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Posted 2/18/2011 1:16 PM (GMT -6)
Since having my catheter removed on 02/07/2011, I have been a dripping machine. When i first got home ,I leaked all the time. Sitting, standing ,laying down, it didn't matter. Earlier this week,I notice that I was not leaking while sitting or laying down but the minute is stand up,stream than drippage. The Doc says that is normal and that all cases are different. I'm tired of being normal and now I want to be Abinormal!( Reference from the Young Frankenstein Movie).
I will be a lot more at ease to leave the house after this slows down some.
Thanks for letting me vent!!!! :-)
Posted 2/18/2011 1:36 PM (GMT -6)
magnesium 250mg daily will help relax the bladder so it can with stand higher internal pressures and thus hold urine better. Try it, its cheap just do not take more than 250mg daily
Posted 2/18/2011 1:44 PM (GMT -6)
Daslink,

Very normal and very frustraing at this early stage. Good luck as you dry up! And vent all you want.
Posted 2/18/2011 2:20 PM (GMT -6)
Many men note that their first improvement is being dry at night, so watch for signs of this.

The first couple of weeks after the cath was out I was always planning my next bathroom trip. Never more than 1 hour away. But things will gradually get better.

In the meantime you can actually get used to the idea of chatting with the supermarket clerk even though you are peeing in your pants at the same time!
Posted 2/18/2011 3:11 PM (GMT -6)
This is one of those things that moves along at it's own pace and liitle you can do about it. It sounds like you are making progress and believe me, you should not wish for " abnormal" you might get it and it might not be good. At this point you could start the kegel exercises if you have not already. Have the doc send you to a physical therapist that deals with incontinence, that should speed things up.
Good luck in the dryness quest.
ron
Posted 2/18/2011 3:43 PM (GMT -6)
Yep, I'm pretty much in the same boat as you. I had my da Vinci RP the day after you and my catheter out on 2/3. Last night was my first night without a pad. But I didn't have any wine or beer with dinner either.

I have pretty good control in the AM. But by the afternoon I get a few squirts here and there. I think the true test for me will be when I can have a couple of Crown Royals and hold it in.
Posted 2/18/2011 4:15 PM (GMT -6)
Axle,I have not had a beer or cocktail since the surgery. I do like the red & darker one. I am doing the Kegel's as instructed and low and behold, I had my first real stream today. All though it was small,it was still a stream!
I will feel better when I am comfortable enough not to use a depends as a backup.
As far as not having to use a pad at night,GREAT! But I hate you for it just the same! :)
Posted 2/18/2011 5:59 PM (GMT -6)
DSALink,

Modifying traditional kegel exercises with "elevator kegels" can help educate the muscle tone of your pelvic floor muscles. 

Elevator Kegels:  "Full power" pelvic floor muscle contraction for ten seconds  transitioned to "half-power" contractions for ten seconds.  Then rest ten seconds.  Three sets of ten.

(I found doing this to my favorite music very helpful.)

The relevant "Pelvic Floor Muscles" include the the pubis muscles above the penis,  the muscles surrounding the anus,  and all the muscles in between.  A good way to isolate these is stopping a urine stream from a full bladder midstream - several times.  After isolating the muscles, the exercises are more effective if done without the urine stream.

My observations:

The unconsciously controlled bladder valve that remains after a radical prostatectomy is stretched and distorted somewhat by the urethra that is now stretched covering the gap where the prostrate once was.  This usually takes time and healing while the patient takes it easy as the entire pubic cavity is recovering from trauma!

Even as the urethra eventually stops "tugging" open the bladder valve, the kegel exercises assist the unconsciously controlled bladder valve but do not work 24/7 stopping the flow.  It is more like a conversation.

It is not a clamp.  It is more like harmony.  It reminds me of the coordination required driving with a trailer. 

I found the muscle tone encouraged by "elevator kegels" is similar to the post RP pelvic floor muscle tone required for continence while walking.

Good luck and Godspeed!

Cedar

ICTHUS!

Posted 2/18/2011 6:06 PM (GMT -6)
Cedar, my man!!!!!!!!!! Was absolutely startled to see your monikor, had to go back and look twice to make sure I had saw right.... wink How's things going? How about an update, remember you still have a seat at the fire.... tongue
Posted 2/19/2011 7:17 AM (GMT -6)
Cedar: Your observations about post surgical anatomy are clear and understandable. It is a better explanation than I have seen nearly anywhere. Did you obtain this explanation from your urologist or is this a personal theory. No disrespect intended, but did you get a doctor's explanation about how the body deals with missing the presence of a prostate? Again, the explanation sounds clear and reasonable.

I have read about the elevator kegels. Amazing how many different ways are suggested to do pelvic floor exercises. They do make a difference along with watching fluid intake to an extent. Please, remember to drink because not drinking water causes more problems when your urine becomes concentrated.

DaSlink: Congrats on having a day where you can hold some urine to deposit into the toilet. That is progress.

Mike S.
Posted 2/19/2011 11:26 AM (GMT -6)
seems like there are a couple of parallel threads going on this. as I posted in the other thread, I am also recently decath'd - on 2/11. leaking a lot, not so much at night, but during day on average 20mL/hour. if I am walking, then about double.

my question is: I understand that during the surgery, one of the sphincters (the one at the bladder neck) is removed, and one is left with the "other" sphincter muscle. Cedar Chopper - you mention the bladder valve is "unconsciously controlled". as of right now, it is taking pretty much a full effort to keep the darn thing closed, and basically can't go for very long. so much so that I am questioning whether it will take a conscious effort to not pee myself for the rest of my life. sounds like at some point it does become more subconscious?

My 4 year old who is getting out of diapers is making better progress.

and yes, I do think about how good a beer would taste. a really nice cold one. maybe two. yeah
Posted 2/20/2011 1:56 PM (GMT -6)
Cyclingboy:  Sorry, it is more like two sphincters are removed.  The one at the neck as indicated and the less formal one that the prostate gland provided.  So you are left with the pelvic floor muscle to do the job.  Urination is actually a very complex voluntary and involuntary act.  It is hard to find a good lay person text that explains it well. Both the brain and muscles work in concert to open passages and trigger muscles to empty your bladder.

I get the same feeling in this recovery period.  Will I have to always think about and hold back my pelvic floor muscle so I don't void when I don't want to?  My understanding and please guys correct me if I am wrong, is that once proper healing takes place the pelvic floor muscle is toned to the point where it keeps the sphincter closed.  Further the sphincter is healed to the point where it wants to positively hold back urine.  

I think the fight for continence boils down to this:  The pelvic floor muscle is still in training or perhaps very strong but the sphincter has not healed yet and still leaks so that despite a great conditioned pelvic floor muscle, the sphincter does not seal properly yet because it has not healed enough to form a strong seal.

Otherwise, all it would take for everyone is a few weeks of conditioning the pelvic floor muscle and ta-da, we would all stop leaking very shortly.  Despite the exercises, the unknown variable is how long it takes for the body to heal the sphincter.

Please don't anguish over this so soon after your surgery.  Most folks are barely back to feeling like going to work at 20 days after surgery if they are leaking and still have some pain/discomfort issues.  Even when you get to the point where standing still does not inspire leaking, when you walk for a time before proper healing takes place, you will leak some.  So your 20 ml per hour will start to fall to smaller and smaller amounts.

Patience, patience, patience.

Mike S.

Posted 2/22/2011 10:23 AM (GMT -6)
thanks for the good advice in the many posts Mike. Patience will have to be my new mantra.
AB
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