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Thread: Incontenence

  1. #1
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    Incontenence

    I am 5 days post RPR, My doctor told me to drink 2 liters of fluid of any kind (water, soda or tea). I have alot of incontenence during the day during any kind of movement that incurs bladder stress (if Im walking or stand I have less incontenence). A pad is no good for me so I wear an adult diaper. At night I have no incontinence what-so-ever (I may get up 3 times a night with the urge to urinate, but no wet diaper. Im a little depressed about the incontenence, I hope to start seeing improvement. My wife says that since I have bo problems a night at all. that that must be a good sign. Anyone else having similar problems or advice?

    50 yrs old
    6(3+3) Gleason
    6 of 12 cores positive
    Neg margins
    Divinci Robotic assisted

  2. #2
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    Sorry I meant to say 5 days post catheter removal.

  3. #3
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    hey JB,

    my best advice is do your Kegel exercises ..... see another thread here started this week by mtsarpilot, he very generously spelled out the Kegel exercises his phys therapist prescribed for him.

    Regaining continence following RRP can be frustrating, i know, I'm there with you. I'm one month post-op today. I think my continence is improving every day, I'm doing the exercises, and started going to the gym doing the treadmill and the elliptical macine... I think walking and exercise helps with the incontinence also. I"m not completely dry yet, but I've seen improvement. When I was only 5 days after catheter removal like you, it was not easy, you're also still dealing with the abdominal pain/discomfort and still not able to do normal activities. But the Kegels are important.

    Hang in there and let us know how you're doing.
    Age 57
    PSA 4.03 (Jan-11) ... increased from 3.5 in one year
    1st biopsy (Feb-11) ... 1 of 12 cores atypical w/chronic inflammation in 1 core
    2nd biopsy (Jun-11) ... 1 of 12 cores atypical w/chronic inflammation in 3 cores
    3rd biopsy (Dec-11) ... 1 of 12 cores Gleason (3+3 = 6) 12%; 2 cores atypical
    Robotic prostatectomy 16-Feb-12 @ UF Shands Medical Center, Dr. Li-Ming Su
    Organ confined, margins clear, final pathology Gleason 6
    PSA @ 4 months post-op < 0.01 (15-June-12)

  4. #4
    Recovery from RRP is a long haul. At 5 days out your insides are still in trauma. Keep doing your kegels and walking and you'll see improvement over time. The first couple weeks are pretty tough, but it soon gets better. You have a long way to go so try to be patient. You're cancer-free, hopefully. That's the big thing.
    ~ Greywolf ~

    Clinical: psa 5.7
    DRE negative
    biopsy 3+4
    1 of 14 cores positive
    6 cores HGPIN
    Da Vinci RP 9/8/11
    negative margins
    negative lymph & SVs
    final pathology 3+3
    final stage T2c

  5. #5
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    JB22, your experience is not uncommon, maybe even closer to the norm. The first stage is being dry overnight - you are there. Bask in the positive of that. Over time you'll progress to being dry when seated, then when standing, then as you transition, and so it goes. 5 days out is real early to expect great continence. You'll hopefully see some fairly big improvements week on week over the first 6 weeks.

    Your doctor's advise on liquids is close but a bit misguided based on what my surgeon and local Uro both told me. Drink lots of liquids for sure. There are many bladder irritants, and any of them in your urine will cause your bladder to want to get rid of the urine. Making it tougher to control that lonely bladder sphyncter. The more you drink, the more you keep any of the irritants diluted. Some of the irritants to avoid include:

    - Uria. Yes, you by definition has urea in your urine. But the more dehydrated you are, the greater the concentration, thus why your urine gets yellower. Keeping well hydrated keeps the urea concetration down. Drink lots to keep your urine clear.
    - Caffiene. It's a diuretic and an irritant. Thus drinking tea is a bad idea if it has caffiene. Herbal teas are as the are not caffinated. Coke and other caffinated soda are also therefore unfriendly to your continence.
    - Alcohol. A double whamy. An irritant and a muscle relaxer. Just say no. Even when I was doing real well on continence, when I tested with a beer I had problems holding it.
    - Citric juices. They are irritants too. Orange juice and grapefruit juice are the worst offenders. Highly concentrated in citric acid.
    - Cranberry juice. I don't know why, must be the acids in it too. Just know they told me to stay away.

    So what can you drink - water, water, and more water. If you like juice, go with apple. Caffiene free soda if you like soda.

