down to no pads at night and one pad during the day, barely needing that. However, the last 10 days have been different, and it’s hard to describe.

Generally, I start off with a normal, decent urination. It feels fine, but 1-3 minutes later I have to go back to expel a small amount of urine (small squirt or just drops). Two minutes later I have to repeat this. Two minutes later, same thing. This feeling continues much of the day. If I don’t go back to the bathroom, I feel VERY uncomfortable. Oddly enough, I can actually get through the day without a pad.

I am not sure if things have improved or not. I feel more miserable this way, although there are pretty much no involuntary squirts (a cough or sneeze might create one). I feel like I empty my bladder well, but yet more drops remain. I don’t know if my bladder has lost its elasticity or the loss of the upper sphincter muscle is just allowing drops to exit the bladder prematurely.

 

Based on my morning urination, my bladder can hold a decent amount. I generally do not have to get up during the night (sometimes maybe once).

Before my PC, I had BPH and at times I was having problems with retention. I know how that felt. It was truly miserable and uncomfortable. Flomax did work very well for me for many years. Anyway, that kind of retention is NOT at all the feeling I have now. It is that constant additional bit of urine in the urethra (or perhaps up a bit from there). It also starts to burn and irritate at times. I have been checked for an infection (urine culture) and none has been found.

Can any of you relate to these symptoms? Is this perhaps normal as part of the recovery process? I know they have P/T folks here who specialize in incontinence and it may be a matter of strength/training of some pelvic floor muscles. I don't know.

I have a new local urologist who I'll be seeing at the end of April (they are so busy)

 Suggestions?

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. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities.

Next Event: First post-op PSA on 3/9/10


Ricky2
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 3/8/2010 6:46 AM (GMT -6)   
Hi Mel,

I had a like problem of dripping shortly after i urinated. In fact, it seemed like I could hold the urine better when I had a full bladder. Of course your always producing urine and when the bladder is empty the brain isn't trained yet to keep that sphincter tight. Me thinks that it is also a healing problem. Remember that bladder was connected to a sphincter muscle that you never needed before. So the connection has to heal. It sounds like you are doing well for the time that you have been on the other side. Hang in there, things will get better.

Ricky
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 12/17/2009. Every other day for 15 min. Cialis .20 mm twice a week
PSA 02/08/2010 <.1
02/22/10 Trimex injection .2ml less than 50% just a little discomfort.


Magicianatx
New Member


Date Joined Feb 2010
Total Posts : 14
   Posted 3/8/2010 9:30 AM (GMT -6)   
HI, I'm about 8 weeks past opeen surgery and about two weeks ago I started having similar issues, needing to urinate but only drops and and a small squirt, and then repeating a little while later. Tested for urinary tract infection but no infection, did take three days of antibiotics, even tried pure cranberry juice, how do you spell pucker. Finally the last few days, good stream is back on its on, so I would say just give it a few more weeks. I also had BPH and my prostate was measured at 126 versus a normal 40 when it was removed.
Diagnosed: June 2009
Age: 54
PSA: 8.0
Gleason: 3+3
Surgery, open Prostate: Jan. 4, 2009


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 3/8/2010 9:56 AM (GMT -6)   

Let me clarify. I don't feel that I need to have a normal urination and only a few drops come out. After a normal urination, I keep feeling that there are a few drops left. It is very annoying. I then go and only the few expected drops come out. Then a few minutes later, same problem.

Someone said it sounds like a stricture, but I would think a stricture would be having to urinate normally and not being able to.

Anyone out there with such an experience (stricture)?

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. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities.

Next Event: First post-op PSA on 3/9/10


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4849
   Posted 3/8/2010 10:04 AM (GMT -6)   
It sounds to mike like you need to retrain your bladder....Don't give in to the sensation and hold back...

Age 55   - 5'11"   215lbs
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.


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 3/8/2010 10:46 AM (GMT -6)   
Mel...somewhere back if memory serves me (from this forum and I apologize I don't remember the name of the member), the urethra is not in a straight line and can sometimes hold urine after empting the bladder, which will give you that urge. A method that was mentioned to try, was to press upward at the very base of the penis to push the urethra upwards slightly to expel any remaining urine after emptying the bladder. For awhile that seemed to work for me until the nerves healed and the sensations went away. Might be worth a try.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 3/8/2010 10:51 AM (GMT -6)   
LV-TX, glad you brought this up. I told Mel about it earlier, but wasn't sure if I had heard of it here on the forum. No one ever said they remembered and Mel didn't say if he tried it or not, so I didn't know if anyone saw it or not. The drooping loop in the tube was a subject of discussion?, good deal............

Mel, maybe try this technique and see if it relieves the feeling? LV says base of the penis, i recall behind the scrotum, try either method and see.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
Gonna Make Myself A Better Man: www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
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


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 3/8/2010 10:53 AM (GMT -6)   

I've tried both. No joy. I might be doing it wrong.

 

Mel


Bluenose
Regular Member


Date Joined May 2008
Total Posts : 260
   Posted 3/8/2010 12:08 PM (GMT -6)   

 

   What Steve said......and, yes I had this going on for awhile with time, and maybe a few good extra shakes of the ole' boy it took care of itself!

 You're doing great!

 


 
  age: 53 @ Dx, Pre-op PSA Feb 08' 5.0, April 08' 4.1
  Biopsy 5.1.08, 5 of 15 cores postive, T2a, Gleason 3+4=7
  DaVinci performed 7.29.08
  Bladder sling installed, umbilical hernia repaired during surgery.
  Path report, "cancer fully contained, margins clear".
  Cath removed 8.8.08, ED therapy begins 8.9.08
  100mg Viagra three times a week, pump for ten minutes daily
  and hold for ten minutes.
  8.16.08 switched to Levitra 20mg, immediate results
  9.15.08 Pad free at night, one thin (light) pad during the day
  9.18.08 1st Post-op PSA Undetectable Zero's....Yes!
  12.22.08 2nd Post-op PSA  Zero's still...
  6.23.09 1yr Post-op PSA Still a zero..
  12.23.09...another zero
  Pads gone 1.3.09, finally found the courage...Thanks ya'll
          ".....tryin' to reason with hurricane season...."
       


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2461
   Posted 3/8/2010 2:59 PM (GMT -6)   
Mel,
I had that problem for 4 months, even now, there are times when I feel like I lost few drops only to find out that nothing was lost. Sometimes, I will sit on the toilet a empty my bladder and yet I can still have few drops left.
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


Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 664
   Posted 3/9/2010 12:12 PM (GMT -6)   

Mel,

I remember that you had the temporary superpubic approach; it may be interesting to see if any other members of HW had that model and perhaps similar symptoms.

Hero

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