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Incontinence after cath removal

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Researcher87
New Member
Joined : Dec 2006
Posts : 14
Posted 1/27/2007 4:33 PM (GMT -7)
What is everyone's experience with incontinence for the first few weeks after your catheter was removed? Are some days worse than others? I'm having bad day today!
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two-of-us
New Member
Joined : Jan 2007
Posts : 13
Posted 1/27/2007 4:49 PM (GMT -7)
Every day was bad for me- BUT it does get better! Just hang in there- keep plenty of pads around- Excerise- and get on with life!

I always stuck a pad in each pocket when we went out and carried extras in the car. Walking for an hour at the mall required a change after thirty minutes (it would be soaked) then a change before leaving. That lasted for several months before continence returned... You could do better or worse.

R
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BenEcho10
Regular Member
Joined : Jan 2007
Posts : 133
Posted 1/27/2007 5:32 PM (GMT -7)
Hi Researcher,

It has been seven weeks since my catheter came out. From the very first day, I have had little or no leakage when lying down or sitting. However, when standing or walking, I have pretty much constant leakage. I use Depends Male Guards. I change them about every hour when I am up and around (at work for instance.)

It has gotten slightly better lately but I would still say that I am still pretty much incontinent when I am on my feet. I have heard several people say that it typically takes about three months to get dry. Some do better. Hopefully you will be one.

Don't expect miracles. I did and was disappointed and frustrated. If you are having "good and bad days" then you must have some control. Just hang in there. It will get better.

Ben
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Bent1
Regular Member
Joined : Jan 2007
Posts : 26
Posted 1/27/2007 5:54 PM (GMT -7)

Hi Researcher,

I can't say that I ever experienced the degree of incontenance that many on here describe.  HOWEVER, to respond to one of your questions, some days are positively worse than others.  I was never able to identify just exactly why.  It did seem like caffene, i.e. Diet Coke, etc. may have made it worse.

It does get better with time. 

Bent1

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Researcher87
New Member
Joined : Dec 2006
Posts : 14
Posted 1/27/2007 6:08 PM (GMT -7)
Thanks guys. Intellectually, I know it will get better... it's just hard to believe it when you leak like a sieve sometimes! :-)

I think today is worse becuse I had more coffee then I have had in recent days, so Brent1, thanks for validating my suspicion.
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spinbiscuit
Veteran Member
Joined : Apr 2006
Posts : 818
Posted 1/27/2007 7:01 PM (GMT -7)
Hi Reseacher,

It has only been 2 weeks, and as my doctor warned me it could be up to 3 months before you become 100% dry. I my case it was about 10+ weeks to achieve 98% continence. So don't dispair do your exercised, and you will get better. I noticed that improvements occured all of a sudden. For several weeks nothing seemed to be improving 5-7 Depends a day; then the next day I would only need 1-2 pads. Another few weeks went by then just 1 pad, and that was only for an occational leak. A little after the 10th week I had become "Pad Free".

You are right about the coffee; it does not help, but it's one of the few vices that I really enjoy.

Good luck to you, and I hope you improve quickly.

Glen
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SJC
Regular Member
Joined : Jul 2006
Posts : 113
Posted 1/28/2007 4:12 AM (GMT -7)

Researcher:  Regaining continence is different with everyone.  As my urolgist says, you just have to be patient.  However, continence will return!

During the period immediatley after catheter removal, I discovered more dripping/leakage toward the end of the day.  I was told this is typical b/c your muscles are tired after working so hard during the earlier part of the day.  In time, however, this aspect improved.  I am totally continent and you will be too in due course.

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Tamu
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Joined : Oct 2006
Posts : 626
Posted 1/28/2007 6:28 AM (GMT -7)
Researcher,

The first week post cath removal was disappointting for me. Some days were worst then others. I started walking more and more and while that caused the leaking to be worse it resulted in the improvement in overall leaking. I have to say I was really depressed and could see myself in pads for a long time. The second week was a lot better. From there I got down to one pad a day at about 4 to 5 weeks after surgery and I became completely continent at exactly two months after the cath removal just about when my surgeon said I would. So hang in there it will get a lot better soon. One thing that helps is to go urinate about every hour on the hour for a while. This seems to help retrain your system that it needs to hold the urine.

