Incontinence at night - SOME nights - Kegel excercise?

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BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
 		   Posted 9/22/2010 1:09 PM (GMT -6)   
Hi. I'm 4 months post op. Had a few beers over the weekend (was in Vegas, ok, more than a few)... and had no problem controlling. Awoke each morning, no problem. Other times, I  have very little fluids, walk 3 miles.. and wake up in the morning to find i'd had an accident. I guess I cant squeeze that muscle when i'm sleeping?
 
I am ALWAYS holding that muscle closed.. do you think the problem is I need to actively do more Kegels? Hold,. Release? Repeat? Maybe simply "holding" the muscle closed isn't enough?
 
Also, feel some sensation with the aid of cialis.. a little soemthing happening there. At 4 months, time to talk with my doc about OTHER solutions?
 
Thanks in advance all.
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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Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
 		   Posted 9/22/2010 1:31 PM (GMT -6)   
BobCape,

Two things:

First, you asked about Kegels and continence recovery. Please visit this link, as it has one of the best description of a proper Kegel, and also other tips for buildling Kegels into other exercises in order to accelerate recovery. At four months, only about half of men after RP have gained full continence, so hang-in there and keep working at it.
http://www.healthboards.com/boards/showpost.php?p=4098349&postcount=4

Second, you asked about sexual function recovery. You didn't give much detail (I realize this is a sensitive subject) but I've been surprised to learn about men who took one of the PDE-5's (Cialis, Viagra, or Levitra) after RP, and simply thought results would happen all by themselves. There needs to be some...er...active involvement by the patient and/or partner to try to get things going. The quality of the erections might not be too good at first, but it oughta generally get better each time. Similar to continence recovery, you are still too soon (4 months) to be overly worried about it...keep working at it.

Hope this helps...
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tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2840
 		   Posted 9/22/2010 2:32 PM (GMT -6)   
Bob - at four months ( 12 weeks) you are still healing up from major surgery - and nerve endings are regrowing and the body bits are starting to talk to each other again -
-do you wear male guard (pad) during the day? - and do you worry about having to wear one at night? -
-I was advised it was at about week 14-16 after surgery - when the incontinence starts to be more in control -it may seem you have to hold that muscle all the time - but with regular kegel exercises, that worry / conscious action will diminish in time
-ED is a different issue and affects each man differently - especially regarding what nerves were spared and if there were ED issues before surgery.
-all the best in your recovery.
BRONSON
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Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
 		   Posted 9/22/2010 2:42 PM (GMT -6)   
Bob,  The National Association for Continence has an informative article on frequency and types of Kegels.  Try the following link:
 
 
Hope this helps.
Carlos
Diagnosed 2/2008 at age 71, PSA 9.1, Gleason score 5+3, stage T1c.
Robotic surgery 5/2008, LFPF at 6 wks.,nerves spared, stg. pT2c, N0, MX, R0, Gleason 5+3
PSA <0.1 at 26 months and at all tests since surgery.
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BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
 		   Posted 9/22/2010 6:32 PM (GMT -6)   
Each response was of assistance. So I thank each of you for having responded. Funny how that works.
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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goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
 		   Posted 9/22/2010 8:19 PM (GMT -6)   
Bob,

Are you consistent in your evening drinking schedule ? I have found that stopping fluids after 9 or 10, aqnd staying away from Iced tea with sweetnlow helps me. I don't drink but some guys say that wine causes them issues.

It took me 8 months, and I still have a drip now and then, but I made it.

Good luck and hang in there. I would say the dry periods are a good sign. You will be ok.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01
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English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2211
 		   Posted 9/23/2010 3:19 AM (GMT -6)   
I am becoming increasingly aware that walking is my worse enemy when it comes to continence.
I can ride a pushbike, do gardening, dig holes, lift heavy objects, climb ladders, lay carpets, even lay paving and not have much in the way of trouble, if any, but walking seems to somehow sets things off very quickly, as does driving to a lesser extent, and while walking often makes me desperate to pee the actual volume produced is very small when I get to the WC or go behind a tree. The only thing worse than walking is running.
Maybe it's the rhythm, maybe something's moving up and down more with the prostate not there, maybe it's the muscles, not sure.
Even if I wait to have a walk till about two hours after I've had a drink, by which time I have emptied my bladder twice I will still find I will feel the need to pee within about ten minutes. I thus either have to walk towards the woods or towards shops where I know there is a WC.

Altering what I drink or when I drink doesn't seem to have much effect on this or my overall continence, except for caffeine; the only thing I have to watch is to keep my total fluid intake per day roughly the same.

Alf
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Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
 		   Posted 9/23/2010 12:07 PM (GMT -6)   
Alfred,

Walking and holding a Kegel is almost impossible without going knock-knee'd because of the duration. Contrast this to lifting, standing, digging, etc which are all motions in which you can clinch, release, clinch, release. However, walking is an excellent exercise to strengthen the pelvic floor muscles which need to be engaged (now, for the first time) to control leakage. These are not the same muscles you formerly used; they need training.

Keep walking, but if you are still leaking, do expect to hold a Kegel the whole time or be leak-free while walking.
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Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3626
 		   Posted 9/23/2010 5:57 PM (GMT -6)   
Bob, have you seen a physical therapist who specializes in "pelvic floor" rehab?? They can be a BIG help. Doing Kegel's is not a casual, haphazard thing..There is a right way and a wrong way..

Even though I was continent right after surgery, I'm still following the therapists advice and instructions to get as strong as I can in that regard..
Age 68.
PSA at age 55: 3.5, DRE negative. Advice, "Keep an eye on it".
PSA at age 58: 4.5
PSA at age 61: 5.2
PSA at age 64: 7.5, DRE "Abnormal"
PSA at age 65: 8.5, DRE " normal", biopsy, 12 core, negative...
PSA age 66 9.0 DRE "normal", 2ed biopsy, negative, BPH, Proscar
PSA at age 67 4.5 DRE "normal"
PSA at age 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP performed Sept 3 2010
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