Incontinence Like Dripping Faucet

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Reminderman
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Date Joined Dec 2010
Total Posts : 15
   Posted 12/4/2010 5:40 PM (GMT -6)   
mad  Three weeks ago I had a robotic laproscopic prostatectomy and 12 days ago had my catheter removed.  Since the removal of the catheter Iv'e had total incontinence which is described in an article as being like a dripping faucet.  This dripping occurs day and night, and the only time I feel like I need to urinate is during the night while in bed.  By the time I make it to the bathroom I have leaked some more and can only urinate for about 5 seconds.  I have been doing my Kegal exercises but so far they have not made a difference.  From what I have read in the literature, it seems that this type of incontinence is not that typical.  My doctor/surgeon does not think it is unusual.  I'd be interested in knowing if others have encountered this type of incontinence and if there is some hope in getting continent with just he Kegal exercises.  Thanks in advance for any sharing of experience. 
 
Butch39

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 12/4/2010 5:47 PM (GMT -6)   
Butch,

You just need to give it time. Average seems to be 6 to 8 weeks, maybe as much as 12. Took me 8 months.

You can't see the effect of kegels. The only way you can see them a little is to kegel while you are at the toilet. If you can stop and start your stream, you are exercising the right muscles.

We all know how frustrating it is. Hopefully you have found the right combination of pads/briefs to allow you to get back to living normal. Don't let it get you down. You have a good probability of recovering. A lot of guys seem to be doing poorly and in a day of two report dramatic progress.

Welcome to HW.
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

Jazzman1
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Date Joined Sep 2010
Total Posts : 1163
   Posted 12/4/2010 6:26 PM (GMT -6)   
I had surgery almost five weeks ago and I'm just as frustrated as you are.

My doc tells me it's mostly just a matter of time. I guess we'll both just have to ride this out and try to be patient.

mr bill
Veteran Member


Date Joined Sep 2010
Total Posts : 709
   Posted 12/4/2010 9:01 PM (GMT -6)   
Had my robotic on Sept. 8, 2010.  The usual progression goes from constantly wet, dry at night,then dry during A.M., then late evening, and finally during the day.  I am still using pads but improving. It really does take time, and can be frustrating. Believe me it will get better.
 
Mr Bill
Age 66
BPH since 1996. at least three negative biopsies Erie. Uro did not prescribe finasteride
2007 acute urine retention photovaporize Clev. Clinic prscb finasteride
8-9-10 PSA rose to 10.14 with finasteride positive biopsy Cleveland gleason 9, cat & bone scan negative
9-8-10 RP at Cleveland. Biopsy 9 nodes 2 positive, 2 positive,seminal & vas deferens
PSA 3 wk .06, 6 wk <.03, 12wk 0.0

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3742
   Posted 12/4/2010 9:09 PM (GMT -6)   
Hey Butch,
Welcome to Healing Well.

I too say give it time. 2 out of 3 guys will be dry by 3 months. Of the remaining 1/3, 2/3 will be dry in one year. Unfortunately I am in the "lucky" 1/9 group of leakers.

Carry pee pads in every pocket and pee jars in every car.
Good luck to you
Jeff

---------------------------------
Married 35 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 Gleason 7, both lobes and apex. EPE, PNI extensive
pT3aN0MX
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.

PSA 7/12/2010 1 year - 0.03 (Siemens Centaur, direct chemilum); <0.01 (Roche Cobas 601 ECLIA)

Post Edited (Worried Guy) : 12/4/2010 7:13:03 PM (GMT-7)


Highwayman
Regular Member


Date Joined Sep 2010
Total Posts : 148
   Posted 12/4/2010 9:18 PM (GMT -6)   
Butch,
Take heart brother, two weeks post cath was when I discovered that I had a bladder again. I'm a month out and things are much more normal now. Down to two pads a day. It takes time. Good luck with your Journey.
Mike
Age 48 w/diagnosed
10/06 PSA 3.0
11/06 PSA FREE %13.2
10/07 PSA 3.4
12/07 Biopsy-neg
1/09 PSA 4.6
6/09 psa 5.8
2/10 psa 8.7
7/10 PSA 10.8
8/2010 3rd biopsy GG 3+3=6, one of eight cores -2%
Lap 10/22/10 Dr. Troxel
Path- Neg Margins, Gleason 6, Nerves spared, 85 gm
Cath out Nov 2, Dec 2nd 2 pads/day

Dave7
Regular Member


Date Joined Jul 2006
Total Posts : 202
   Posted 12/4/2010 9:37 PM (GMT -6)   
You may try backing off on the kegels and see if that makes a difference.  If you're doing them a lot the muscles may become fatigued and unable to operate properly.
 
