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Continence

RichardRS's picture
RichardRS
Posts: 44
Joined: Nov 2007

Catheter removed; not uncomfortable procedure, although for some it has been painful. I wonder what the stats are on this and why the difference.

Pathology report confirms CA confined to Prostate.
One incision is not healing properly so trying new antibiotic.

Continence is very good. Slept thru night without incident. I had been doing Kegels with the wrong muscle. I found it was the one that makes my penis twitch. Is this correct?

I have been trying to track when drips occur. I notice it is when I unconsciously relax the muscles as part of some other movement, ie, sitting down, just after getting up, passing gas, burping. Now I am trying to be aware of these moments and do a kegel squeeze just before the movement. Seems to work, but not always.

This process reminds me of riding a sensitive horse where I have to be aware of what he is thinking and communicate to him at all times through subtle pressure of seat and inner thighs until it becomes second nature to us both.

Dr. Hwang said that for post-op men: 10% have reasonable continence within 3 days. 40% with in 3 weeks and 50% 3-6 months. Does this track with your data?

rogermoore's picture
rogermoore
Posts: 265
Joined: Mar 2002

Richard,

It sounds like you are doing remarkable. Yes the muscle that makes your penis twitch is the one you need to train. As far as tracking when you are leaking, that is exactly what I did. It works, and sooner or later you will have covered all the circumstances that you need to tighten the muscle.

You are doing wonderful. Keep up the exercises and ointment use and you should be up and going in no time at all.

CONGRATULATIONS AND MERRY CHRISTMAS!!!!!!!!!

Roger

RichardRS's picture
RichardRS
Posts: 44
Joined: Nov 2007

Roger.

thank you for your feedback. It is very helpful to know I am on the right track.

I wish the blessings of Christmas to you, your family and to all of us surviving PCA.

Richard

RichardRS's picture
RichardRS
Posts: 44
Joined: Nov 2007

+4 days after catheter removal. Conintence going well. It is quite a feat to sneeze and do a kegel at the same time. I have learned that many women have the same issue after childbirth when sneezing. Makes my concerns sound minor.

I was put on Viagra Therapy but have found that Cialis works better for me. No erection but I understand that is at least a few months away. Still it is nice to have sensation again. Having a difficult time convincing Blue Cross that is a medical treatment, not recreational.

I remain astounded at how quickly I have become functional. Now I must heed the advice to still take it slow and get lots of rest. Fortunately I have many friends reminding me .

fcatroneo
Posts: 89
Joined: Jan 2007

Great news Richard. My surgeon suggested Cialis (vs. Viagra). He claims Cialis helps get blood to the nerves. The nerves become numb from the surgery and Cialis gets blood to them and helps them heal. He had me taking a 1/2 pill every other night. I did so for about 2 - 3 months. I was having erections in a week or so. He claims Viagra only works for 4 hours and doesn't help the nerves heal like Cialis.
I also had problems with my insurance. I had my doctor write a letter saying is was to help the healing. The insurance company gave me a one year approval.

Happy Holidays
Frank

RichardRS's picture
RichardRS
Posts: 44
Joined: Nov 2007

Frank Thanks for the advice on Viagra vs Cialis.
I will also get a letter from my doc re insurance.

Please send me info on the PCA support groups associated with your efforts in the Northern Virginia (Warrenton, Fairfax, Arlington, Alexandria) and/or Washington DC.

Thanks and Merry Christmas
Richard

RichardRS's picture
RichardRS
Posts: 44
Joined: Nov 2007

I just found a set of muscles deeper than the "twitch" muscle which seems to manage the "four steps and drip" problem.