    As FLmlp mentions, do your Kegel exercises. The single greatest thing you can do at this point. Check out my post on Physical Therapy regimen. Careful not to overdo it until the muscle gets stronger. Overstressing the muscle will tire it out and make things worse. Build up slowly.

    At 50 years old you are young, this plays in your favor. This along with physical condition affect recovery as well. The stronger you came into RP, the better you'll do in gaining control back.

    You'll improve, give it time. You've had major surgery and the muscles and internal tissues have a lot of healing to go.
    Age 49, healthy, physically very active
    PSA 6.9
    DRE felt nodule on right side
    Free PSA 13%
    Biopsy 10/24/11, Gleason 3+4, all cores positive
    Surgery 1/26/12
    Pathology: T2c, Gleason 3+4, 1 mm positive margin at apex
    PSA 3/9/12 - 0.01

  6. #6
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    If you're only having stress incontinence (even a lot) and don't leak at night, you're light years ahead of many guys at your stage. Like mtsarpilot said, ditch the caffeine and citrus drinks. Caffeine and citrus drinks cause the bladder to spasm, hence the leaks. Stick with water. I do pretty good most of the week, but on Saturdays (like today) I like to pressure test the bladder with about 8 beers, and I leak like a sieve. But on Sunday it's back to normal (just some stress incontinence). Only 5 days after catheter removal, you're doing great and it should improve as every week goes by. Good luck.
    Age 55 at Dx
    PSA 1.34 10/08
    PSA 1.93 04/10
    PSA 4.1 10/11, Free PSA 20%
    Biopsy 12/11 - One core 40%, rest negative, T1c, Gleason 3+3, Some PNI, Prostate 47.4g, PSA Density .086
    RALP City of Hope/Dr. Wilson 2/15/12. Pathology: Prostate 52 grams, 20% total involvement (bilateral), N0MX,
    T2c, Gleason 3+3, margins clear.
    PSA 3/12, 6/12, 10/12, 01/13, 06/13, 11/13: Undetectable

  7. #7
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    Thanks to all for tips on incontinence, esp. mtsarpilot's list of kegel specifics. I have been doing mine in preparation for my upcoming DaVinci. Best to all who walk this path.
    age 62
    Jan 08/11 PSAs 2.2 2.5 2.7 2.6, DRE-
    Jan 12 PSA 3.6 DRE+
    Jan 12 MRI 4.5x3x4, marr/sem/rectoprost all-, midgland 11mm nod affecting contour
    Feb 12 biop PCaDx, 4/12 cores+; 3 of 3+3, 1 of 4+3; 3% of tot cores; pT2a
    Apr 12 RALP pT2c pN0 pMx; 31g; 3+4=7; r lat mar focally+; 30% involv; EPE-; perineural+; 8 lymph-, sv -
    post PSAs @6 wks <.01 @10wks < .01

  8. #8
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    Thanks for all the input. I do feel better today. Another night no leaking, but leaking like holey damn today. I will keep at the excercises and rid myself of the caffiene and drink lots of other fluids. Its amazing just reading about everyone elses experiences makes one feel better...Thanks again guy and good luck to those reading this that have yet to have the surgery (the surgery is the easy part)..

  9. #9
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    Hello all, I too am a first time user of this forum, and am just two and a half weeks out of surgery. I am in the same position right now with my incontinence and am getting frustrated. It is good to hear from others with the same problem and know that it will get better. I am very active and have a hard time sitting around, so I go through 5 to 6 pads a day right now. Am I better off trying to take it easy right now, or should I stay active to become more continent?

    Thanks to everyone on here, reading all of this really helps, as I am sure everybody that has gone through this cancer knows.

  10. #10
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    2.5 weeks out from surgery you need to be pretty inactive. Walking is about the only activity you should be doing. Most doctors advise 4 weeks before beginning any physical activity or strengthening. No lifting more than 10 lbs for the first 4 weeks. For us active guys, this drives us bonkers to sit around, but you have to do it. You have 6 incisions in your abdomen and some major healing to do in the pelvic floor. Don't do too much or you'll do damage instead of healing.

    At 4 week I started light abs workout like a few situps, a short plank, some stretching, etc., then when the body did well with that I added a little more each day. At 7 weeks out I am going at full force. I play competitive level tennis, and played doubles with 3 teaching pros today, so you can imagine the intensity level. All went fine.