Tamu
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GreenAcres
Regular Member
Joined : Jul 2006
Posts : 474
Posted 1/28/2007 8:16 AM (GMT -7)
Hi, Researcher. Hope today is going better for you! My husb. was almost completely dry, except for a few squirts, for the first two weeks following cath removal. Then the gushing began with activity. We had such a good start and then it went totally downhill. So, we understand how you feel.

We're almost six months post and still incontinent with standing or any activity. That obviously puts us in the long-range planning group! However, we did change up our kegel routine and took Biker90's 10x/day rather than our surgeon recommended 2x/day. I do believe we're seeing some improvement (Thanks, Biker!). Hope it holds up, because it is so tough to go through every day leaking like a sieve. The emotional and "studly" side really takes a beating. Even when you know to expect it pre-surgery, going through it is a completely different deal.

Two-of-us - I just noticed you had yours in Austin. That's where we went for our da Vinci. What a lively city - when you're up to partying, that is!
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biker90
Veteran Member
Joined : Nov 2006
Posts : 1465
Posted 1/28/2007 11:39 AM (GMT -7)
Hey Researcher, this is a really good topic.

I had control over my stream as soon as the catheter came out but that didn't mean that I was continent by a long shot! My doc said to not try to hold it for 24 hours, just let it go into the pad then start to do Kegels the next day. I was so happy to have control right there that I thought I wouldn't need to do anything else. He put his finger in my face and told me to do Kegels anyway. How right he was.

I leaked when I stood up, when I coughed or sneezed or made any quick motion. What a letdown! So I've been doing Kegels since then. The other thing was that I had to get used to the new plumbing arrangement. It felt different and I had to isolate the sphincter muscle. Bluebird had a post that explained what was done during surgery that left me with just the external sphincter. (I think that is what she called it.) So having only one way to hold my pee, I had to strengthen but not overwork it. Too many Kegels can do that as I found out one day and had a big wet spot in bed that night. (Too much of a good thing is not necessarily a good thing!)

Anyway I stopped leaking 99% of the time after about a week after the catheter came out. I have a small one now and then if I get too tired or stop Kegels. Getting used to the aftereffects of PCa is probably different for each of us. My biggest fear was incontenence. (Men just don't pee their pants!!!!!! Referencing Greenacres "studly" comment.) So if I have to do Kegels for the rest of my life, I will gladly do it.

I also think that another advantage of surgery over radiation is that you know what you have to deal with as soon as it is over. Then it is just a matter of healing and learning how to operate the new system.

See ya....