RichardRS's picture
RichardRS
Posts: 44
Joined: Nov 2007

This is the note from the ACS staff on Continence:

Date: December 26, 2007

Author: ACS_Team

In order to answer your question regarding incontinence let us first discuss what incontinence is. There are 3 types of incontinence:
stress incontinence
overflow incontinence
urge incontinence
Men with stress incontinence leak urine when they cough, laugh, sneeze, or exercise. It is usually caused by problems with the muscular valve that keeps urine in the bladder (the bladder sphincter). Prostate cancer treatments may damage the muscles that form this valve or the nerves that keep the muscles working. Stress incontinence is the most common type of incontinence after prostate surgery.
Men with overflow incontinence take a long time to urinate and have a dribbling stream with little force. Overflow incontinence is usually caused by blockage or narrowing of the bladder outlet by cancer or scar tissue.
Men with urge incontinence have a sudden need to go to the bathroom and pass urine. This problem occurs when the bladder becomes too sensitive to stretching as urine fills it.
Surgery for prostate cancer can cause some damage to the sphincter (the valve that stops urine from coming out), which allows urine through at unexpected times. Gravity does exert some pull on the urine, but it isn't the only factor. You have already noticed that a "Kegel squeeze" tightens the sphincter and closes off the dribble when you first get up.
Incontinence is the inability to control the stream of urine, causing leakage or dribbling. It is often temporary. It can be demoralizing to lose control over such a basic life function. No matter how severe your incontinence problem may be you have a choice of safe, effective methods to deal with it. Kegel exercises are one of these methods that you may already be using.

These simple exercises mainly involve training the pelvic and lower abdominal muscles to contract, which improves muscle tone and strength. Training usually consists of starting and stopping the flow of urine to locate and specifically exercise pelvis muscles. After a person is able to completely stop urine flow, a series of daily muscle contraction exercises over a couple of months to a year or more if needed will continue to strengthen muscles.

If Kegel exercises all by themselves are not effective, more invasive methods can be used. There are also medicines to help the muscles of the bladder or sphincter. Most of these medicines affect either the muscles or the nerves that control them. These medicines are more effective for some forms of incontinence than for others.
Surgery may also be used to correct long-term incontinence. Material such as collagen can be injected to tighten the bladder sphincter. If your incontinence is severe and not getting better on its own, an artificial sphincter can be implanted, or a small device called a urethral sling may be implanted to keep the bladder neck where it belongs. Ask your doctor if these treatments might help you.
If your incontinence cannot be completely corrected, it can still be helped. You can learn how to manage and live with your incontinence. Incontinence is more than a physical problem. It can disrupt your quality of life if it is not managed well.
There is no one right way to cope with incontinence. The challenge is to find what works for you so that you can return to your normal daily activities. There are many incontinence products to help keep you mobile and comfortable, such as pads that are worn under your clothing. Adult briefs and undergarments are bulkier than pads but provide more protection. Bed pads or absorbent mattress covers can also be used to protect the bed linens and mattress.
When choosing incontinence products, keep in mind the checklist below. Some of these questions may not be important to you, or you may have others to add.
Absorbency: How much does the product provide? How long will it protect?
Bulk: Can it be seen under normal clothing? Is it disposable? Or reusable?
Comfort: How does it feel when you move or sit down?
Availability: Which stores carry the product? Are they easy to get to?
Cost: Does your insurance pay for these products?
Another option is a rubber sheath called a condom catheter that can be put over the penis to collect urine in a bag. There are also compression (pressure) devices that can be placed on the penis for short periods of time to keep urine from coming out.
For some types of incontinence, self-catheterization may be an option. In this approach, you insert a thin tube into your urethra to drain and empty the bladder. Most people can learn this safe and usually painless technique.
You can also follow some simple precautions that may make incontinence less of a problem. For example, empty your bladder before bedtime or before strenuous activity. Avoid drinking too much fluid, particularly if the drinks contain caffeine or alcohol, which can make you have to go more often. Because fat in the abdomen can push on the bladder, losing weight sometimes helps improve bladder control.
It may also help you to know that urinary incontinence continues to improve for up to a year after radical prostatectomy, with most of the improvement happening in the first 18 weeks after surgery. Since you had your surgery less than a month ago, it is likely that your continence will keep getting better.
Fear, anxiety, and anger are common feelings for people dealing with incontinence. Fear of having an accident may keep you from doing the things you enjoy most -- taking your grandchild to the park, going to the movies, or playing a round of golf. You may feel isolated and embarrassed. You may even avoid sex because you are afraid of leakage. If your incontinence continues, please be sure and talk to your doctor so you can begin to manage this problem.
We hope you find this information helpful, please write us again if we can assist you further.

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