So, if I have strong enough Kegel muscles that I can stop urinating in mid-stream, that's good strength, correct? Do I need to keep strengthening them or am I already there?
Nick, I was thinking about
a response to this but went to my iMac, as I am a much better typer on a keyboard than on an iPhone!!!
As some have mentioned, your continence after RALP is an unknown, with quite a few variables, not the least of which being the competence of your surgeon.
Pre-surgery, under the advce of my surgeon, I started a routine that I kept up until the day of my surgery, and resumed at catheter removal. Pre-surgery, and skip a paragraph for people who are bothered by TMI...i...
...found tremendous increased forced in ejaculations. And let me tell you, my wife was not pleased, or at least didn't seem to mind too much
Diuretics, by their nature, cause you to pee more. For someone who has recently had their prostate removed, and thus two thirds of the muscles controlling their continence, you can understand why this might be an issue. Consider, with a prostate, you will pee more after drinking more coffee and more beer.
What was stressed to me, by Uro, Uro surgeon, GP and PT, was, post-surgery, drinking lots of water, staying well hydrated, is good for the recovery of your urinary tract. After Foley is removed, the elasticity of your bladder is greatly affected. Hydration helps with bladder elasticity, and, it is my understanding, helps the whole system to get back to 'normal,' despite the increase in leakage and increased frequency of urinations.
For many, and myself included, progress is slow...there were certainly periods of depression and anxiety....never leaving the house without a back pack with a change of drawers, underwear, several pads and a Depends, to....maybe or maybe not....taking an extra pad on a day out.
Furthermore, regarding Kegels, PT was/is an integral part of understanding how to retrain existing muscles to optimize continence. After a few sessions, some of it seemed intrinsic, common sense really, and quite logical regarding the progression from simple, and over time, complex Kegels (i.e. laying on back, knees raised, kegels, to using a resistance band, to performing keels doing squats while twisting torso, this last one I incorporated after realizing that performing this action while sitting at my desk was causing leaking).
However, despite increased urination from drinking diuretics, my surgeon reassured me, on several occasions, that, while temporarily increasing leakage due to diuretic consumption, it has no effect on long term healing. This includes temporary dehydration due to excessive diuretic consumption.
PSA: 05/16 6.2, 6/16 5.5, 08/16 5.4
Biopsy: 11/16 - 3 of 12, 3+4
01/17 PSA 8.5
RALP: 2/08/17, Dr. Dena Engel
Lymph, bladder neck, apex: neg
t3a N0 M0, 4+5
6-week post-op PSA 3/17 "Undetectable"
Erect: 90-100% functioning
Incont: down to 2-4 pads (after cath removal ~ 8-10)
2-wks Casodex pre short term Lupron (4/17), 7 wks IBRT to come