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weston
New Member


Date Joined May 2010
Total Posts : 15
   Posted 6/4/2010 12:53 PM (GMT -6)   
Just got caught up on my forum reading; and looking to see if I could help answer any questions.  I should have listed my questions first; they seem so trivial now!  Going to ask them anyways; a few things driving me nuts!
 
1) about 10 days since cath removed; I still have little/no control over my bladder.  I can stop a spurt now when getting out of my chair, but at just about every step I squirt.  By time I get to the bathroom, I am almost empty. Many pads used every day (7-8).  I guess I have to accept I am a slow starter; any ohter slow starters out there that can offer some hope? I leave in two weeks for 3 weeks out West - leaking or not!
 
2) I do my Kegs 4 times per day; anything esle I can do?
 
3) Pads (TENA) are driving me nuts. They dont move with 'me' like my jockeys! The rubbing is very uncomfortable, and now I have a rash on my scrotum and penis.  Any helpfull ideas?
 
Thanks for listening and thanks for any advice.
Mike, Weston, Florida
Dec, 2008: PSA 2.0
Feb, 2010: PSA 2.7 / Lump on prostate
March 2010: Biopsy / Gleason 4+3; 40% one side
April, 2010: Bone scan clear
May 14, 2010: DaVici Prostatectomy (age 63)
Pathology:
-Scattered small foci of prostatic adenocarcinoma Gleason 4+3 (right lobe)
-proportion of P gland invloved by tumor = 3%
- seven benign lymph nodes
- P size: 4.6X3.7X3.3 / 40.5 grams
- pTNM Stage: PT2a / regional lympth nodes PN0
 
Side effects: Dry mouth; swollen scrotem; rash
               
May 24, 2010: Catheter removed!! ED and continence journey started!
June 4, 2010: No progress re: continence; starting low dose Cialis today.
 


Drums
Regular Member


Date Joined Mar 2010
Total Posts : 134
   Posted 6/4/2010 1:01 PM (GMT -6)   
At first, I tried using a smaller size brief with the thought that it would better contain things, but found that was just too tight. I'm using a brief that fits normally and it still gives me room for the pad. It does not fit up close but still catches the drips. Have you tried the pull-on type of Depends? You put them on like underwear.
Age 52 at diagnosis, father died of PCa, PSA: 10/16/09 - 2.8; 1/11/10 - 3.8
Biopsy 11/25/09, 11 core samples - HG PIN on right side
Biopsy 2/17/10, 11 core samples - left side, adenocarcinoma, Gleason 6, one core at 5%
Notified of dx on 3/12/10 (27th wedding anniversary)
MRI 3/17/10 and bone scan, 3/23/10, indicate: gland volume is 27mL, PCa is confined to prostate, seminal vesicles and vas deferens are unremarkable.
RALP conducted 19 May 2010 by Dr. Lee at U. Penn Presbyterian
8-10 pads per day (sometimes more!)


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 6/4/2010 2:27 PM (GMT -6)   
I was over two months getting below 7 pads a day -
I used the Depends pant (generally 1 for the day) with a Walgreens or Depends Mens guard inserted (as many as needed). That covered the more serious leaks.

The big Tena Heavy (women's) pads are too large for daytime - the edges are rough. The Tena Male Guards, although I like the profile, cover most of the groin, and yes, cause itch.
Most pads will be uncomfortable on a hot summer day. I'm thankful my worst was fall/winter (DaVinci 10/09 at age 56).

Kegels - when you say 4x per day, 4 sets of 10 - a set being hold for 10 seconds with 10 seconds rest between, is a good target. Some do as many as 10 sets a day, but with some previous lower back issues, 4 would be to max for me as well. Spread them out over the day, and walk in between. It seems to be a balancing act.

