I'm a long time member here but have not posted in awhile. Had RALP sugery in 2013 and have had ultra low PSA ever since and have been very grateful for that result in spite of some of the familiar side effects. One of those was the stress incontinence I've had since the surgery and I was resigned to that as a fact of my post surgery life.
Fast forward to December of 2024. My Hgb A1C was inching up to 6.1 (pre-diabetic), My BMI was also inching up to 29.5 (0verweight) and I had also had CABG surgery ( quadruple coronary bypass) in 2021. My cardiologist and I had a discussion about what my options were. I had tried to lose weight with exercise and diet modification but without much success. She offered to put me on Mounjaro. I started in January of this year. To make this a short story (There were several twists and turns.) It is now June of 2025 and I have gone from 192 lbs to 155.
Now here's why I posted here. My stress incontinence is reduced by around 95%. My urologist was impressed and attributed the change to the loss of visceral fat around the bladder. I'm still amazed.
Age at dx: 63. Initial PSA 3.9 Biopsy 10/16/13 5/12 cores, 2 cores 3+3 50%, 1 core 3+4 20%, 1 core 3+4 5%, 1 core 3+3 10%, T1c
RALP 11/26/13. Post op staging t2c, N0, Single focal point on right margin. Final Gleason 7 (3+4). Tumor volume 5% right side and 10% left side. Post op PSA 1/8/14 <.1, 3/12/14 <.1, 6/11/14 <.1, 9/10/14 <.1, 12/3/14 <.007, 12/21/16 <.007, 6/7/17 ,.007
Good to know info. Excess weight does not seem have much good going for it from a health perspective. I sure hope these new drugs are as good as it seems without major negatives. New is always suspect in my mind until some time has gone by.
The stress incontinence part makes some sense with major weight loss as there must be less stress in some manner. Whatever the reason, good news for you.
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024
The stress incontinence part makes some sense with major weight loss as there must be less stress in some manner. Whatever the reason, good news for you.
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024
This is good to know, congratulations
I have some minor stress incontinence, not enough to bother me. Coincidentally I am seeing my cardiologist next week and plan to ask him about going on either metformin or one of the GLP-1 drugs, as I have metabolic syndrome, one of the symptoms for me being visceral fat.
I am not a doctor, just a guy without a prostate
Dx Age 64 Nov 2014, PSA 4.3
BX 3 of 12 cores positive original pathology G6
RALP Jan 6, 2015
Post surgical pathology G7 (3+4), - ECE, - Margins, -LN, -SV
PSA @ 6 weeks 2/15, <02, remained <0.02 until 1/2017, .02, repeat 2/2017, still .02. 5/2017-.033, 8/August 2017- .033 8/17 .046, 3/2018 .060. 6/2018 .068, July 2018 - .08, 8/ 2018, .078, Start ADT+SRT.
Sept 2018 thru May 2022 –PSA = <.05
Decipher test, low risk, .37 score
My story.... tinyurl.com/45w7789x
Every day’s a bonus – Sonny3
I have some minor stress incontinence, not enough to bother me. Coincidentally I am seeing my cardiologist next week and plan to ask him about going on either metformin or one of the GLP-1 drugs, as I have metabolic syndrome, one of the symptoms for me being visceral fat.
I am not a doctor, just a guy without a prostate
Dx Age 64 Nov 2014, PSA 4.3
BX 3 of 12 cores positive original pathology G6
RALP Jan 6, 2015
Post surgical pathology G7 (3+4), - ECE, - Margins, -LN, -SV
PSA @ 6 weeks 2/15, <02, remained <0.02 until 1/2017, .02, repeat 2/2017, still .02. 5/2017-.033, 8/August 2017- .033 8/17 .046, 3/2018 .060. 6/2018 .068, July 2018 - .08, 8/ 2018, .078, Start ADT+SRT.