Jim
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bluebird
Veteran Member
Joined : May 2006
Posts : 2543
Posted 1/28/2007 12:38 PM (GMT -7)
Hi Researcher….   Kegels!!!   What does your doctor tell you to do?   Obviously there are different opinions…   After understanding that we had to help the new muscle that was going to be in charge of our urinary continence…. We read up on him (the sphincter muscle) and found that we could work together!!! The sphincter muscle is so important to retaining urinary continence. Before surgery get this guy in shape…. Like any type of exercise… you can over do it.   But since he’s never had to work before you better get him learning the ropes J   Before surgery: Our urologist said to work the muscle when urinating… the start, stop, hold, start several times during urination .   This strengthens the muscle.   Also, walking stairs is a really good exercise.     After surgery:   We were to still do the kegels when urinating and stairs during his regular workout.   This is the only time Buddy does them.   He allows his first urination in the morning to have a nice steady flow!!  Then the rest of the day he does his start / stop / start /stop.   No doubt in our mind that the kegels, walking, and stairs have been instrumental in our continued recovery of urinary continence.  I will tell you this... the sound of the early morning stream is music to my ears.... and the start / stop / start / stop continues to bring a smile to my face.  I put together a little bit of information…. I hope it helps you! I also popped Kegel Help! Thread back to the top of the forum…1-28.   Partial Quote from Jim *Our Biker90 Post-op day 9, past-cath day 3. Still no floods, no leaks and no drips. I threw out the remaining pads and diapers this morning as a gesture of dedication to continence. Doing Kegels as prescribed by the doc. (5 reps of 5 secs on and 5 secs off, 10 times a day, on the hour from 6 am to 4pm) The time of day is mine not his. Did my daily stretching excercises (for arthritis) and my daily walk. It sure feels good to get back to a routine again. I drink lots of water because peeing feels so good. This is a side benefit of getting rid of my oversized, lumpy prostrate. I keep discovering small pleasures that I had taken for granted or overlooked entirely. EXCERPT:…..On page 247 of Dr. Walsh’s book he states: Exercises you can do:   Every time you urinate, do it standing up.   You can’t practice the following exercises, which strengthen the external sphincter and speed up your recovery of urinary control, while you’re sitting down.   Start your stream, and once it’s in full force, stop the stream by contracting the muscles in your buttocks --- not your abdominal muscles, not the muscle “up in front” around the penis.   Tighten your buttocks: imagine you’re trying to hold a quarter between your cheeks.   Hold the urine back for 5 or 10 seconds, and repeat as many times as you can.   Note: Only perform these exercises when you’re urinating; if you keep contracting these muscles throughout the day, you’ll overdo it—the sphincter tires easily—and you’ll end up wetter than you would otherwise.   Previous paragraphs address… things to speed up your urinary control.   One is not using any artificial devices…… and certain high blood pressure medication relaxes this muscle so you may need to check with your doctor.     After the catheter is removed…. Excerpt from Dr. Patrick C. Walsh’s “Guide to Surviving Prostate Cancer      > Until your urinary control has returned to an acceptable level, don’t force fluids.     >Once the catheter is out, you’ve got to slow the pace considerably.   Avoid drinking excessive amounts of fluids, and stay away from caffeine in all forms---coffee, tea, even soft drinks.   Caffeine, especially, is a powerful pharmacological agent that increases the frequency and urgency with which you need to urinate.   Also ~ make sure you’re doing your kegels and walking stairs when possible.   Buddy had a great recovery with urinary continence and we attribute it to no caffeine intake.     Obviously ~ everybody's body is different....... so figuring out what's best ~ is trial and error for sure.  Glad we can pull from all the postings and see what fits in our path.     Direct Links to….. Kegel information…   http://www.ucihs.uci.edu/urology/prostate/patient_inst/curpatient.html (UC  Irvine Da Vinci surgery) Dr. Thomas Ahlering   Excerpt from Dr. T. Ahlering website Initiate a regular routine of male kegel exercises .  Kegel exercise strengthens the pelvic floor muscle group which are involved in stemming the flow of urine.  By building them up now, you will speed up your return to continence after surgery.  Also, strengthing the pelvic floor muscles improves orgasmic function, and thus will help you preserve and regain potency.  In the interest of continence and potency, it is essential you begin a consistent regiment as soon as possible and continue to maintain it faithfully after surgery.   http://www.ucihs.uci.edu/urology/prostate/patient_inst/kegel.html   (Male Kegels)   Good Luck!!   Kay   Miyoko / Member     Kegel Help?   Thread by KW / Member (direct link ~ just click on the title!   Reminder to click on the REFRESH icon once there)    
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lifeguyd
Veteran Member
Joined : Jul 2006
Posts : 691
Posted 1/30/2007 12:14 PM (GMT -7)

Hi Friends

I checked in on this forum some months ago when I first entered the diagnosis jungle.I'm back...

I had my DaVinci surgery two weeks ago today.  Everything went well and all the tests look good.  I have had my catheter out for just 5 days and I am getting good control most of the time.  I credit that to the fact that my urologist sent me (and all his patients) to a Physical therapists with personel first hand experience in recovery. He suggest that you "palpate" (push against with your finger to feel the proper clinching during kegal exercise).  It seems to work. 

My question has to do with the amount of urine flow.  I feel like I have to go most of the time and usually urinate every hour or so, except at night.  The flow is strong but short in duration.  I wonder if I am really emptying my bladder.  Is this something I should talk to my urologist about or wait until my next appointment in about three weeks?

Thanks, Bill  1/30,2007

Surgery 1/16/07

gleason 4+4=8

t2a

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lawink
Veteran Member
Joined : Oct 2006
Posts : 621
Posted 1/30/2007 12:47 PM (GMT -7)
Hi Bill!
Back when Bob had his surgery I had a question almost similar to yours regarding frequency and small amounts of urine. He was going sometimes every few minutes -- up to 5 or 6 times per hour. I was wondering on his behalf if this was the norm. . .again finding out each case is different.

The control seemed to come back in spurts (no pun intended . ha ha). His greatest control was at night it seemed and gradually he leaked less and went less often during the day. Days would go by without any sign of progress and then "poof" the next day a big step would be taken. All the while he kept up his kegals. . . . .again, remember NOT to overdo them either. Groups of 10 or 12 up to 3 times per day seems to be sufficient.. . . .so as to not overwork the muscle!

Now at 4 months post surgery, Bob continues to use one light pad daily, most days with no or very minimal leakage.