Just a thought.

Reminderman
New Member


Date Joined Dec 2010
Total Posts : 15
   Posted 12/5/2010 5:47 PM (GMT -6)   
Thanks to all that responded to my conern.  I didn't hear anyone, however, say that they had experienced the "dripping faucet" type of incontinence.  I use 3 or 4 pads during the night and 6 or 7 pads during the day.  I agree that limiting liquids does affect the number of pads, but doesn't change anything with being able to control the leakage.  Has anyone gone from dripping type leakage to being able to empty the bladder voluntarily, at least occasionally?
Thanks

Arch
Regular Member


Date Joined Jun 2010
Total Posts : 192
   Posted 12/5/2010 6:25 PM (GMT -6)   
Reminder,
 
I had my catheter out 6 months ago and still use 1-2 pads a day. Today I went for a walk of a couple miles and went through an entire pad...continuous leaking. If I'm working its usually 2 pads a day, if I'm home and take it easy, only 1 pad. I am however dry at night and have been for some time. I find drinking lots of water actually helps as it keeps the urine diluted, concentrated urine irritates the bladder.
 
Initially I was unable to voluntarily empty my bladder (it just dripped, 12 pads a day), it took about a month to hold fluids and that was only accomlished when I sat.
 
Over the same time span my ED went from nothing to great but it was a slow process. I must admit I'm getting concerned with the leakage but I'm assuming it will come with time.
 
r
age 56
PSA 5.5
Biopsy, both lobes involved
Gleason 3/4=7
open RP May 18, 2010
Pathology: 15% involved, lymph nodes and v. d. clear, margins clear
June 3-10 10-12 pads/day
2 months 8 pads/day
Aug 1, 2010 5-6 pads/day
Aug 20, 2010 3-5 pads per day
Aug 16, 3 month PSA: undetectable
ED 95% with viagara
Sept 22, 2 pads a day
Oct 12, PSA 0.03
ED, 100% with viagara, just doeable without

Bandersnatch
New Member


Date Joined Sep 2010
Total Posts : 16
   Posted 12/5/2010 6:34 PM (GMT -6)   

     I remember standing in the shower watching myself drip and trying not to. 8/10 pads a day. Very frustrating and scary. Improvement came unexpectedly and in leaps. All of us heal differantly but I think you are OK for your stage in the process.

   As far as bladder control, the only time I can't hold it now is when I use a trampoline. Luckily I have found it easy to avoid trampolines. Good luck to you.


Reminderman
New Member


Date Joined Dec 2010
Total Posts : 15
   Posted 12/6/2010 3:40 PM (GMT -6)   
Again, thanks to all for the replies. The last two from Bandersnatch and Arch related specifically to my problem and made me feel a lot better.
Thanks
Reminderman

Recovery
New Member


Date Joined Dec 2010
Total Posts : 8
   Posted 12/6/2010 8:19 PM (GMT -6)   
I had my catheter out last Friday and had no idea what to expect. On Friday, I had virtually no urinary control, just a steady drip. Since then, I’ve noticed that in the morning, I’m relatively dry until I stand up, then the bladder empties. Yesterday, I did not have the experience of going to the toilet with anything in my bladder left to void. I’ve been doing kegal exercises, although those muscles are tricky to locate and isolate. Today, in the morning, I was able to stand and hold it for a moment. From my experience thus far, it seems to me that the most important event is the ability of standing up (not much leakage while sitting) and being able first to partially keep from voiding while getting to your feet, and then perhaps getting to the toilet with something left to void.

What was your experience in this regard? Anyone out there who has gotten to satisfactory continence, how long did it take you to stand and not void right away? How long did it take you to get to the toilet with something left in your bladder? How did things progress after that point?