    You'll get back to it, just give you body time to heal.
    Age 49, healthy, physically very active
    PSA 6.9
    DRE felt nodule on right side
    Free PSA 13%
    Biopsy 10/24/11, Gleason 3+4, all cores positive
    Surgery 1/26/12
    Pathology: T2c, Gleason 3+4, 1 mm positive margin at apex
    PSA 3/9/12 - 0.01

  11. #11
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    I'm going to be the contrarian and vote for activity. My surgeon told me that walking, elliptical training, etc was okay as long as it was within my ability. I was up to a mile a day the week of surgery while I still had the catheter in (not all at once!), 2 miles a couple of weeks after, and within three weeks back to 4+ mile walks. Hit the elliptical 2 1/2 weeks after surgery but kept the RPM's down the first time. That did make me a little sore so I layed off for a week and then went back to the gym. This past week I was back up to full steam on the ellipticals. My surgeon said no lifting over 15 pounds for 6 weeks, I cheated a little and did a few bicep curls at the gym as their machine isolates the biceps really well and there didn't seem to be much strain on the adbomen. Went scuba diving 3 1/2 weeks after surgery but had my buddies haul my stuff into the water for me so I would't have to lift it at all (I did ask the surgeon if it was okay to go "swimming"). I would rate myself at about 95-98 percent continent with only the occasional stress drops, so in my case I think activity helped. I am 4 1/2 weeks post surgery now. Your mileage may vary. Best of luck.
    Age 55 at Dx
    PSA 1.34 10/08
    PSA 1.93 04/10
    PSA 4.1 10/11, Free PSA 20%
    Biopsy 12/11 - One core 40%, rest negative, T1c, Gleason 3+3, Some PNI, Prostate 47.4g, PSA Density .086
    RALP City of Hope/Dr. Wilson 2/15/12. Pathology: Prostate 52 grams, 20% total involvement (bilateral), N0MX,
    T2c, Gleason 3+3, margins clear.
    PSA 3/12, 6/12, 10/12, 01/13, 06/13, 11/13: Undetectable

  12. #12
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    Thanks, Guys, all my doctor told me was to take it easy and not lift over 15lbs for 6 weeks, so it's hard for me to gauge what take it easy means. lol.

  13. #13
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    I am a first time user and only now entering the forum. Not sure if this is correct time or place. I am 67 years old, but an active runner. Radical protate surgery 9 weeks ago, dry at night after 2 weeks, but continue to drip during day, especially late evening. I know I should give up the coffrees (3 a day) and wine at night? I do my pelvic exercises every day and want to start training for a 14 KM race in 7 weeks time, but think may leak more, if I push too hard. Any advise?

  14. #14
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    Quote Originally Posted by LEN View Post
    I am a first time user and only now entering the forum. Not sure if this is correct time or place. I am 67 years old, but an active runner. Radical protate surgery 9 weeks ago, dry at night after 2 weeks, but continue to drip during day, especially late evening. I know I should give up the coffrees (3 a day) and wine at night? I do my pelvic exercises every day and want to start training for a 14 KM race in 7 weeks time, but think may leak more, if I push too hard. Any advise?
    Welcome. Caffeine and alcohol are both likely to make you leak, as are citric juices. So it's your call. I leaked like crazy for a couple of months after surgery when I'd have a few beers, but considered it a good tradeoff. Pretty much 99.9999999% continent now, but no caffeine and limited orange juice. Alcohol only on weekends. With any kind of luck you should be about at the point where you'll be leaking less and less every day. Good luck.
    Age 55 at Dx
    PSA 1.34 10/08
    PSA 1.93 04/10
    PSA 4.1 10/11, Free PSA 20%
    Biopsy 12/11 - One core 40%, rest negative, T1c, Gleason 3+3, Some PNI, Prostate 47.4g, PSA Density .086
    RALP City of Hope/Dr. Wilson 2/15/12. Pathology: Prostate 52 grams, 20% total involvement (bilateral), N0MX,
    T2c, Gleason 3+3, margins clear.
    PSA 3/12, 6/12, 10/12, 01/13, 06/13, 11/13: Undetectable

  15. #15
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    Many Thanks, I will cout the coffee and alcohol during week.

  16. #16
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    Mtsarpilot -

    You're a bit ahead of me, so thought I would reach out to you for advice. At a just-turned 54, I was diagnosed with prostate cancer in January, and had it out just over a week ago through Da Vinci surgery.

    Like you, I was very fit, which is helping my recovery.

    My question though is how long before I can run without fear of stress incontinence (I am dry overnight)?

    When after the decent interval of six weeks post surgery did you feel fit again, that is, ready to do push-ups, pull-ups, etc.?

    How about sex? The urge has returned, but I want to be careful about damaging anything.

