Incontinence

What I learned about incontinence and prostate surgery and how to help overcome it, if not prevent it.

I was incontinent as a result of prostate surgery.  I did not expect this at all from the pre-surgery research I did and from discussions with my doctor and his staff. 

This is not to say anything went wrong; I am fairly young, in good health, I had a topnotch doctor at a top research hospital.  My cancer was caught early and was well confined to the prostate, not even close to the borders.  The surgery was with a DaVinci system.  Before surgery, everything pointed to minimal problems; all the statistics looked great.

But I still ended-up incontinent.  I have regained continence and wanted to share my insights so that others might have a better experience than I had.

Of course, the most important thing is that I am cancer free-the surgery was successful.  I am very thankful for that.

Here are the things I learned:

1.  While the surgeon and his staff were very competent with the surgical side of things, they were not very helpful regarding incontinence.

a.   The pre-surgery instructions to prevent incontinence was “do kegels.”

b.   Post-surgery, they had no idea how to deal with incontinence except to tell me to “do more kegels” and it make take “1-2 years” to get better.

                                       i.    It turns out this is bad advice.

2.   Here is what I learned and how I regained continence:

a.   The kegel muscles are very fragile muscles and are easily overworked.  In other word doing more or longer kegels may actually make the problem worse.

b.   Do not wait until after surgery to address the issue, start before surgery.

c.    Ask your doctor for a referral to a Pelvic Floor Physiotherapist.  The one I had worked wonders.  I regained full continence after 8 sessions!

                                       i.    Have a consultation BEFORE surgery, this will help you be better prepared before surgery, as well as ready to start therapy if needed post-surgery.

                                     ii.    If you are incontinent post-surgery, seek help soon.  The longer you wait, the less likely you will regain continence.  My PFPT said that after about 1 year, you probably will not regain it.

                                    iii.    In my area, at least, the demand for PFPT’s exceeds the supply; all the more reason not to wait.

                                    iv.    Most incontinence patients are women, but PFPT’s treat men as well.

                                     v.    Continence is more than just kegel muscles; there are more muscles involved and you need to be properly trained in using them together.  Furthermore, the food you eat and the physical activities you do all effect continence.

                                    vi.    Training and strengthening the muscles is a slow process at first so that they are not overworked and fail.  Be patient, do what the therapist tells you to do.

                                   vii.    After you regain continence, expect to do maintenance exercises everyday for the rest of your life. If you slack off (as I have sometimes done) you will start to leak.

1.   Additionally, you may find that you leak a bit in some situations-like heavy ab exercises.  If so, wear a liner for those times.

                                  viii.    My PFPT advised me to urinate sitting down because for a man that more completely empties the bladder and leakage is less likely.  I have found this to be true.  I do not like it, but I do it-its better than wet pants.

I hope this helps and best of luck.