Jerry L.
Veteran Member


Date Joined Feb 2010
Total Posts : 3072
   Posted 12/7/2010 4:07 PM (GMT -6)   
Not to sound like a broken record, but giving it time is key.  I had Robotic surgery Dec, 2009.  After cath was removed, I had 0 control.  It was that way for weeks.  Significant improvement didn't come until month 3.  It took a good 6 months to get to 85%.  Hang in there...

fertree
Regular Member


Date Joined Jun 2010
Total Posts : 118
   Posted 12/8/2010 2:05 AM (GMT -6)   
I leaked like a sieve after the catheter came out. I used 3 pads a night, and at least 7 or 8 during the day. I tried stopping and holding while peeing, but couldn't do that. If I walked a dozen steps, I would squirt when I stopped, and as hard as I tried, I couldn't control that either. Then, after 3 months, practically to the day, things improved dramatically, and I went from 6 to 8 pads to 2 to 3 pads practically overnight. For 3 months I was as frustrated and annoyed as you are. Wait it out.

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 12/8/2010 7:56 AM (GMT -6)   
That's great news questionsaboutit, strange that it happened so suddenly.
Soon you will have to change your signature .... to moderate incontinence and then hopefully to stress incontinence and then hopefully to just a pad for security...

Wish you all the best,
An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg margins, seminal vesicles, extraprostatic extension. Multifocal, with involvement in the peripheral, apex, fibro-muscular and transitional zones.
Post RP PSA, Sep10 – 0.02

MikeS24
Regular Member


Date Joined Oct 2010
Total Posts : 131
   Posted 12/9/2010 9:30 AM (GMT -6)   
My surgery was on July 20, 2010. After a month or so I was glad I started to keep a voiding diary. My doctor suggested I get a postal scale to measure the output. I thought it was odd at first but I dutifully measured a dry Depends pad approx 23 g and then measured pads. At first I was all over the map regarding the volume and the time to change pads so without some elapsed time consistency, I was just measuring how full my pad were. Once I went back to work and started to maintain a consistent schedule it made sense to measure pads. My output in September got to a point where I did not have to change my pad during the work day. I could put it on and measure it when I got home in the evening. With a fairly consistent schedule my pad goes on at 6:20 am and I weigh it when I get home at 7:00 pm

The physical world cuts us a break here. 1 gram of fluid is almost equivalent to 1 cc of fluid so that makes the conversion easy to perform in finding out how much fluid has been leaked into a pad. Cc and ml are equivalent so conversion to ounces is easy as well.

It was rather comforting to know that even when I experienced a bad day and my leaking seemed to be excessive, I could look back a month or two earlier and see that progress was being made. Sure, I could recall the early days after cath removal when taking off the pad revealed a bloated ready to drip mess, but after that subsided it was hard to tell just by looking or holding the used pad in my hand, what I had put into it during the day.

It does get frustrating and perhaps more so when you have a string of good days of small amount of leaks and spurts and then a day where you feel like you are back right after catheter removal. However, measuring at that point is reassuring. Wow! I only leaked 40 cc of fluid instead of 140 cc

At 141 days from my surgery, I am feeling a bit senior to those who have been posting about surgery in Sept and October and fretting about leaking. I look back to my Sept stats and leaking of 210 cc in my all day pad and then to October at 175 cc, Nov at 70 cc and now at around 35 to 48 cc and see progress. Oh, sorry all the measurement are gross weights. Subtract 23 g to get the actual fluid output.

I have great confidence in my doctor's surgical stats. With over 3,000 RP completed, he has a 95 precent success rate for incontinence. However, it does frighten me to think I could fall into that 5 percent who fail to make it to continence. This would be more tolerable if I knew that I will make it all the way to being dry and pad free. I would just go along for the healing ride and not fret so much.

So I remain putting out about 15 to 20 ml of fluid in my pad over a 13 hour period. That includes walking to work 1 mile each way on city streets. Any encouragement from those in the 4 to 8 month post surgical incontinence club will be appreciated.