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 6/4/2010 2:39 PM (GMT -6)   
Mike,
You are right where I was. Squrit squirt until you reach the bathroom and by then it's all gone. Are you able to hold it at night? When I got up at night I would go to the bathroom on the other side of the house to get a little more exercise and train myself for a bit.
I used briefs one size too small. That worked for me. Kind of.
On the other hand, I am at 10 months and still leak like a rusty rowboat. Maybe you should not do what I do. ;-)
Jeff

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 6/4/2010 3:10 PM (GMT -6)   
Weston,
The only suggestion I have to avoid caffeine, alcohol and acidic fruits and drinks. There are some pads which are wider and fit better (don't remember the brand).
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 5 months
2 months 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 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005


Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 6/4/2010 7:24 PM (GMT -6)   
weston said...
1) about 10 days since cath removed; I still have little/no control over my bladder.  I can stop a spurt now when getting out of my chair, but at just about every step I squirt.  By time I get to the bathroom, I am almost empty. Many pads used every day (7-8).  I guess I have to accept I am a slow starter; any ohter slow starters out there that can offer some hope? I leave in two weeks for 3 weeks out West - leaking or not!
 
You are making good progress by holding it when your get up from your chair...keep working on it.  Average time to continence is closer to 5 months after surgery.  You've got a ways to go, and it will be s-l-o-w...sorry to have to remind you of that fact.
 
 
weston said...
 
2) I do my Kegs 4 times per day; anything esle I can do?

Yes, but you need to wait to be cleared by your doctor to do sit-ups.  Ask him at your 6-week visit.  After you are cleared, try sit-ups done like this:  clinch Kegel, sit-up, down, relax Kegel, repeat.  Three sets of 10 every day.

 

weston said...
 
3) Pads (TENA) are driving me nuts. They dont move with 'me' like my jockeys! The rubbing is very uncomfortable, and now I have a rash on my scrotum and penis.  Any helpfull ideas?

Washcloth with water, or paper towel with water, every time you change your pad.

 

You are doing fine, but will need to be patient.  Average continence is 5 months.

best wishes...


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 6/4/2010 7:34 PM (GMT -6)   
Yeah, I forgot to mention the wet wipes. Get some Cottonelle or even just Walgreens wet wipes. Clean after each trip to the can. It helps.

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2842
   Posted 6/4/2010 8:31 PM (GMT -6)   
you can also use zinc oxide - desinex diaper rash cream - that helps a lot for healing -
the depends guards are more comfy and less bulky than the tena pads -
also
relax - you are still healing - it takes a while for all the new stuff to connect and talk to each other ...
the best advice I was given here was it takes about 12-14 weeks for the nerve ending affecting continence to start kicking in again ... at week 14 I was finally able to stand without leaking like a sieve ( 4 ounces or more on the spot !).. and slowly get control so I wasn't leaking all the time....
it depends on:
1- the original shape and configuration of the original plumbing and parts -
2- the changes to the plumbing and parts and their new location due to surgery -
3- any damage to the new acting sphincter muscle -
4- your body control with the kegels - I had to do 20 at 5 times a day ( standing pelvic thrusts like ROCKY HORROR SHOW "time warp dance"
and your emotional level -
5- and relax - getting your knickers in a knot due to peeing your pants will not act as positive reinforcement -

all the best
hugs
BRONSON
(now down to one pad at night for safety sake - and one pad during the day )
.................
Age: 54 - gay - with common-law spouse of 13 years, Steve - 60
PSA: 04/2007- 1.68 - 08/2009 - 3.46 - 10/2009 - 3.86
Confirmation of Prostate Cancer: October 16, 2009 - 6 of 12 cancerous samples , Gleason 7 (4+3)
Doctor: Dr. Mohamed Elharram -Urologist / Surgeon - Peterborough Regional Health Centre
Radical Prostatectomy Operation: November 18, 2009 , home - November 21, 2009
Post Surgery Biopsy: pT3a- gleason 7 - extraprostatic extension - perineural invasion - prostate weight - 34.1gm -
ED Prescription: Jan 8/2010 - started daily 5mg cialis - girth back to normal -but not much length - will go for trimix in April when I see doc
Incontinence: Feb 2010- 3-5 pads/1-2 clothes changes/day- March 3, 2010 - week 14 after surgery -finally seeing improvement - March 29- incontinence better - 1-2 pads a day - one pad at night - May 25 - 1 pad during day - 1 pad at night for security (barely needed at all) - stress incontinence at work - lifting trees and shrubs...
location: Peteborough, Ontario, Canada
Post Surgery-PSA: - April 8, 2010 - 0.05 - I am in the ZERO CLUB - hooorah!
Next PSA - October 8, 2010 - TBA -
............