Take care and please keep us posted!

;o) Linda & Bob
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biker90
Veteran Member
Joined : Nov 2006
Posts : 1465
Posted 1/30/2007 2:34 PM (GMT -7)
Hey Bill,

I had the same thng (frequent unination and small volume) for about 3 or 4 weeks post-op. I had "open" surgery and finally decided that swelling around my bladder might have caused the volume problem. As the days went by, my volume increased and my frequency decreased. Now I am back to normal except that I have a lot stronger stream than before surgery. For the last 2 years my stream had become weaker, probably due to my enlarged and lumpy prostate.

See ya...

Jim
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Tamu
Veteran Member
Joined : Oct 2006
Posts : 626
Posted 1/30/2007 5:24 PM (GMT -7)
Bill,

I had a similar experience when standing up or moving around. Sleeping at night I was able to go all night without getting up to go but that first step out of bed in the morning would cause leakage. In looking back I now believe that the amount that your bladder will hold is totally dependent upon the development of the new sphincter for the uretha. After the first two weeks I began to be able to hold more urine and go longer. Today, I can generally go 3 to 4 hours without having to urinate. One of my problems was that I just did not have that sense or feeling of when I needed to go for about six weeks after the surgery. My surgeon said that was common and that it would come back. He was right. about a week after I saw him all of a sudden that feeling came back.

Tamu
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kw
Veteran Member
Joined : Nov 2006
Posts : 883
Posted 1/31/2007 8:20 PM (GMT -7)

    I'm still leaking quite a bit.  Change pad (Depends Underguard) almost every hour at work.  On my feet most of the time there.  I do good when sitting or sleeping.

    I have had very little caffene the since surgery.  I can tell the differance when I do have some.  The leaking get's worse!

    Don't feel alone.

    KW

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bluebird
Veteran Member
Joined : May 2006
Posts : 2543
Posted 1/31/2007 9:22 PM (GMT -7)
Hi~ KW,   As time permits…. Maybe you could start your own Thread… “Your Journey” and give us an overview (for all of us and Newbies)… as to the path you’ve walked.   Your signature page has a lot of information and with the Feb. 20 th appointment… for Cystoscope with possible Cottigen injection into bladder neck to help control leaking…   Your stepping-stones need to be documented .....(just my personal opinion)      Let us know how things are going with you….Okay!!!   Our thoughts and prayers are with you ~ each and every day! In Friendship ~ Lee & Buddy
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kw
Veteran Member
Joined : Nov 2006
Posts : 883
Posted 2/1/2007 9:22 PM (GMT -7)

    BlueBird.....how do you start a Thread?  I would not mind at all telling my story in more detail.  It might help some of those guys that aren't having shuch a great time with their recovery.  Just to let them know they are not the only ones that are having a rough time with the bladder issues.

    What do you mean by steping stones?  I assume you mean just a more detailed history of my Journey!

    Thanks for all the time you put into this forum.

     KW

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bluebird
Veteran Member
Joined : May 2006
Posts : 2543
Posted 2/3/2007 6:10 PM (GMT -7)
Hi! ~ KW, I’m going to start a New Topic / Thread   so we can talk…Okay!! Look for a new Thread called    For KW…Getting Started with a New Topic / Thread See you there!!!!      Lee
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PianoMan
Regular Member
Joined : Feb 2007
Posts : 365
Posted 2/4/2007 3:55 PM (GMT -7)

Hi Researcher:  Looks like you and I may have had surgery the same day.  I hope all on this board are recovering well.

Regarding incontinence-- good days/bad days, I was asking myself that same question when I found this forum today.  It seems that's what's happened to me.  Things were heading in the right direction, but since yesterday, I've been dripping like a faucet.  Like member, "two-of-us," my problem is when I'm vertical.  I'm dry through the night or when in the recliner, but once I'm up and around, I start leaking.   I've talked to two guys who pretty-much overcame the incontinence right away, only having to buy one package of pads.  Not so here, I'm also changing them quite a bit.

I'm wondering if my increased incontinence over the past two days is coincidental to my beginning to mentally and physically stimulate myself to get blood flowing into the penis?  Unbelievably, I got about a 90-percent erection yesterday, without Viagra or anything.  It was a welcome shocker, but I've got to wonder if it caused the increased leaking.

Anyway, I'm thrilled to have found this site and look forward to learning and sharing with my fellow PC survivors.

