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total incontinence 12 weeks after surgery

chewbydo
Posts: 9
Joined: Jul 2012

57 y.o. Had Da Vinci radical prostatectomy 12 weeks ago. Because of anatomical problems, prostate removed in pieces. Nerves on left side were totally destroyed. ~40% of nerves on right side spared. Must change pads throughout day and night. Practice kegels, but so far no signs of improvement. Surgeon says that maybe after year or more he hope to see some improvement. Any advice?

VascodaGama's picture
VascodaGama
Posts: 1531
Joined: Nov 2010

I am sorry for the outcome of your treatment. Incontinence is very much linked to surgery cases and it seems that the causes are more frequent when the operation is done by unskilled doctors. The dissection of the prostate at the bladder is a very delicate thing. One millimetre cut to the right could signal disaster.

Robotic operations are not that easy to perform and I heard that some doctors change procedure in the mid of operation using their hands to remove delicate parts. The worrisome in your case is if the “removed pieces” included portions of the muscle/nerves that control the bladder sphincter.

I had radical open surgery in 2000 and never experienced incontinence, since taking out the catheter. My doctor regarded quality of life as important and would not withdraw the catheter if the “V” shaped neck at the sphincter had not been properly secured. He would not allow his patients discharge from the hospital with the catheter in place. (Old ways of thinking, probably)

In any case, there are guys with successful outcomes from Da Vinci that managed to get back to continent status after disastrous initial stages.

Hope for the best.
VGama

Timon
Posts: 7
Joined: Nov 2012

Chewbydo --

I had the robotic operation in March 2011. I remained catheterized for several weeks afterwards and have remained severely incontinent ever since the catheter was removed in April 2011. I use the depends pads -- as much as 6-8 or more per day -- and, if I plan on being somewhere away from a restroom for an extended period of time, such as driving a long distance, going to a movie, or going to Sunday Mass, I wear the depends underpants. I went to a physical therapist who taught me the proper method of doing the Kegles but despite my best efforts, I remain incontinent. However, after all these months, I've recently noted a slight improvement. I'm now 63, still about 30 lbs. overweight, and, believe it or not, I've started jogging every morning before work. I've always been a fast walker and regularly walked as part of my exercise routine. But a month or so ago I started jogging (very slow) for about 5 minutes, then walking for the time it took to catch my breath. I now jog (very slow) for 45 minutes to an hour at a stretch about 5 times a week and I am just starting to notice a slight improvement in the incontinence. I think the jogging movement is helping to strengthen my "core". Again, I am moving real slow, probably slower than when I walk fast, but the movement seems to exercise a different set of muscles. Anyway, maybe it's totally unrelated, but I have noted at least a slight decrease in the number of pads I use per day.

Good luck and keep a positive attitude!

Timon

Timon
Posts: 7
Joined: Nov 2012

Chewbydo --

I had the robotic operation in March 2011. I remained catheterized for several weeks afterwards and have remained severely incontinent ever since the catheter was removed in April 2011. I use the depends pads -- as much as 6-8 or more per day -- and, if I plan on being somewhere away from a restroom for an extended period of time, such as driving a long distance, going to a movie, or going to Sunday Mass, I wear the depends underpants. I went to a physical therapist who taught me the proper method of doing the Kegles but despite my best efforts, I remain incontinent. However, after all these months, I've recently noted a slight improvement. I'm now 63, still about 30 lbs. overweight, and, believe it or not, I've started jogging every morning before work. I've always been a fast walker and regularly walked as part of my exercise routine. But a month or so ago I started jogging (very slow) for about 5 minutes, then walking for the time it took to catch my breath. I now jog (very slow) for 45 minutes to an hour at a stretch about 5 times a week and I am just starting to notice a slight improvement in the incontinence. I think the jogging movement is helping to strengthen my "core". Again, I am moving real slow, probably slower than when I walk fast, but the movement seems to exercise a different set of muscles. Anyway, maybe it's totally unrelated, but I have noted at least a slight decrease in the number of pads I use per day.

Good luck and keep a positive attitude!

Timon

tpelle
Posts: 150
Joined: Aug 2003

I've been incontinent since RPS in 2003 - 2+ depends pads per day. Before surgery I was treadmill-walking at 3.6 mph 5 - 6 days a week. A year or so after RPS I got back into the old routine of 3.6 mph, six days a week this time, for several months. Pad usage dropped noticeably. But as soon as I stopped fast treadmill-walking, I was back up to 2+ pads per day. I think the lower pad use was from sweating out some of the moisture in my body rather than building up any strength in the pelvic floor area. I take a water pill late afternoon every day, when I plan to be home. It causes me to be up a couple of time at night to urinate leaving the bladder empty after the first toilet visit in the morning. Then, if I don't have any liquids for breakfast and during the morning hours, my prior night's 11 PM bedtime changed-pad is almost dry until noon. tpelle

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