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Continence Recovery after Robotic Surgery

jacksonholeguide's picture
jacksonholeguide
Posts: 4
Joined: Sep 2010

I had my robotic surgery on August 19th. My catheter came out 8 days later and my recovery has been no less than amazing from a wellbeing standpoint. I feel great. Lost a little weight which makes me look all the better. You will not believe the compliments I have received. I have returned to a very normal life. I do get a little fatigued when I do things that are a little out of the norm, but early to bed solves that problem.

I am looking for a little guidance as to the recovery of my continence. I am at a point where I don't wear a pad to bed at night as lying in bed, occasionally rolling over do not cause any problems. I also get out in the morning for a 3 1/2 mile walk. I don't wear a pad during these walks, but do find a little moisture in my briefs when I finish my walk. However, it is not much and well contained by the brief. At work I wear only one pad during the day and it is reasonably dry throughout the day, unless I go too long between urinations.

The two areas where I do find continence a problem are at cocktail events and when doing something that has some vigor to it like golf. In both instances the pad gets a little soggy.

I have been doing my Kegel exercises, but not as frequently as my urology group had suggested.

What I am trying to get is an understanding of is what can I expect as to continence recovery? How long to full dry, if ever? Any advice on speeding up the process would be appreciated.

Lastly, with even slight dripping, sex is something that is not very appealing. I know it's a little early to be thinking about that, but hopefully that will be in the future. Any thoughts on that would be appreciated.

chitown
Posts: 90
Joined: Mar 2010

i am past 3 months and am 95%+ continence. most days totally dry. few day slight dripping 2-3 a day. my recovery for first month was similar to yours. no real way to speed it. dont do too much kegel right now..just 2-3 times a day else you will tire the muscle. my doc had told me 3 month is magic number for continence recovery and 6 month to normal sexual recovery and then 10 month around normal in all aspects. the recovery is not linear but more zigzag..so hang in there..time and attitude is the healer

chitown
Posts: 90
Joined: Mar 2010

i am past 3 months and am 95%+ continence. most days totally dry. few day slight dripping 2-3 a day. my recovery for first month was similar to yours. no real way to speed it. dont do too much kegel right now..just 2-3 times a day else you will tire the muscle. my doc had told me 3 month is magic number for continence recovery and 6 month to normal sexual recovery and then 10 month around normal in all aspects. the recovery is not linear but more zigzag..so hang in there..time and attitude is the healer

griff 1
Posts: 114
Joined: Jun 2010

i am about where chitown is now. i had robotic surgery on the 23rd of june and had the cath out 12 days later. i was on 1 or 2 pads a day at the start, now i haven,t really needed one for close to 2 months. i guess my dr did real well, not much in the woody dept but it is coming. when i have dripping it is when i walk or run the school track with my twin boys or getting up too fast. i ahve my first pca test on oct 5th and i hope it is zero, i do not want radation. all iv,e heard is that is when you have incontinence. as far as kegels i do them about once a week. well goodluck to you. griff ps have you had a post surgery blood test yet?

ProfWagstaff's picture
ProfWagstaff
Posts: 98
Joined: Jun 2010

Had my DaVinci in May of '09. I was at full continence in just under 4 months. My brother had the same surgery 7 months before I did and he recovered his continence in about 3 months I had the misfortune to catch a cold during my recovery. The resulting coughing and sneezing made control doubly hard so that set me back about 2 weeks. Still, I was off pads at 4 months. Occasional slip of a few drops maybe once a month for another few months but not enough to show through or even make me uncomfortable. Clean and dry the last few months. No complaints about the surgery or the surgeon. Best of luck to you in your recovery.

ghdeaver
Posts: 16
Joined: Sep 2010

I am curious as to whether you saw a gradual increase in continence over time or did it improve suddenly? I had my surgery on August 24 and was immediately dry through the night when teh catheter was removed.. I am dry when I sit and can cough and sneeze with no problem. I go for 30 minute walks twice a day. I do about 40-50 kegels a day. However I leak when I walk to the point that my bladder is empty by the time I get home and I leak if I stand for too long. I usually use 2-3 pads a day. I have seen no improvement at all since the catheter was removed on September 1. I understand I need to be patient, each person is unique and it takes time...I just dont know what to expect in terms of improvement over time.

jacksonholeguide's picture
jacksonholeguide
Posts: 4
Joined: Sep 2010

Yes I have seen a gradual but steady increase in continence over time. More and more during the routine day I believe I could go now without a pad. I am wearing brief underwear which is a little more absorbent than boxers and for the occasional small drip they are all I need. However, as a businessman I still wear a pad to the office, just in case. I can cough and sneeze without losing any urine. I find I can make movements such as lifting, bending and turning which previously all led to small discharges. Now these movements don't cause me any problems.

I attended the Atlanta Falcon football game yesterday. Tailgated before going into the game. Lines in the restroom were very long. I had one beer while tailgating and some bottled water. As I was a guest among a group of attendees I wore a pad, so not have anything embarassing happen. Because of lack of regular access to a restroom, my pad was a little soaked when the game was over. I did go before game time and at the half but could have used another visit or two which likely would have eliminated any problem.

