Peeing since surgery

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Susan R
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   Posted 5/11/2011 1:03 PM (GMT -6)   
Hey guys, who else is having a problem with pee stream? Michael is having this problem, whenever he pees, the stream seems to have a mind of its own and goes everywhere. He said it is safer to start sitting down to pee, so the pee doesnt get everywhere. Others having this issue, and ideas on how to handle it?

SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 5/11/2011 1:18 PM (GMT -6)   
I remember aiming stright on and it always shooting to the right. Eventually it cleared up. Sitting down is definately more accurate during this stage. Squid.
*Age 64, PSA July 2009 .66; Biopsy: 2 of 12 cores positive, Gleason 3 + 5
*open Surgery 10/22/09
*Post Surgery Biopsy Gleason 4 + 3; 2 positive margins
*03/11/10 - Bladder neck surgery for stricture
*PSA - 30 day/.07, 90 day/<.1, 180 day/.21
*07/27/10 - IGRT done - 39 zaps, 70 gys
*Post IGRT PSA - 9 mo. PSA, still <.1

James C.
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Date Joined Aug 2007
Total Posts : 4462
   Posted 5/11/2011 1:19 PM (GMT -6)   
Susan, that's common here, I think. As to correcting it, I don't know if there is much to be done, other than healing and time.
James C, 64, Kingsport, E. TN
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% inv, lf. lobe, GS6
9/07: Nerve Spar. open RP, Path: pT2c, 110 gms., clear except:
Probable microscopic involvement-left apical margin -GS6
3 Years: PSA's .04 each test until 4/10-.06, 9/10-.09, 12/10-.09, 2/11-.08, 5/11-.08
Bimix .30

clocknut
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Date Joined Sep 2010
Total Posts : 2649
   Posted 5/11/2011 1:23 PM (GMT -6)   

Susan, I've had that happen a few times.  Usually, it seems to be those times when the organ, for whatever reason, is very short (think Seinfeld's "shrinkage" episode).  Sometimes, I think a hair gets stuck across the urethra opening and splits the stream.  I've learned to be careful when the circumstances seem right for a bad stream.  A few tugs at it before starting seems to prevent this from happening.  It's embarrassing to miss a foot-wide toilet.


142
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Date Joined Jan 2010
Total Posts : 6885
   Posted 5/11/2011 1:26 PM (GMT -6)   
Been there, done that. More on the wall and floor than in the pot.
 
I don't remember how far out from surgery he is, but the first 6-7 months for me were really bad. Uro explained that it had to do with the way the urethra re-attachment heals. Yes, sitting helped.
 
At 18 months out, I still have the occasional "spray". It seemed to get better as my flow improved, as the bladder seemed to hold a bit more with time.
 
If that spray gets worse or it becomes more difficult to pass urine, he will want to visit the uro and get checked for a stricture as soon as possible.
DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

wifeandmother
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Date Joined Feb 2011
Total Posts : 45
   Posted 5/11/2011 1:37 PM (GMT -6)   
Hubby says sitting is better. It will get better as he does.

logoslidat
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Date Joined Sep 2009
Total Posts : 5632
   Posted 5/11/2011 11:28 PM (GMT -6)   
142, Understand your concern, but susan's
first statement, about who is having problem with stream, IMO was not about the volume or intensity which would indicate a stricture, but about the spray. Her first statement could lead you to think that the problem was a weak stream, when in fact, I think it was all about the spray which I think we all had at some time or another. Heck it happened to me before PCA. I say this not to criticize you, I just dont want wife and mother to think Hubby may have a stricture when , to me, that was not indicated from her post.
Susan, can you, if you wish, clarify that point. Does he have a weak stream once it pops thru the head or is it ,other than the spray , a normal stream. Also in case u r not sure what a stricture is, to my knowledge, when urethra is reconnected, well up the line where prostate was, there is a chance of scarring which can cause, a stricture or a closing of the urethra which can get so bad, a catheter is used. It is very treatable, but can, rarely, require surgery. I dont believe this is the case, but if worried, see urologist as 142 suggested.
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

Radical
Veteran Member


Date Joined Mar 2009
Total Posts : 739
   Posted 5/11/2011 11:44 PM (GMT -6)   
I find the water way too cold when sitting down. lol sorry couldn't resist. [I wish]...............Kev
Kev 53yrs [Gold Coast Qld, Australia]
PSA 4 Gleason 7 [3+4=7]
RP 24/12/08 Dr Philip Stricker [Sydney]
Upgrade Gleason Score 7.6 [4+3=7]
Stage 2 Margin status- Focal Involvement
ED- okay with Meds.
PSA at 2 yrs, no change remains 0.03
"Every-day in Every-way I Get Better"

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3731
   Posted 5/12/2011 4:35 AM (GMT -6)   
(Did somebody call my name? I thought I heard someone ask about peeing!)