    Thanks for any advice you might offer.

  17. #17
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    Quote Originally Posted by BrianBoru View Post
    Mtsarpilot -

    You're a bit ahead of me, so thought I would reach out to you for advice. At a just-turned 54, I was diagnosed with prostate cancer in January, and had it out just over a week ago through Da Vinci surgery.

    Like you, I was very fit, which is helping my recovery.



    My question though is how long before I can run without fear of stress incontinence (I am dry overnight)?

    When after the decent interval of six weeks post surgery did you feel fit again, that is, ready to do push-ups, pull-ups, etc.?

    How about sex? The urge has returned, but I want to be careful about damaging anything.

    Thanks for any advice you might offer.
    Soft tissue healing is 6-8 weeks for everyone, so, if you're pushing things physically before 8 weeks, you could be harming more than helping. After 8 weeks, you're as healed in the soft tissue department as you ever will be, so bombs away. Now, there may be things you CAN'T do, (like running without leaking), but you won't be in danger of harming yourself.

    mkane09
    PSA 6.48, biopsy Gleason 3+4, robotic prostatectomy 9/17/08, pathology Gleason 4+5, pathologic stage T2c, positive margins, SRT completed May 22, 2009. 1st post-radiation PSA, 8-4-09, <0.06. 2nd post-radiation PSA 12-22-09 <0.06. PSA, July 23, 2010: <0.06. PSA, January 10, 2012: 13.90. Re-test, February 6, 2012: 16.47. April 6, 2012: 25.6. PSA, May 2, 2012: 37.74. PSA, May 27, 2012: 37.4. PSA, June 17, 2012: 51. PSA, Sept 27, 2012: 110.24. PSA, January 28, 155. May, 2013, Well, you get the idea...

  18. #18
    BrianBoru, if you google prostatectomy recovery, you'll find a number of articles that talk about physical activity post surgery. Three weeks for light activity and six weeks for normal (running, etc) activity seem to be the rule. My surgery was 2/14 and I'm somewhat where you are with incontinence.

    Sex is written up as - wait for 4 weeks or longer. Like mkane09 writes, the soft tissue healing takes a while. Go slow man. If you are an athlete, you know the patience required to rehabilitate. Don't risk injury trying to get back on the field too quickly.
    Age 55, white
    PSA 5.2 in October 2012 after 5 years of 3ish. (Father prostate cancer survivor; mother breast cancer survivor)
    PSA recheck 5.2 with Free PSA .5
    DRE no indications of tumor
    Biopsy November 2012
    6 cores Gleason 6 at 5% + 2 cores Gleason 7 (3+4 5% & 20%) + 1 core Gleason 7 (4+3 5%)
    Diagnosis: T1c
    Surgery (robotic) 2/14/2013 successful
    Post op pathology - organ contained, seminal vesicle involvement - absent, lymph node involvement - absent

  19. #19
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    Quote Originally Posted by drakebullet View Post
    Sex is written up as - wait for 4 weeks or longer.
    Oops. I was back at it 17 days after surgery.
    Age 55 at Dx
    PSA 1.34 10/08
    PSA 1.93 04/10
    PSA 4.1 10/11, Free PSA 20%
    Biopsy 12/11 - One core 40%, rest negative, T1c, Gleason 3+3, Some PNI, Prostate 47.4g, PSA Density .086
    RALP City of Hope/Dr. Wilson 2/15/12. Pathology: Prostate 52 grams, 20% total involvement (bilateral), N0MX,
    T2c, Gleason 3+3, margins clear.
    PSA 3/12, 6/12, 10/12, 01/13, 06/13, 11/13: Undetectable

  20. #20
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    Quote Originally Posted by ThatBiopsyHurt View Post
    Oops. I was back at it 17 days after surgery.
    You animal.......


    mkane09
    PSA 6.48, biopsy Gleason 3+4, robotic prostatectomy 9/17/08, pathology Gleason 4+5, pathologic stage T2c, positive margins, SRT completed May 22, 2009. 1st post-radiation PSA, 8-4-09, <0.06. 2nd post-radiation PSA 12-22-09 <0.06. PSA, July 23, 2010: <0.06. PSA, January 10, 2012: 13.90. Re-test, February 6, 2012: 16.47. April 6, 2012: 25.6. PSA, May 2, 2012: 37.74. PSA, May 27, 2012: 37.4. PSA, June 17, 2012: 51. PSA, Sept 27, 2012: 110.24. PSA, January 28, 155. May, 2013, Well, you get the idea...

 
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