Dec 11, 2005 - 1:12 pm
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.