Susan,
That is very common. I could not pee well when sitting down so that was not an option for me. When standing, my stream aim was so bad there were times when it actually came out behind me! How is that even possible?!? It would run down my scrotum and fly off the bottom either onto the floor or into my shorts down around my ankles. Ridiculous.
To save our marriage, :-) I did three things and my wife did one:
1) I peed in the shower whenever I took a shower. 3 times a day sometimes.
2) I started peeing into a 20 oz (600ml) plastic cup that I kept on the back of the toilet. That gave me the added benefit of being able to measure (and plot) my pee volume.
3) I kept a bath towel on the floor in front of the toilet.
and
4) My wife always left the seat up when she was finished.

This phase will pass. I promise.

Jeff (Still peeing in a cup when nobody's looking)
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: Glsn 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 Dry

Post Edited (Worried Guy) : 5/12/2011 4:38:23 AM (GMT-6)


142
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Date Joined Jan 2010
Total Posts : 6885
   Posted 5/12/2011 7:48 AM (GMT -6)   
Logo,
 
No, don't want to create extra concern, but my uro/surgeon did make a point that if the spray got progressively worse, and was accompanied by difficulty passing urine, that it might be scar tissue on the inside of the urethra re-attachment point. That was a "call doctor" item.
 
It is on my doctor-provided check list, so I mentioned it.

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5632
   Posted 5/12/2011 9:23 AM (GMT -6)   
Roger that 142, thanks for understanding my concern.

worried guy you should change your tag to witty guy, then unlike me you would not be in the witless protection program. Eh, did I just make a funny!!!
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

April6th
Regular Member


Date Joined May 2010
Total Posts : 264
   Posted 5/12/2011 10:47 AM (GMT -6)   
It seems strange that if there is problem with the urethra way back near the bladder that it would cause a unusual spray pattern while peeing. It seems like the last inch of the urethra at the tip of the penis would determine the spray pattern of urine just like a nozzle at the end of a garden hose would.

Dan

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6885
   Posted 5/12/2011 10:54 AM (GMT -6)   
It was explained to me that having extra tissue inside along the otherwise smooth urethra causes the flow volume and pattern to change. Try pinching a hose at different points. It isn't just the nozzle.
 
By the way, "way back"? not sure how long that is for you, but ain't far for me cry

Susan R
Veteran Member


Date Joined Dec 2010
Total Posts : 511
   Posted 5/12/2011 11:42 AM (GMT -6)   
To clarify, he was just complaining that he couldnt direct his urine into the toilet when he was standing up and because of that it would get all over the place. So, I thought I would ask the question......who else has had the peeing all over the place issue and how long might it take to resolve.

Thanks so much for the comments!!!
Husband 39 at diagnosis 12/2010.
No symptoms, PSA 18 in 10/2010
one month antibiotic then PSA 12.6 in 11/2010
biopsy end of 11/2010 Gleason 6
Da Vinci prostatectomy 2/2/2011
1-2 pads per day
nocturnal erections within a month, and able to have sex with Levitra.
1st post-op PSA less than .05

staging: pT2aNo, Gleason 6

clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2649
   Posted 5/12/2011 11:52 AM (GMT -6)   

If it's only an occasional thing, I would still suggest that it's caused by the "shrinkage" that most of us notice after surgery.  When the penis resembles a turtle peeking out of its shell, the spray pattern changes.   Now, I don't know what causes that occasional severe shrinkage situation....often things are about as they always were pre-surgery.  But when the penis is retracted like that, a pubic hair can get in the way of the opening, or the urethra may get kind of "kinked" at the end.  That's my experience.  So now, if I find it like that when I have to go, it's helpful to stretch it a couple of times before starting  the flow.  Then it shoots straight.

 


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 5/12/2011 11:59 AM (GMT -6)   
Having had stricture problems three times - two fixed temporaily with dilation, and the last with surgery, I realize that the slow stream and inability to empty the baldder is a pretty good sign of a stricture problem. But also, I do remember aiming straight and ending up peeing 45 degrees or more to the right each time. This was before the stream started to diminish. Could be a first sign of problems, maybe not. Having gone thru both problems, I agree with 142 that a call to the uro is a good move if the stream starts to diminish.