Yes, I am a little over 3 weeks since catheter removal and progress has been encouraging, but I am not where I want or need to be yet.

thegriz
Posts: 23
Joined: Nov 2008

Coming up on 3 years since DaVinci and doing well. As was said, everyone is different, but you are doing fine, especially considering the short time since surgery. I haven't worn pads on a regular basis for quite some time, but sometimes install one if I'll be attending a big social event, just to be safe. I've found that the old saying "beer seems to just go right through me" is often the case, or a lot of any other liquor -- it seems to loosen the wrong muscles. Discovered I could keep a pad in the "hidden" compartment in my wallet, should it be needed.
Haven't seem as much verbage as I'd like on the forum about "sex leakage", but it's still an issue with me, and does "cramp our style". Seems that as the body changes towards having sex, some residual leakage can occur. Best "solution" I've found is to not be "on top", and have a very understanding wife.
Wish more survivors would write about their findings concerning this issue.

Klemon
Posts: 26
Joined: Jun 2010

I too am glad to see someone writing about the leakage during sex :>) This is something nobody talked to us about prior to surgery. My husband is 2 months post op.. he had no leakeage for the 1st month at all- in any form. we started sexual "rehab" the day after the catheter came out..during the first 3 weeks, worked on alot of manual and oral stimulation and he was able to achieve orgasm but not much of an erection..although we got a better response every day....small steps. At week 4 we went to the vacuum and achieved 100% erection immediately and ability for sexual intercourse every time,.we also noticed -which was new- leaking urine just prior to orgasm. This has continued and it is just at the one point during the activity..not throughout. We noticed that as we have hit the 2 month post op point, the past couple times it was less in amount. We figure it will improve as it seems everything improves ever so slightly each day. I hope this helps,,, we were laughing about how with all the research I had done online in regard to the surgery and the cancer.. how I never ran across this issue :>)

ProfWagstaff's picture
ProfWagstaff
Posts: 98
Joined: Jun 2010

At cath removal, they told me to do a set of 10 kegels 5x per day. Every week, I was to add 5 reps to each set until I was doing 5 sets of 60 per day. That would give the pelvic musles a real workout. Progress seemed to drag on for me. I'd go a week using 4 or 5 pads a day with seemingly no change. A fellow survivor told me not to look for progress by day but rather by the week. After catheter removal, I started at about 5 pads per day and a full depends overnight. Within a month I was dry at night and down to 3 or 4 pads per day. At my three month surgical follow-up, my urologist's PA said that since I was down to 1 pad per day, I should try going without it. She said that sometimes knowing the pad is there serves as a mental crutch keeping me from concentrating on controlling it. In my case, she was right. Now that I have satidfactory control back, I still do a set of 15 kegels every morning on the way to work. Got to keep those muscles in shape.

142
Posts: 169
Joined: Dec 2009

I'm a long term leaker - 11 months from DaVinci, and still at 1-3 pads per day (started post-cath removal - ok at night, 8+ pads per day). At night, no leaks, unless it is a flood, which still happens perhaps 2-3 times a month, and always a coke, coffee, or beer late in the day seems to be the trigger.

I can say from experience, if you back off the Kegels, a few days or a week later, leaks get worse.

Be careful with "full dry" as an objective. The standard "specs" I've seen for "continent" allow 1 pad per day. "Full dry" to me means "Leak Free, Pad Free (LFPF)", which ity seems is pretty rare after surgery, although my Uro didn't tell me that. He claimed a 98% continent rate, which makes me feel to be a part of a doomed 2% minority.

I've seen a link posted on the board, probably 7-8 months ago, from Cleveland Clinic, that basically said that truly LFPF is almost unattainable.

I'll continue to hope for it, but ...

Klemon
Posts: 26
Joined: Jun 2010

My husband 64 had the robotic surgery in July. Catheter came out at 8 days and he was 100% continent. We were very pleased- as he is extremely active. However, he was given the green light for "no restictions" at 4 weeks. After no leaking at all during the first month, we noticed that during month 2, he started to see the occassional "drip". This occures basically, in the late eve after he has done the Kegels, if his bladder is full and he lifts something heavy, or if he is at the gym doing alot of sit ups with a full bladder. We have also noticed just in month 2 that he is leaking just prior to orgasm during sex. He has never needed any pads, although he wore a couple for good measure early on...I think he has now figured out what to expect and when to take an extra trip to empty his bladder..if he is going to be doing certain things. Hope this helps... we figure it's going to be an ongoing process.. Right now I am preoccupied with the pending post op PSA..fingers crossed. Oh, and PS.. I would recc not avoiding sex due to the dripping, we have a sense of humor about it and try to spend time doing something every day to continue to work on sexual recovery.. the benefit and increased intimacy your partner and you will enjoy will totally outweigh the annoyance of the occassional dripping :>)

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