When does the urgency to urinate return?

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Regular Member

Date Joined Jul 2009
Total Posts : 102
   Posted 4/12/2010 8:17 AM (GMT -6)   
Hi Guys,
Well it's been 6+ months since my robotic surgery. While I have gone from 8-10 pads per day to 2-4 pads per day, I still really don't have any real urgency to urinate except at night.  During the day, I don't feel the urgency at all but leak a lot. Is this normal?  I never feell like I have to take a pee, AT ALL!  Let me know your experiences, please.

Age: 65
DX: 7/10/09
Gleason: 7
Biopsey: 2 chips with some cancer cells out of 30.
Robotic Surgery: 9/10/09
Cath out: 9/23/09
1st post op PSA: 10/20/09 <0.1
2nd post op PSA:  1/25/10 <0.1

Worried Guy
Veteran Member

Date Joined Jul 2009
Total Posts : 3742
   Posted 4/12/2010 8:33 AM (GMT -6)   
Welcome to my world. The only times I feel urgency is when I wake up in the morning and when I stand up after sitting for an hour or so. I drink a full 12 oz glass of water before bed. I figure that rehydrates me and stimulates the urgency.
Married 34 years, DX Age 56. First routine PSA test on April 8, 09: 17.8. Start 2 weeks of Cipro to rule out protatitis. May '09 PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, 20%-70%, Gleason 6=3+3. Bone and C/T scans neg.
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 See Uro 1/22/10 Trimix #1. Try 0.08- 25%, 0.12-25%, 2/26/10 try 0.16 First Success! 90%.
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day (Try cutting down on fluids. Bad idea. I know.)
12/11/09 5 months: 3 pads per day, 400-450ml/day
02/26/10 7 months: 3 pads but leak is now 320 ml (5 day avg.)
03/22/10 8 months: 3 pads per day, 280 ml/day (5 day avg.) PT says all muscles are tight and working properly. There must be another issue. Uro mtg 4/23. Did I waste 6 months?
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04, 1/14 6 months - 0.05.

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4849
   Posted 4/12/2010 8:39 AM (GMT -6)   
Doesn't sound normal to me at all. What do your doctors say about it?

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.

Worried Guy
Veteran Member

Date Joined Jul 2009
Total Posts : 3742
   Posted 4/12/2010 9:17 AM (GMT -6)   
I'm coming up for my 9 month Uro visit where we will discuss incontinence and my options. I've already been to the physical therapist who performed biofeedback, imaging, poking and other unspeakable acts on me. She said I am doing everything right. My pelvic floor is in great shape. I am fully emptying my bladder.
According to the Uro and PT, in general, it is best to wait one year post surgery before deciding on a course of action. Given my leak rate of 300 ml per day (4 pads per day for you guys without Mettler balances) it is likely I will need some assistance in this area.
They will send me to an incontinence specialist who will run a scope up there to check things out. My own measurements (don't ask! )indicate a small leak at my sphincter of about 70 um -slightly larger than the cross section of a hair.

I need to be patient and wait until the one year mark. Maybe a miracle might happen.

Len, How much are you leaking? Did you ever weigh your pads?


Casey, I do Kegels many times a day! Even when I hold it, I drip. According to the PT I am doing them perfectly.

Post Edited (Worried Guy) : 4/12/2010 8:23:49 AM (GMT-6)

Veteran Member

Date Joined Sep 2009
Total Posts : 3172
   Posted 4/12/2010 9:21 AM (GMT -6)   


How rigorously and regularly have you been doing your Kegel exercises?

The sole purpose of Kegels is to address the symptoms you described.

best wishes...

Regular Member

Date Joined May 2009
Total Posts : 121
   Posted 4/12/2010 1:05 PM (GMT -6)   
I use to be doubled over when the urge hit, now it is much uich more subtle. I have learned if it feels full at all time to empty.
Dx'ed 5/08 one core 2%  out of 12  3+3 gleason
DREs all negative
PSA was in the 3-4 range then jumped to 7
I have the enlarged prostate, on the order of 100cc.  After taking Avodart for 3 months  my
PSA was cut in half.
I did Active S for a year but concluded that I didn't want a life
of biopsies and Uro meetings.
DaVinci on 6/24/09  UCI Med Center  Dr Ahlering, long surgery based on size and location
Final was 5% one side all clear, but had a huge 90 grm prostate
Now we work on pee control, ok at night but sitting is a big problem.