Timm
Regular Member


Date Joined Feb 2010
Total Posts : 83
   Posted 6/4/2010 11:13 PM (GMT -6)   
Hey Mike
 
I'm seven weeks out and by no means dry but alot better than the first couple of weeks. I get up at about 5:00am with a full blatter.
 
Getting killed by California Hay fever, sneezing and squirting,sudden moves too but am able to hold much more.
 
Trying to look at three months instead of three weeks, in the mean time have got to get used to the pads. Baby wipes a must an a tube of Hydrocortisone 1% anti-itch cream. The Tena work for me and when you go out always fine the bathroom first, Hey any things better than the cath. [ sorry David].
 
I think the first sign is your blatter just holds more and more, still cant' drink a bottle of water and hold it for a walk.
 
                              Hang in there,     Tim
58 yrs.
PSA 6.94  12/10
Bio. 8 of 12 cores pos. 2/1
Gleason   3+4=7
Da Vinci    4/14
Tumor volume  9%
Extraprostatic extension- within margins
Margins    clear
T2c NO Mx
PSA. 6wks. post sugery .01


Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 6/5/2010 8:06 AM (GMT -6)   
Mike,
 
I thought I would add some depth to two points from my previous reply.
 
  • Regarding Kegels:  Medical studies have shown that doing Kegels help accelerate one's return to continence, so I'm glad to hear that you are diligently doing them.  However, it is important to do them correctly, and target the correct muscles.  Here's an outstanding description to help focus in the correct area  (think of it as the "cutting of a fart method").  The main point is to concentrate, go slowly, and engage the correct muscles:                            

Imagine trying to stop yourself from passing wind. To do this, you would squeeze the muscle around the anus. Try squeezing that muscle as if you really did have wind. You should be able to feel the muscle move. You should be aware of the skin around the anus tightening and the anus being pulled up and away from whatever you are sitting on. Do not move the buttocks and thighs. Do not hold your breath - breathe normally. Do not tighten your abdominal or buttock muscles - keep them relaxed. Later, you can check whether you are contracting the correct muscles by touching [I skipped this part] the opening at the rectum as you are tightening the muscle - you should feel the opening of the rectum contract at the same time.

  • Regarding the variation in time to regain continence:  I read tatt2man's comment "...it takes about 12-14 weeks for the nerve ending affecting continence to start kicking in again..".  That's a very narrow window (and it has nothing to do with nerve sparing).  It might have taken him 12-14 weeks, but the range of variation across a larger population of men is much wider.  Here's some published statistics to the amount of time to "pad-free":

Months after surgery:.........Percent of patients "pad-free":
..........1............................. ..............20%..........
..........3............................. ..............45%..........
..........6............................. ..............70%..........
.........12............................. ..............94%..........

One can easily see from the statistics here that the variation in time is wide.  Don't set any particular expectations for yourself, just keep working at it.  It seems slow and frustrating, but it is getting a tiny bit better every day.

best wishes...

 


weston
New Member


Date Joined May 2010
Total Posts : 15
   Posted 6/5/2010 12:54 PM (GMT -6)   
Thanks to all for your thoughts.

By the way, is it possible to respond / reply to any individual person's reply to me?
Mike, Weston, Florida
Dec, 2008: PSA 2.0
Feb, 2010: PSA 2.7 / Lump on prostate
March 2010: Biopsy / Gleason 4+3; 40% one side
April, 2010: Bone scan clear
May 14, 2010: DaVici Prostatectomy (age 63)
Pathology:
-Scattered small foci of prostatic adenocarcinoma Gleason 4+3 (right lobe)
-proportion of P gland invloved by tumor = 3%
- seven benign lymph nodes
- P size: 4.6X3.7X3.3 / 40.5 grams
- pTNM Stage: PT2a / regional lympth nodes PN0
 
Side effects: Dry mouth; swollen scrotem; rash; perineal pain
               
May 24, 2010: Catheter removed!! ED and continence journey started!
June 4, 2010: No progress re: continence; starting low dose Cialis today.
 


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 6/5/2010 1:14 PM (GMT -6)   
Mike,

Most just put the id of the person thay are addressing comments to at the top of the comment.

I've seen sites where the replies drop in under the message you are replying to, but then you lose all sense of being able to just look at the end for new messages, as they are scattered in the thread. Not sure I prefer one style over the other?
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