Bladder retraining

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Steve n Dallas
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Date Joined Mar 2008
Total Posts : 4834
   Posted 3/8/2011 9:21 AM (GMT -6)   
"A lot of bladder control issues start in the brain," ob-gyn Jill Rabin says. By adjusting your mental associations with bathroom visits, you can help extend the length of time you can last between them.
 
If, say, you feel the need to urinate every 20 minutes, work on extending that amount of time by small increments -- just five minutes a week. Instead of giving in automatically to the overwhelming urge, try to sit quietly for a few minutes. Focus on deep breathing or distract yourself in another way (listening to one more song on the radio, doing a series of pelvic floor muscle exercises). Know that the need to urinate is felt in waves, so an initial urge that's resisted tends to subside a bit.
 
Don't be discouraged by occasional breakthrough leaks. "Through timed voiding, you can gradually stretch the interval from every 20 minutes to every 2 hours," Rabin says.
 
Some people find it useful to set a timer to help extend the intervals between bathroom breaks. Urinating on a timed schedule -- whether you feel the need or not -- is another way to introduce a structure of less-frequent bathroom visits."
http://health.msn.com/health-topics/urinary-health/articlepage.aspx?cp-documentid=100269577&gt1=31062
 

daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 3/8/2011 9:49 AM (GMT -6)   
Thanks for posting that Steve. Sounds a lot like our "retraining the bladder" technique discussed on the forum.
Dave in Durango CO
07-06 PSA 2.5
01-08 PSA 5.5
09-09 PSA 6.5
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5
03-01-10 Age 55 RRP in Durango CO by Dr Sejal Quale and Dr Shandra Wilson
03-16-10 Path' G-8 (4+4+5) Bilateral involving 21% of left lobe, 3% of right lobe, SVI, Focal positive margin, pT3b NO MX

All PSA as of 1-25-11 <0.04

axle
Regular Member


Date Joined Feb 2011
Total Posts : 35
   Posted 3/8/2011 10:07 AM (GMT -6)   
Thanks Steve; good info. It is something I am working on these days.
Age 58; da Vinci on 1/26/2011
PSA History: 10/2005 = 1.7; 10/2007 = 2.8; 10/2009 = 3.6; 10/2010 = 4.9
Abnormal DRE in 2009; Increasingly abnormal DRE in 2010
Thank you POPs!
Biopsy on 11/23/2010: GS = 3+4 (right side) with 4 of 6 cores positive @ 40%.
Post-OP pathology: GS=3+4; tumor = 35%; pT3b; R. seminal vesicle invasion; Extraprostatic extension into the R. bladder neck; margins uninvolve

Worried Guy
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Date Joined Jul 2009
Total Posts : 3734
   Posted 3/8/2011 10:11 AM (GMT -6)   
I'll add one more tip. Keep a pencil and paper by the toilet - or on the refrigerator next to the pictures of the grandkids - and record the time (and quantity if you have a scale) of every UE, urination event, or 'pee' in technical terms. That way you can track your progress and see if you are improving or not.

Hopefully in a few months you will heat your house with the papers. But there is a 1 chance in 10 that after one year you will still be buying pee pads. The data will prove to be invaluable when deciding your next steps.

(Sadly I speak from experience.)
Jeff
Age: 58, Mar 35 yrs, 56 dx, PSA: 4/09 17.8 6/09 23.2
Biopsy: 6/09 7 of 12 Pos, 20-70%, Gleason 4+3 Bone, CT Neg
DaVinci RP: 7/09, U of Roch Med Ctr
Path Rpt: Gleas 3+4, pT3aNOMx, 56g, Tumor 2.5x1.8 cm both lobes and apex
EPE present, PNI extensive, Sem Ves, Vas def clear, Lymph 0/13
Incont: 200ml/day ED: Trimix
Post Surg PSA: 10/09 .04, 4/10 .04, 7/10 <0.01, 12/10 <0.01
AdVance Sling 1/10/11

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4834
   Posted 3/8/2011 10:28 AM (GMT -6)   
If you click on the link and read the article - most of the "guys" here can skip #3.

DaSlink
Veteran Member


Date Joined Feb 2011
Total Posts : 713
   Posted 3/8/2011 11:31 AM (GMT -6)   
I though I was making some good progress then BOOM. Yesterday I had hardly any control at all. Not till late in the day. I guess my bladder was showing me who is really in charge!
Better day today...so far.
Every minute you fish or ride,adds an hour to your life!

