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Incontinence following RPS

tpelle
Posts: 146
Joined: Aug 2003

We see many messages regarding varying degrees of incontinence following radical prostate surgery. And it appears that the first recommended remedy are Kegel exercises which are supposed to reactivate the sphincter after a time. Why haven't the sphincters reactivated fully in these continuing incontinence situations following months of Kegels.

Immediately following RPS three years ago my surgeon told me on several occasions that the sphincter was perfectly preserved. Then why am I still dripping, using one pad per day? I can live with this. When considering an artificial sphincter installation, I wonder if I should leave well-enough alone, or should I have the artificial sphincter surgery with the possibility that it would not solve the dripping problem, or worse yet, cause other problems.

When I first saw the size of the tubing of the Foley catheter exiting the penis following surgery, I thought it was a very large diameter for the urethra and the sphincter to be stitched around, then close fully after the tubing was removed. I am wondering if the surgeon has any freedom in selecting the size of the Foley catheter tubing or if "one size fits all." On my first visit after the catheter came out, the surgeon asked if the urine was flowing adequately. I said "it's flowing like a garden hose." Was this a sign of continuing incontinence later? Now, three years later, when I void, even with a full bladder, it takes only a matter of a few seconds to empty the bladder. I would prefer less volume of flow during urination and a tight closure of the sphincter after the bladder is emptied. Of course I wouldn't want the sphincter connection to the urethra to be so small that the urine flow would not begin when needed.

Back to my earlier question, did the surgeon have any choice in his decision as to the size of the sphincter opening when he connected it to the urethra aroung the catheter tubing? Is there now a successful procedure for reducing (or increasing) the sphincter opening?

Does any of this make sense? I would appreciate any comments.

stuart
Posts: 88
Joined: Dec 2001

You said you use one pad a day and can live with it...As you know surgery always involves risk...If you said you can't live with it than surgery would make sense...My situation is somewhat simaliar to you in that making it to the bathroom first thing in the morning is always a challenge but I can also live with it...I see it as an inconvience so In my case I am leaving well enough alone...

tpelle
Posts: 146
Joined: Aug 2003

Your comments help, Stuart. My stance up to now has been to leave well-enough alone, still hoping for improvement. My situation is a bit different than yours in that urinary control in the morning hours is good (after a night's sleep lying flat with no gravity pressure on the sphincter). But, later in the day after standing for a while I have reduced control. So, I sit a lot at the computer, reading or watching T.V., and reluctant to do the outdoor things that I did before surgery. I face a challenge like you of getting to a bathroom but only in the afternoon and evening hours. When it's happening, the drippage seems more than the pad actually shows. I would still like to know why the sphincter isn't working properly since it was "perfectly preserved". It opens and closes on command, but it doesn't close tightly enough to hold the urine even after the bladder has recently been emptied.

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