Mike
Dx 56
Biopsy: Gleason 3+3=6, PSA 6.6 One core of 12 with 5% T1c
Surgery: July 2010
Pathology Gleason 6, Neg Margins, Neg Lymph, Neg Sem Vesicles
Recovering from incontinence and ED slowly

Recovery
New Member


Date Joined Dec 2010
Total Posts : 8
   Posted 12/9/2010 3:00 PM (GMT -6)   
I guess some of the more experienced on the board will think this question is self evident because "things" get better with time, but if you think back before you had the experience you now have, this info would have been useful. I not looking for reassurance, what will happen will happen, I'm really looking for specific information from people who've had the experience. Here's what I want to know. We've all talked about dripping like a facet and no control--that's essentially my experience right now (1.5 weeks after catheter). I never have enough left in the bladder to void anything by the time I get to the toilet--it's all in the pad. If anyone remembers, when and how did you begin to be able to hold enough in the bladder to actually void something at the toilet? Any details of how that happened would be appreciated.

macmc
New Member


Date Joined Dec 2010
Total Posts : 1
   Posted 12/9/2010 3:13 PM (GMT -6)   
yeah  I was convinced that I would never have to stop wearing pads.  My situation improved almost overnight.  It took nearly 9 months but now I have regained full control.  Still waiting on the sexual function to improve though. 

Ger42
Regular Member


Date Joined Apr 2010
Total Posts : 189
   Posted 12/9/2010 6:07 PM (GMT -6)   
This cold weather here in South Florida has me leaking more. It may not be cold for you people up north but for me it's cold. It just comes on can't figure out what is going on. All of a sudden I'm leaking.

MikeS24
Regular Member


Date Joined Oct 2010
Total Posts : 131
   Posted 12/9/2010 7:51 PM (GMT -6)   
Recovery:  See my post above so you know I am still in the process.  Despite the dripping I knew I was retaining something the day when just standing still I could hold a bit of urine in the bladder.  It was not much but before that, it never had the chance to be retained.  It just dripped out before anything could be retained.  For me that started about 2 months or so after surgery.  1.5 weeks after the cath. I was still filling pads.  You are way too early in the process to retain urine, but stranger things have happened and suddenly you might just stop and hold urine very soon.  Who knows.

Recovery
New Member


Date Joined Dec 2010
Total Posts : 8
   Posted 12/9/2010 8:16 PM (GMT -6)   
Thanks Mike. My current state is that I am pretty dry when sitting, or in the morning laying in bed. When I stand, I can feel it all coming out. I have made it to the toilet (just out of bed), sat and had some squirt out, once a decent amount. It felt like normal urination, but I did not have the sensation of controlling the bladder. And when I get up from sitting, absolutely no control over it, just a steady stream into the pad. I like your scientific catalog of pad/urine volume as a function of time. I'm more interested in the actual circumstances under which some sense of control returned.

Arch
Regular Member


Date Joined Jun 2010
Total Posts : 192
   Posted 12/9/2010 9:54 PM (GMT -6)   
Recovery,
 
it was about 6 weeks before I had any control and the ability to not leak on the way to the toilet. I was also getting up 5-6 times a night to urinate and lost half of it on the way. I now get up once and sometimes twice a night but just started sleeping without a pad. I may have a tiny drop here and there but it was suggested that I not become pad dependent. I'm thinking of trying to go pad free in the late evenings next week but I still leak some during the day. I just had 3 days in a row with only 1 pad but the last 2 days have been 2 a day. Its up and down, maybe because of different foods?
 
I tend to drink 3 cups of fluids before work, maybe 2 cups through the day at work and then another 2 cups when I get home, I don't drink after 8 pm, this keeps me hydrated and allows me to stretch my bladder during times when I am most likley to be sitting and have the most control.
 

age 56
PSA 5.5
Biopsy, both lobes PCa
Gleason 3/4=7
open RP May 18, 2010
Pathology: 15% involved, lymph nodes and v. d. clear, margins clear
June 3-10 10-12 pads/day
2 months 8 pads/day
Aug 1, 2010 5-6 pads/day
Aug 20, 2010 3-5 pads per day
Aug 16, 3 month PSA: undetectable
Sept 22, 2 pads a day
Oct 12, PSA 0.03
ED OK with no drugs Dec 2010

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 12/9/2010 10:59 PM (GMT -6)   

The only time I was continent after catheter removal was when I was lying in bed.  For several weeks, 4 to 6, I would have to squeeze my penis tightly to make it to the toilet.  Initially I would get up 2 or 3 times a night.

After about a month or so, I could make it for most of the night, but the trip to the potty was still a challenge.  During the day I would use 4 or 6 pads.

As I continued to kegel, I would see small anmonts of progress.  But for about 2 months, I would use a Cunningham clamp dusing the day so that I didn't wet my pants through the pads during the day.  Working at industrial sites on electrical panels wasn't conducive to wet pants.