Age 52 Dx age 53 daVinci surgery
prostate volume 24gms
Biopsy 12 cores with 7 positive- left base,right base,left mid gland,right mid gland, left apex.
Gleason score of 7
First PSA 38.7 on10/05/2010
Second PSA 49.9 on11/23/2010
CT negative
Bone scan Negative
daVinci RRP on 01/25/2011 by Dr Mark G Delworth at Bethesda North Hospital.

p_elliott
Regular Member


Date Joined Nov 2010
Total Posts : 143
   Posted 3/8/2011 11:42 AM (GMT -6)   
 A lot of the time after my surgery the way I knew I had to go pee was I was leaking out my dick. I had no urge to go to the bathroom just leaking. When I did have an urge it was like right now. I think Jill needs a prostate then get it ripped out. Like me telling a woman how to deal with a hysterectomy.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/8/2011 11:56 AM (GMT -6)   
Steve, sounds like good advice in general. Makes a lot of sense.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

MikeS24
Regular Member


Date Joined Oct 2010
Total Posts : 131
   Posted 3/8/2011 1:06 PM (GMT -6)   
Guys: Don't throw away hint number 3 so fast. I read a paper just the other day on a device used for incontinence training for guy using a "cone." The study was on rehabilitating some long term incontinence patients and they described the use of an anal cone. I kid you not. Patients "sit" on the cone in a semi-squatting position, using the anal muscles to hold the cone from falling out and bring the cone upward while holding it. The idea was to introduce a weight training component. The cone is hollow and can have weights added to it to provide more resistance. They saw some improvements but man, the indignity of that is more than I could bear. Imagine the patient coming to see the physical therapist for the first session with the cone. "You want me to do what with that?" Yikes, isn't that illegal is some states? My questions is: who get to clean the cone after you are finished with your reps. This is not like wiping down the stationary bike seat at the gym with your towel. Hmmmm.....

The advice the author gives is standard urology protocols. Hey, give the woman a break. Many women have hysterectomies and end up incontinent. They have kids and end up incontinent. A few other things make women have the same urinary problems as prostate surgery. It is not just a mens issue.

Worried Guy: I agree in charting output on occasion to see just how much you can retain. I have moved my baby bladder from 75 cc to 100 and now to about 200-250 cc just by making an effort to hold off urination for a time to promote stretching and permanent expansion. It does work.

Use the start and stop flow only to ID the muscle group. Don't use this as the form of exercise. It might set you back a few weeks in recovery.

Try not to urinate just to empty a partial bladder if you can help it. It makes your bladder weak and susceptible to urge incontinence and spasms.

DaSlink: You crack me up. As I told you, if you charted your progress it would look like the teeth on a bow saw with lots of ups and downs. Check to see what and when you ate or drank that might have triggered a much greater output. Some foods and an abundance of liquids at the wrong time will cause leakage. Somewhere on the Sloan Kettering website they have a comprehensive list of trigger foods. So you got to stop eating the Jalapeno chips with spicy tomato salsa, washed down with 2 beers. Your going to have trouble, even if it is bowling night. You won't get the deposit back on the shoes if you bring them back soaking wet! nono

Keep kegeling...
Dx 56
Biopsy: Gleason 3+3=6, PSA 6.6 One core of 12 with 5% T1c
Surgery: July 2010 J. Hopkins
Pathology Gleason 6, Neg Mar, Neg LN, Neg Sem Vesicles
9/15/10 1st post op PSA >0.1 undetectable
3/11/11 PSA - TBD
Incontinence - very slow recovery
Aug -Sept 2010 - 4-5 pads
Oct 2010 3 pads
Nov 2010 2 pads
Dec - Feb 2011 1 pad all day - 1 pad at night
ED: slow improvements

DaSlink
Veteran Member


Date Joined Feb 2011
Total Posts : 713
   Posted 3/8/2011 5:30 PM (GMT -6)   
But I do loves the spicy foods. I had some Jalapenos over a week ago and no beers yet since the surgery (I miss my beers). Unfortunately bowling season is over for the year but I do have my own shoes. I could just wring them out and put them back in the bag for a week. Man that'll keep the flies away.
I just can't wait till every time I cast a rod or set the hook that I piddle on myself. That will take fishing to a whole new level. I don't even want to talk about riding my Harley yet. But I sure all the vibrating will not have the same joy as it used to!!!
Every minute you fish or ride,adds an hour to your life!

Age 52 Dx age 53 daVinci surgery
prostate volume 24gms
Biopsy 12 cores with 7 positive- left base,right base,left mid gland,right mid gland, left apex.
Gleason score of 7
First PSA 38.7 on10/05/2010
Second PSA 49.9 on11/23/2010
CT negative
Bone scan Negative
daVinci RRP on 01/25/2011 by Dr Mark G Delworth at Bethesda North Hospital.

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 3/8/2011 5:48 PM (GMT -6)   
I know for someone just recovering from surgery and dealing with the initial problems, this sounds like BS.

But, it will become more important as you recover. Initially, we jump and run to the John so we don't wet our pants. As we get better with the bladder control, it still thinks we are going to jump and run every 20 minutes. You can retrain it again.