 

54 years old

PSA = First ever was 9.8 in late Oct. ‘07, two weeks later, 10.1

DRE: Negative

Biopsy results 11/22/06  -- 6 out of 8 cores positive, both lobes, Gleason 3+3 = 6

Da Vinci Robotic RP surgery, Jan 12, 2007

Post surgery pathology – organ confined, Gleason still 6, volume less than biopsy suggested, margins clear.

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naimnut
Regular Member
Joined : Jan 2007
Posts : 93
Posted 2/5/2007 5:17 AM (GMT -7)

Pianoman,

Who was your surgeon, and where?

Thanks,

Markus

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PianoMan
Regular Member
Joined : Feb 2007
Posts : 365
Posted 2/5/2007 10:36 AM (GMT -7)
Hi Markus:  My surgeon was Dr. Mark Kawachi, with City of Hope in Duarte, California. Below is a link to his bio. information.

It is a wonderful facility -- they took very good care of me and were very accomodating to my wife while we were there.  They also have an excellent Triage Call Center where you can call a nurse 24-7 and get questions answered.  His associate, Dr. Wilson, is equally competent.

Good luck with your decision.  We all know it can be very difficult to make a choice -- there are so many options and considerations and it's easy to get confused.  I had done a lot of research and felt very comfortable about letting Dr. Kawachi do my surgery.  He and his partner have done over 2,300 robotic prostatectomies, which was reassuring to me.

Here's the link.

http://www.cityofhope.org/urology/kawachi.asp

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Researcher87
New Member
Joined : Dec 2006
Posts : 14
Posted 2/5/2007 10:53 AM (GMT -7)

PianoMan said...
Hi Researcher: Looks like you and I may have had surgery the same day. I hope all on this board are recovering well.

Regarding incontinence-- good days/bad days, I was asking myself that same question when I found this forum today. It seems that's what's happened to me. Things were heading in the right direction, but since yesterday, I've been dripping like a faucet. Like member, "two-of-us," my problem is when I'm vertical. I'm dry through the night or when in the recliner, but once I'm up and around, I start leaking. I've talked to two guys who pretty-much overcame the incontinence right away, only having to buy one package of pads. Not so here, I'm also changing them quite a bit.

I'm wondering if my increased incontinence over the past two days is coincidental to my beginning to mentally and physically stimulate myself to get blood flowing into the penis? Unbelievably, I got about a 90-percent erection yesterday, without Viagra or anything. It was a welcome shocker, but I've got to wonder if it caused the increased leaking.

Anyway, I'm thrilled to have found this site and look forward to learning and sharing with my fellow PC survivors.

Thanks PianoMan. Yes, we did indeed have surgery on the same day, although I opted for an open RP. I too have been having erections... actually had a partial one when my cath was still in! I think this is due to surgeon skill (Cleveland Clinic).

Still got the drip, drip, drip when I'm up and about. Takes time, I guess.

Best of luck in your recovery.
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jerrio
New Member
Joined : Nov 2006
Posts : 18
Posted 2/6/2007 2:03 PM (GMT -7)
I just read all the post on this page. I had Mr. Hang removed yesterday and was feeling pretty depressed last night. I was OK when setting or in recliner but when I stood up felt like a water fall. Stayed mostly dry all night,kinda "pinched" myself off before getting out of bed and headed for the thunder head. Then went for my walk and dribbled all the way. Reading all these posts sure help find that what I am going thru is pretty much normal. Thanks to everone for thier imput and maybe someday we will be drip free.

Gerald
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PianoMan
Regular Member
Joined : Feb 2007
Posts : 365
Posted 2/6/2007 4:04 PM (GMT -7)
Hang in there Jerrio.  Same thing happened to me.  Catheter came out in California and that night I went out to dinner with no problems. The next day, the 4-hour drive to Vegas was non-eventful -- two stops to pee and that was it.  Then a couple of nights later, I swallowed a little water down the wrong pipe; coughed, and the floodgates opened right in my kitchen.  I ran into the bathroom and couldn't believe what was happening -- I was trying to get my pants off and peed in my shoes and everything.  Now they're telling me that incontinence can get temporarily worse as you heal, when the internal swelling goes away.  Go figure.  In my case, I find the dribbling is worse late in the day and in the evenings and I'm told it's because the pelivc muscles are tired at that time of day. I'm 3-1/2 weeks out now and having better continence in the mornings and early afternoons.  Everybody says it just gets better, so try to be patient my friend.  We're all tryin' with ya.
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