can incontinence return

Damp

I posted this in a reply instead of a new topic, so not sure if it will be read by many.  I am 7 months post robotic prostatectomy combined with a diverticulotomy.  As a result, I have the ususal side effects of ED and incontinence.  There are days when I think I am making progress with my control, then other days not much success...very unpredictable.  I'm curious if incontinence can return after being dry for months to years, and is the unpredictablity normal.  I manage by wearing diapers of some kind, and have become comfortable and at ease with this approach.  I had incontinece issues before my surgery, so diapers are not a new phenomina.  I'm 70 years old, and wondering if my situation is farily permanent?  The most frustrating thing for me is not knowing what the future holds.  

Clevelandguy

More healing?

Hi,

At 7 months you still have some healing to do, after my RP I had improvement(healing) into my second year.  I have read and from my own personal experience it takes about two years to heal.  The fact that you are better on some days is a good thing, hopefully the good days will get more frequent as time goes on.  From what I remember I made more of a slow steady progress but each person is different.

 

Dave 3+4

GeneRose1

3 Years Later

Damp, Three Years later and I'm still going through four to five Depends Undergarments a day. I'm never going to accept this and believe that an AMS-800 implant is in my near-term future. I'm 60 years old and starting to turn into a semi-recluse because of this. There's got to be a better way and I think that's the answer.

Best/Gene

CleanGene

Clevelandguy said:

More healing?

Hi,

At 7 months you still have some healing to do, after my RP I had improvement(healing) into my second year.  I have read and from my own personal experience it takes about two years to heal.  The fact that you are better on some days is a good thing, hopefully the good days will get more frequent as time goes on.  From what I remember I made more of a slow steady progress but each person is different.

 

Dave 3+4

Healing?

Hello, Dave 3+4, 

My Gleason score was 4+3. Surgery got it all and cancer had not spread beyond the capsule. Anyway, I would appreciate a better description of the "healing" that we're waiting on. What, onEarth, is being healed? I'm just about three weeks out from robotic surgery. The keyholes are looking like scars. I no longer am stiff in the gut.  My kegel muscle is sore from workout. The leaking continues. What still needs to be healed, and how will I know when it's healed? I'm looking for straight talk. thanks! 

CleanGene  

Grinder

Nerve sparing

Clean Gene... Were you not briefed by your urologist? It takes 3 to 6 months to see improvement, and then some 1 to 2 years for total continence, and 1 to 2 years for ED, depending on the nerve bundles spared. What you are waiting for is the severed, scored, or traumatized nerve bundles to recover from surgery trauma and regrow nerve connectors so that certain muscle groups will refunction. This is why robotic surgery is termed "nerve sparing".

However, in cases more frequent than anyone cares to admit, the nerve bundles are damaged or removed, possibly by necessity, or sometimes not. Only the surgeon can say for sure whether nerves were spared, or they were not. And if he isn't saying anything, then it is a wait-and-see approach. 

This is why in RP, as well as radiation and other therapies, you wanted the best most experienced surgeon/oncologist available. The best surgeons are very expert at sparing the nerve  bundles, whenever it is possible to leave them in. My surgeon was a master at it. My prostate had been shrunk down to 197cc, which is still massive by normal standards, but he still was able to do excellent nerve sparing. I have just about fully recovered from ED after 1 and a half years, and my incontinence is down to a minipad that is rarely needed. I compare very similarly to my wife, as women after menopause deal with slight leaking issues as well. 

Nerve recovery after RP is not like a cut healing over the weekend. If you really do want the information, you could study how nerve assemblies operate, including the firing of acetylcholines over nerve synapses as neurotransmitters. Then come back and explain it to me, as I have forgotten almost everything I was taught about neurotransmission.

But, like happened to GeneRose, there are instances of permanent nerve damage. I don't know if you have ever mentioned what happened during your RP, GeneRose... Did the surgeon suspect your nerve bundles were compromised by the PC and had to be removed? 

Anyway, Clean Gene, unless the surgeon had to remove those nerve bundles, your recovery should be right on schedule. Did you get a final report after the surgery? If not you can request one. And if you publish your final report other guys on here that are more expert, like VdG and Max, can give you a better idea of what happened during your surgery.

Grinder

Snapshot of my Surgical Pathology Report

Grinder

Not great

Ok, that is pretty much illegible. If I figure out a better way to post it, I will. But that is probably what you want from your surgeons office and should be available upon request.

There is a page two to this report, but no point in displaying it until I figure a more accurate method.

Please notice I left my name cut off at the top and recommend anonymity.