For Worried Guy, your description of peeing to the rear had me laughing. That is probably the only direction I didn't get it in. Squid.
*Age 64, PSA July 2009 .66; Biopsy: 2 of 12 cores positive, Gleason 3 + 5
*open Surgery 10/22/09
*Post Surgery Biopsy Gleason 4 + 3; 2 positive margins
*03/11/10 - Bladder neck surgery for stricture
*PSA - 30 day/.07, 90 day/<.1, 180 day/.21
*07/27/10 - IGRT done - 39 zaps, 70 gys
*Post IGRT PSA - 9 mo. PSA, still <.1

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3731
   Posted 5/12/2011 12:19 PM (GMT -6)   
Susan

Peeing was like Gump's box of chocolates - I never knew what I was going to get. Sometimes it sprayed behind me. Sometimes I would spray the toilet seat cover, or my feet. I would lean way over the toilet and try to drop it straight down but I still would end up with wet feet. Gross.

Peeing in the shower, the 20 oz cup and a lot of humor kept my sanity.

Jeff

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6885
   Posted 5/12/2011 12:29 PM (GMT -6)   
In my world we pee in a cup often.
 
It was easy enough to decide to use the cup since I was measuring flow anyway.
 
And yes, puddles appeared in the most unexpected places.

maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 784
   Posted 5/12/2011 6:54 PM (GMT -6)   
I had the same problem, sat down to pee for quite a few months, it will pass.

Mal.
age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept. Totally dry since catheter removed
PSA 23rd Oct.0.5 seeing Radiation Onocologist 31st Oct.
Started radiation treatment on 5th Dec, to continue until 24 Jan. 08.
Finished treatment, next PSA on 30th April.
PSA from 30th April 08, until now range- 0.5 to 0.6, I am now 70

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5632
   Posted 5/16/2011 12:29 AM (GMT -6)   
Aptil 6th, that was my point, I didn't feel it was a stricture at all, for that reason, but Susans first statement could lead someone to believe it was a stricture problem and lead to unnessasary . The point of a slight squeeze up stream causing a spray, garden hose analogy,doesn't make sense to me. I actually could see that, arguably, enhancing stream, viv a vis the physics application of the Bernouili Principal. But spray, no. In any event Susan clarified, and concern diminished.
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

Postop
Regular Member


Date Joined Feb 2010
Total Posts : 385
   Posted 5/16/2011 1:42 AM (GMT -6)   
If Bernoulli's principle could be applied to peeing, we could use it to fly.

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5632
   Posted 5/16/2011 3:54 AM (GMT -6)   
Postop,What principle am I referring to then, the one where water/air, passing thru a restriction, actually speeds up thru the restriction? Something to do whith venturi effect.I know the the B Prin applies to farther distance to pass over top curve in airfoil, increasing speed as it does, hence causing lower pressure above and hence lift. Thought it applied to a enclosed restriction also, farther space to travel due to bend on both side, hence increased speed, hence, and this is where it gets fuzzy for me, which is why I caveated the word arguably, stronger stream. Maybe i just got refudiated. See what you started Susan, LOL On another note, when I googled it , was led to a physic forum . where a discussion was taking place, that the B principal did not apply to lift. Im sure it does, but Im not a physicist, tho I do play one on tv. you think our discussions on this forum get complicated. yikes PS the top of an airfoil is simply the bottom of an enclosed restriction, minus the the top of the resticted enclosure , which looks like a upside down airfoil, if you can envision that. Whew, I stay tired!!!
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

Post Edited (logoslidat) : 5/16/2011 4:24:10 AM (GMT-6)


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3731
   Posted 5/16/2011 4:23 AM (GMT -6)   
There is a physical device called a fluidic nozzle or fluidic oscillator nozzle that emits an oscillating spray from a single hole. They are sometimes used on car windshield washers. No moving parts required, or tiny spray nozzles required.
Here is a good paper on the research.
The cavity is precisely shaped so the flow surface tension causes the flow to move to one side. Then the high velocity causes it to breaks off and move to the other side. Bingo! An oscillating pee stream so fast it looks like a spray. Maybe we should do a high speed video of it for research. It does require an intake air hole upstream of the nozzle. Anyone care to volunteer for a tiny hole installation in your plumbing? ;-).

I figure it is easier to just pee in a 20 oz cup.
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: Glsn 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 Dry

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5632
   Posted 5/16/2011 4:30 AM (GMT -6)   
Hey, where you stay, its 1230 here, can't sleep, so figured I would count the number of angels on a pin. Don't know why I didn't ask the resident engineer or whatever is your expertise. I know it impresses me.
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3731
   Posted 5/16/2011 6:00 AM (GMT -6)   
Hey Logo,
It was 6:30 AM here. As you can tell I am an engineer with a strong physics, chemistry and electrical background. I can figure out anything.
It is both a strength and a disease.
Jeff
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