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Incontinence

ptainter
Posts: 1
Joined: Apr 2018

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.

Old Salt
Posts: 720
Joined: Aug 2014

Thanks for your effort to put together a highly useful summary. I hope it will get a lot of views.

As an aside, it's really too bad that this Forum doesn't have a 'sticky' for 'general' info that has been carefully curated. Newbies would find such a section especially useful.

Unfortunately, the forum's web site (software) is so 20th century...

mtop
Posts: 18
Joined: Jan 2017

Just found this post, wish it had been sooner. Had Davinci surgery to remove prostrate in Jan 2016 then 7 weeks of radiation. Incontant from day one. Not to bad compaired to others. One to three pads a day. Had surgery for Advance male sling on July 14, 2017. Seemed like it was going to work at first but no such luck. Back up to three or more pads a day depending on level of activity. Went to a therapist after surgery about three sessions. Advised doing kegels, but they did not seem to work. worried about over tasking muscles. Doing a lot of walking, change pads two times during an hour walk. Starting to get on my nerves. Is to late for a Pelvic Floor Physiiotherapist? 

jeffman
Posts: 26
Joined: Oct 2017

Good info. My surgeon warned me about over doing the kegels and suggested 3 reps of 10 for 10 secs each. One in thye AM,one afternoon, and one before bed. I found out about the sitting and learned about various situational leakage through experience. After 9 monthe down to 1-2 pads a day depending on activity and 1 at night which is more of a preventative measure rather than a neccessity. (old habits are hard to break)

Progress is slow but steady and I am confident that I'll continue to improve.  It's like the hour hand on a clock. You know it'a moving forward but you don't see it move. You only know it moved in hindsight.

lighterwood67's picture
lighterwood67
Posts: 219
Joined: Feb 2018

My pre-surgery, for incontinence, was to vist a physical therapist, who stuck 3 probes up my rectum and had me flex my kegels.  I did and scored a 4 out of 5.  She told me to do 4 reps of 10 10 secs each 6:00; 9:00; 12:00; 3:00. She told me to stop for a day or so if I felt any soreness rectum up.  I also do a lot of core exercises (stretching and lifting aside from the kegels).  My surgeon performed a cystoscopy on me prior to surgery, he also had me flex my kegels, got to watch what the bladder does when you flex your kegels that.  At that time he also examined the bladder. I will be 4 months post RP July 20.  I wear Depends Men's Shields for light drips and dribbles.  I put one on in the morning and then change to a new one at night.  The night one is usually dry.  The day one will have drips and dribbles, but nothing like it was.  I have went a whole day completely dry. I feel I am getting better everyday.  Anyway, Ptainter, thanks for the article.  A lot of good info there.

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