Regular Member

Date Joined Jul 2009
Total Posts : 102
   Posted 4/12/2010 1:48 PM (GMT -6)   
I am doing my kegels regularly as recommended by my Doc. I must admit that, at times I forget to do them.
Age: 65
DX: 7/10/09
Gleason: 7
Biopsey: 2 chips with some cancer cells out of 30.
Robotic Surgery: 9/10/09
Cath out: 9/23/09
1st post op PSA: 10/20/09 <0.1
2nd post op PSA:  1/25/10 <0.1

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 4/12/2010 7:26 PM (GMT -6)   
My uro said that many men overdo the kegels, and make things worse for themselves by tireing out the muscles they are trying to strengthen. When I was going dry originally, I only tried doing them at most for an hour or two, and never again. I may have just been one of the lucky ones.
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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04
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  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29

Veteran Member

Date Joined Apr 2007
Total Posts : 823
   Posted 4/12/2010 8:42 PM (GMT -6)   
Hi Len

Urgency has always been a problem. I attribute some of this to the BP meds I am taking. Some days it is worse than others. When I feel the urge, I start looking for a bathroom. I usually make it but sometimes I leak a little before I get to the toilet.

age at dx 54 now 57
psa at dx 4.3
got the bad news 1/29/07
open surgery Duke Medical Center 5-29-07
never more than 2 pads
ED is getting better
the shots work great, still can't give them to myself
two years of zero's
Retired again after 36 years February 1, 2010

Veteran Member

Date Joined Sep 2009
Total Posts : 3172
   Posted 4/12/2010 8:54 PM (GMT -6)   
Len, I'm going to recommend some things to try for the next couple of weeks. I'm convinced that these made a difference for me.

First, start to incorporate some "core" muscle exercises with Kegels. Core exercises are things like sit-ups, or any other wide variety of exercises that use muscles in your core abdomen area. You don't necessarily need to do a lot, but do them slowly and carefully in this way: Clinch your pelvic floor muscles into a Kegel, then sit-up (holding your pelvic muscle), then return down, then relax your pelvic muscle; then repeat. Take your time and do them each individually correct. Try a variety of "core" exercises like this. If you need ideas for other "core" exercises, Google "core exercises." These will definitely tire you pelvic floor muscles out (leading to leaking, at first), but will also strengthen them.

Second, you need to start "pushing yourself." On weekends when you are around the house, go without a pad. If you need to go somewhere, go ahead and wear one, but whenever you can go without it, try to push yourself. Make sure that you also go ahead and go to the toilet on a more frequent basis, but try to train yourself to hold it for at least a short time at first, then a little longer. Then, start trying to expand it into your weekday; perhaps just in the evenings at first, then part of the work day if you can. Take a couple of weekends, first, however to work on this.

Write back to me after 3 weeks.

New Member

Date Joined Feb 2010
Total Posts : 18
   Posted 4/12/2010 11:03 PM (GMT -6)   
  I was a heavy leaker for the first 6 weeks after my surgery in early Feb. After discussing this here on this forum one person remarked how it seemed easier for him to hold urine in his bladder if it was at least partly full and that it seemed to just leak out slowly if the bladder was recently emptied. This caused me to try something that I had not considered trying; when I first got up in the morning with a full bladder I performed a hard Kegel contraction, like I had been doing to hold the urine until I could swiftly walk to the bathroom. On this occasion however, instead of going to the bathroom to empty I stood in place and slowly released the Kegel and to my delighted surprise the urine did not flow and I could carefully walk around the house for a while with no incontinence. After about 10 minutes or so I decided to not tempt fate and went to empty. Up until this point I had been unable to retain essentially any urine at all when upright and active. I then advanced to the point of trying this each time that I stood up even when the bladder was not full. Over the last 2 weeks this has progressed to the point that I am now down to 1 to 3 pads per day when before I was using 12 to 14 pads a day. Quality of life is immensely better. I still have to stand for about 20 seconds in a still position each time that I stand up and Kegel firmly until the first bladder contraction noted with standing has passed, but then after slowly relaxing, urine is retained and I can walk for a considerable time without leaking much at all. I find that as the day goes by as one becomes physically tired that leakage worsens somewhat or if I am on my feet and walking for more than 2 or 3 hours at a time. But this too seems to have improved over the last week and even with persistent activity most urine is retained. I never thought that feeling a full bladder could be so pleasant. You might try this and see if it works for you.
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