Incontinence Issues @ night?

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BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 8/21/2010 7:12 AM (GMT -6)   
Hi.
 
After my RP 3 mo ago, I had as much a problem going as stopping. Tested for Urinary Infection, but was negative. We assumed it was just healing process. But this had an impact on my keggle schedule.. More worried about starting than stopping (not starting can REALLY hurt!).
 
Now, 3 mo later, the flow is MUCH better, no pain while going, no blood. However, if I go with the wife to dinner or with friends and have 2-3 beers, then come home an lay on the couch to watch my Red Sox get beat up, I will wake up and my pants are all wet. Not always, but too often.
 
I know the easy answer is dont have a few beers during nighttime. But that isn't good enough. When we're sleeping, we dont have that muscle control that we now need to stop the flow, I guess.
 
Do you think working on Keggles (even though I otherwise have regained nearly complete control) will help? I cant enforce the muscle when i'm sleeping?
First ever PSA test Jan 2010 @ 51 years old. 4.0.
Digital exam in March 2010 showed 1 side hard, other soft.
Biopsy, positive in 3 of 12.
Davinci @ Boston Medical Center, May 17, 2010.
Was suggested prior to it was likely contained.
June 1 advised 3+-4 was really 4+3 per pathology. Pos margins.
Listed on patholgy as PT3, but with extraprostatic extension,
microscopic invasion of the bladder neck, PT3A is perhaps the case.
Catheter removed June 1.. 1 pad/day, doing ok. ED, but not in rush.
Sore as heck down there, but doing much walking with my wife.
To meet with my Uri (1st meeting since) June 17 - 1 mo point, to discuss.
BMC already has me setup to meet with radiology.
Felling a little better each day. Cant tell if my expectancy just went from 10-15 down to 5-7, the information out there appears to be all over the place. I WILL NOT radiate my insides to the point of being a veg for the sake of a few years. QOL is primary to me. Selfish I guess. I pray for all of you as I do for myself, but must remember that i've had a pretty good 50+ years, and know others who have lost their children to disease.. so I dont have the nerve to complain! Update 7/14/2010: When I tried changing this sig a few days after creating it, system was broken. My new rad oncologist are discussing IMRT.. though he says he can see why waiting a bit and watching the PSA on super sensitive basis might make sense. I am leaning towards IMRT.. thinking is my body is pretty strong now, i'm 51, and if I can rid my body of this while trying to minimize the side effects.. I dunno. No really Good answers. When I said I didnt want radiation to the point of being a veg.. I really meant there is a limit as to where I wish to go in order to realize only a small increase in life expectancy.. and not that I am an unreasonable person. I do, after all, have an obligation to my wife and kids.

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 8/21/2010 8:18 AM (GMT -6)   
Wait! Let me get this straight.
You're 3 months post RP. You're continent but, when you have 2-3 beers before gong to bed and you sometimes get wet?

I have not had more than 4 oz of beer at one time in more than a year. It passes through me in one hour, completely filling a pad. It is the combination of alcohol, fluid volume, and the diuretic action of beer that does it.
Give it a little more time and keep exercising.

By the way, You're on my list, pal, you're on my list... ;-)

Jeff (the leaking one)
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 3+4=7, 3+3=6. 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%. 8/9/10 Now at 0.24 still 90%
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day. Try controlling fluids.
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."
5/22/10 10 months: 2 pads per day, 190 ml/day Scope on June 15 "Short sphincter"
7/15/2010 one year: 2 pads per day. 140 ml/day, dry in bed.
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04
1/14 6 months - 0.05 (Siemens Centaur)
4/14 9 months - 0.04 (Siemens Centaur) and <0.01 (Roche ECLIA).
7/12 1 year - 0.03 (Siemens Centaur, direct chemilum); <0.01 (Roche Cobas 601 ECLIA)

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 8/21/2010 8:19 AM (GMT -6)   
Kegels work on the muscles that can close off the urethra, so the exercise is not applicable to just day or night. It is not just to help close it off on demand, but to set up a certain resistance all the time.
At night there is less gravitational pressure, so in theory you get better at night first.
Now - as to a couple of beers late in the evening - they contain three enemies of continence - alcohol, carbonation, and liquid. The first two, in my 10 month battle, are the worst. Part of your new normal needs to be to limit/eliminate them.
Even today, when I have had perhaps two or three night-time "accidents" a month, they have all been related to a beer in the evening, so that is on my "never again" list.
 
(after DaVinci & IGRT since 10/2009, I am at 1-3 pads per day)

Post Edited (142) : 8/21/2010 8:22:35 AM (GMT-6)


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 8/22/2010 3:57 AM (GMT -6)   
Alcohol, amoung other things, relaxes muscles.
 
People like me that snore are told to avoid it etc bla bla bla.
 
Switching from 24 to 36 oz of beer to 2 to 3 mixed drinks might maybe help since you'll be consuming a lot less liquids.

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
05/18/10 - 24 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.
Growing old is mandatory; growing up is optional..

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 8/22/2010 5:00 AM (GMT -6)   
Bob, I was not told about Alcohol either. I am one of the lucky one that have been dry sence the rubber snake was pulled. The exception for me is when I drink Red Wine. At almost 2 years out I almost have that taken care of but not quiet yet. Not sure I will ever get there completely. Not enough of a porblem to cause distress.
 
In the past 4 months that got better each time I drink.  I may need to drink more to make sure I am healing. smilewinkgrin
 
Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
Only issue at this time is ED

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 8/22/2010 6:05 AM (GMT -6)   
Thanks all for the thoutful and useful answers. Glad I have you here to count on!
First ever PSA test Jan 2010 @ 51 years old. 4.0.
Digital exam in March 2010 showed 1 side hard, other soft.
Biopsy, positive in 3 of 12.
Davinci @ Boston Medical Center, May 17, 2010.
Was suggested prior to it was likely contained.
June 1 advised 3+-4 was really 4+3 per pathology. Pos margins.
Listed on patholgy as PT3, but with extraprostatic extension,
microscopic invasion of the bladder neck, PT3A is perhaps the case.
Catheter removed June 1.. 1 pad/day, doing ok. ED, but not in rush.
Sore as heck down there, but doing much walking with my wife.
To meet with my Uri (1st meeting since) June 17 - 1 mo point, to discuss.
BMC already has me setup to meet with radiology.
Felling a little better each day. Cant tell if my expectancy just went from 10-15 down to 5-7, the information out there appears to be all over the place. I WILL NOT radiate my insides to the point of being a veg for the sake of a few years. QOL is primary to me. Selfish I guess. I pray for all of you as I do for myself, but must remember that i've had a pretty good 50+ years, and know others who have lost their children to disease.. so I dont have the nerve to complain! Update 7/14/2010: When I tried changing this sig a few days after creating it, system was broken. My new rad oncologist are discussing IMRT.. though he says he can see why waiting a bit and watching the PSA on super sensitive basis might make sense. I am leaning towards IMRT.. thinking is my body is pretty strong now, i'm 51, and if I can rid my body of this while trying to minimize the side effects.. I dunno. No really Good answers. When I said I didnt want radiation to the point of being a veg.. I really meant there is a limit as to where I wish to go in order to realize only a small increase in life expectancy.. and not that I am an unreasonable person. I do, after all, have an obligation to my wife and kids.
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