Goodlife

DaSlink
Veteran Member


Date Joined Feb 2011
Total Posts : 713
   Posted 3/8/2011 10:41 PM (GMT -6)   
I'm giving the spicy food theory a good check. Tonight I had some chicken tortallini soup and wings medium(6) but still no beers
Every minute you fish or ride,adds an hour to your life!

Age 52 Dx age 53 daVinci surgery
prostate volume 24gms
Biopsy 12 cores with 7 positive- left base,right base,left mid gland,right mid gland, left apex.
Gleason score of 7
First PSA 38.7 on10/05/2010
Second PSA 49.9 on11/23/2010
CT negative
Bone scan Negative
daVinci RRP on 01/25/2011 by Dr Mark G Delworth at Bethesda North Hospital.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/8/2011 11:18 PM (GMT -6)   
Read that the average capacity of an adult bladder, male or female, ranges between 400 and 600 ml. Sure it varies from person to person.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2216
   Posted 3/9/2011 6:43 AM (GMT -6)   
I think I should send my bladder to what I believe you fellows over the sea would call a Military School. He's a badly behaved boy. He can't make his mind up. Very irregular. One part of the day he manages a long gap followed by 300ml another it's all he can to do go for any time at all without a continous dribble. And he keeps getting up at night to go to the bathroom therby stopping me from sleeping.

Not doing as well at present due to the coughing and sneezing anmd nose-blowing resulting from a bad cold.

If you write on lists by the refrigerator make sure nobody then goes to the store and tries to by 350ml of pee.

Alf
Born Jun ‘60
Apr 09 PSA 8.6
DRE neg
Biop 2 of 12 pos
Gleason 3+3
29 Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
17 Nov 09 PSA 0.1
17 Mar 10 PSA 0.4 sent to RT
13 Apr CT
66Gy 28 Apr to 11 Jun 10
Tired + weird BMs
14 Sep 10 PSA <0.1
12 Jan 11 PSA <0.1
Erection OK

MikeS24
Regular Member


Date Joined Oct 2010
Total Posts : 131
   Posted 3/9/2011 9:22 AM (GMT -6)   
Alf: A question. Did you have BPH for a few years before this whole mess with surgery and other treatments? From what I read in Walsh's book and what I am observing from myself, I think the bladder has some "programmed" elements in it that are a byproduct of having several years of BPH. The bladder wall is supposed to be thicker with guys who have had BPH because they had to exert more force to urinate, thus have built up the bladder muscle. Further, the beefy bladder muscle is prone to put more pressure on the sphincter and cause more leaking.

When I get up at 2:30 to 3:00 am to void, I get at least 400 to 500 ml of urine output. I am lucky to be able to hold 250 ml during the day before my bladder is screaming to be emptied and I have had some urge incontinence to remind me that it needs emptying.

Just as you are, I am trying to "grow" my capacity by waiting until very full to void. Avoiding going just to drain off a few ml of urine when I am driving or going to a meeting.

My leak is fairly small but I am getting very discouraged at 7 months and starting to think this is my permanent fate....
Dx 56
Biopsy: Gleason 3+3=6, PSA 6.6 One core of 12 with 5% T1c
Surgery: July 2010 J. Hopkins
Pathology Gleason 6, Neg Mar, Neg LN, Neg Sem Vesicles
9/15/10 1st post op PSA >0.1 undetectable
3/11/11 PSA - TBD
Incontinence - very slow recovery
Aug -Sept 2010 - 4-5 pads
Oct 2010 3 pads
Nov 2010 2 pads
Dec - Feb 2011 1 pad all day - 1 pad at night
ED: slow improvements

DaSlink
Veteran Member


Date Joined Feb 2011
Total Posts : 713
   Posted 3/9/2011 1:06 PM (GMT -6)   
Today is proving that the theory on spicy foods is dead on! I'm gonna miss the kick when I eat mad
Every minute you fish or ride,adds an hour to your life!

Age 52 Dx age 53 daVinci surgery
prostate volume 24gms
Biopsy 12 cores with 7 positive- left base,right base,left mid gland,right mid gland, left apex.
Gleason score of 7
First PSA 38.7 on10/05/2010
Second PSA 49.9 on11/23/2010
CT negative
Bone scan Negative
daVinci RRP on 01/25/2011 by Dr Mark G Delworth at Bethesda North Hospital.

tvwohio
Regular Member


Date Joined Sep 2010
Total Posts : 172
   Posted 3/9/2011 4:13 PM (GMT -6)   
My urologist had a biofeedback training for me- it worked well until strictures and i had a InCare Gyn Kegel stimulator which I used also.
Prostrate Cancer 2001 RP 50 years old PSA 6.8 Gleason 3 + 2 40% T3bNxMo moderately differentiated adenocarcinoma RP - cancer apex area, nerve sparing not successful Bulking using both collagen and teflex unsuccessful for continence. 4 sets of strictures within 1 yr after RP - 3 manual and 1 rotorotor -9/2010 stricture - suprapubic catheter folled by Homan Laser. AMS800 1/22/11.
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