Sept 2018 thru May 2022 –PSA = <.05
Decipher test, low risk, .37 score
My story.... tinyurl.com/45w7789x
Every day’s a bonus – Sonny3
Pratoman
I tried Metformin last year but had problems of the “explosive” kind and had to discontinue. Mounjaro can cause constipation but is manageable with the use of MiraLAX. This might be considered TMI but is good to know.
Before my bypass surgery I had a very high cardiac calcium score which eventually led to that surgery. Since then we have been working to get my lipid numbers driven very low. Besides the statins, the weight loss has driven them much lower.
Age at dx: 63. Initial PSA 3.9 Biopsy 10/16/13 5/12 cores, 2 cores 3+3 50%, 1 core 3+4 20%, 1 core 3+4 5%, 1 core 3+3 10%, T1c
RALP 11/26/13. Post op staging t2c, N0, Single focal point on right margin. Final Gleason 7 (3+4). Tumor volume 5% right side and 10% left side. Post op PSA 1/8/14 <.1, 3/12/14 <.1, 6/11/14 <.1, 9/10/14 <.1, 12/3/14 <.007, 12/21/16 <.007, 6/7/17 ,.007
I tried Metformin last year but had problems of the “explosive” kind and had to discontinue. Mounjaro can cause constipation but is manageable with the use of MiraLAX. This might be considered TMI but is good to know.
Before my bypass surgery I had a very high cardiac calcium score which eventually led to that surgery. Since then we have been working to get my lipid numbers driven very low. Besides the statins, the weight loss has driven them much lower.
Age at dx: 63. Initial PSA 3.9 Biopsy 10/16/13 5/12 cores, 2 cores 3+3 50%, 1 core 3+4 20%, 1 core 3+4 5%, 1 core 3+3 10%, T1c
RALP 11/26/13. Post op staging t2c, N0, Single focal point on right margin. Final Gleason 7 (3+4). Tumor volume 5% right side and 10% left side. Post op PSA 1/8/14 <.1, 3/12/14 <.1, 6/11/14 <.1, 9/10/14 <.1, 12/3/14 <.007, 12/21/16 <.007, 6/7/17 ,.007
Scooter, good to know. Something else I need to discuss with Dr is my bloodwork showed that I have iron deficiency anemia. Which means he will put me on Iron pills. Which is , from my past experience, constipating. So lots to consider
I am not a doctor, just a guy without a prostate
Dx Age 64 Nov 2014, PSA 4.3
BX 3 of 12 cores positive original pathology G6
RALP Jan 6, 2015
Post surgical pathology G7 (3+4), - ECE, - Margins, -LN, -SV
PSA @ 6 weeks 2/15, <02, remained <0.02 until 1/2017, .02, repeat 2/2017, still .02. 5/2017-.033, 8/August 2017- .033 8/17 .046, 3/2018 .060. 6/2018 .068, July 2018 - .08, 8/ 2018, .078, Start ADT+SRT.
Sept 2018 thru May 2022 –PSA = <.05
Decipher test, low risk, .37 score
My story.... tinyurl.com/45w7789x
Every day’s a bonus – Sonny3
I am not a doctor, just a guy without a prostate
Dx Age 64 Nov 2014, PSA 4.3
BX 3 of 12 cores positive original pathology G6
RALP Jan 6, 2015
Post surgical pathology G7 (3+4), - ECE, - Margins, -LN, -SV
PSA @ 6 weeks 2/15, <02, remained <0.02 until 1/2017, .02, repeat 2/2017, still .02. 5/2017-.033, 8/August 2017- .033 8/17 .046, 3/2018 .060. 6/2018 .068, July 2018 - .08, 8/ 2018, .078, Start ADT+SRT.
Sept 2018 thru May 2022 –PSA = <.05
Decipher test, low risk, .37 score
My story.... tinyurl.com/45w7789x
Every day’s a bonus – Sonny3
Keeping some strength training in alongside the weight loss made a real difference for holding onto muscle. Has anyone talked to you about that side of it yet?