Slowly I could see improvement, but at 4 months I was still at 1 pad during the day, and 1 in the evening.  I continued along to where the pads became less and less damp, but still necessary for protection.

Occasionally I would not wear pads on weekends and started to feel better.  Maybe even going to church or some social activity where I wouldn't be exerting myself or lifting heavy objects.  It was a gradual process.

Finally , on Jan 1, I decided to go padless.  Once in a while I would drip a little more than my undies could hold, get a wet spot, but that too happened less and less.

Today, at about 19 months, i will occasionally drip a little here and there depending what I drank, (iced tea with sweetner is the worst ),  time of day, fatigue, I may get more than a few drops, but on the whole, I am totally continent.  Sometimes I change my underwear because they get a little moist, but I can live with that.

Life is good, very good.  I can live with a drip here and there.  Good luck on your journey.  Patience is a key word here.

Goodlife


Recovery
New Member


Date Joined Dec 2010
Total Posts : 8
   Posted 12/10/2010 1:39 AM (GMT -6)   
Thank you for those descriptions of what you encountered on your way to putting this behind you.

MikeS24
Regular Member


Date Joined Oct 2010
Total Posts : 131
   Posted 12/10/2010 9:01 AM (GMT -6)   
To Recovery: OK, actual sense of control. I can address that to some extent. It is not a distant memory but something I am struggling with right now.

First, I am sure you have read ad nauseam that continence comes in 3 phases. Dry when lying down, Dry when standing and Dry when getting up from a seated position. I think the phases are way to broadly defined by my own experience and the experience of others here.

For this discussion we are focusing on the dry when standing and getting up combination. For me, my first big breakthrough was when I could stand up (leaking through the getting up motion) but then when standing perfectly still nothing leaked too much. A little movement left or right might bring a squirt or two. OK, your focus is on the sensation of retaining urine and feeling sphincter control. For me it does not feel solid and tight yet. The sphincter still feels a bit floppy and prone to letting go. It feels like it wants to let go when I shift position quickly, when I breathe in deeply, if I bump my crotch on the edge of a solid object like a countertop table, if I have any gurgling going on in my GI tract. As time progresses, it just feels a little more stable and able to hold back urine.

Since I am still working, that routine becomes a roadmap for the day's events. I repeat the same cycle nearly every work day. So I have been able to gauge progress based on doing the same thing over and over but having the urinary results come out differently as progress is made.

I knew when things starting to get significantly better when I could walk any distance and still have something to void when I completed my walk. Again, the sphincter did not feel solid and tight. Before that, I would walk and a slow but steady stream would come out with every step. A bit later my walk would be punctuated by a lesser stream with every step and if I stopped my leak stopped, but starting up again, I would void everything I had held while stopping and then continue dribbling what was just being produced by my kidneys.

I also noted progress when after a shower, when drying myself I did not have to be so delicate with the towel around my crotch. Early on drying was a delicate operation and once I gained more control, I could use a towel more vigorously and not leak.

As I gain control I deliberately add a bit more fluid to my routine, especially in the morning. Before, I would not drink much until I got to my office so that my 1 mile to work from my train station to the office would not be a leak festival. Within the last week I have challenged myself to hold more fluid and not stop at every bathroom I encounter in my path to work just to empty myself.

I also find that a moderately full bladder leaks less than an empty one. My doctor confirmed my suspicion about that and said it was normal to have the sphincter hold against the fluid better when fuller rather than empty.

This morning was a good one. Drank more fluid than usual. Hit the bathroom at home before leaving. Skipped the bathroom at my local train station and waited until I got to my destination train station to go. Walked my mile to work and as I walked I leaked a bit as usual for no apparent reason (stepping into divots in the road, high curbs, etc) and by the time I arrived at work had a strong urge to urinate. Hit the bathroom at work and by golly, my pad was pretty dry and I had a respectable amount to void.

Again, for me the measurement diary give me some sense of making progress. Without my postal scale, as I am at work, all I can do is stare into the pad and make a gross generalization about my leaking. It is like reading tea leaves but without the leaves.

I hope this helps. I agree with others that we all know the process takes time but we can share in the feeling of how we are progressing and what happened in a particular sequence during recovery.

Mike S.
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