A Question for those who had RP awhile ago

[Tony666]

Hi all - I had an RP 2 years ago and so far no incontenence. My question is whether there are long term incontenence issues from RP. We men without prostates have less “muscles” to hold things back. Maybe in our 60s it is enough. But what about long term - in one’s 70s or 80s - when one is weaker. Anyone out there that did well on contenence in the few years after RP but later as you got older had issues (or not)? I don’t expect medical professionals to know as they rarely track these things long term. But I thought someone on this forum might have to experience.

[Tall_Allen]

You are right that those muscles weaken as one ages, and incontinence is one of the many indignities of old age. That doesn't mean that it's attributable to your surgery.

[Shooter1 in reply to Tall_Allen]

Just old man syndrome with or without RP. I have stress drip at times... esp. when on and off saddle while riding my bike....

[allie2020]

My RP was four years ago. I've been at least 99.5% continent since shortly after surgery. Everything gets older and weaker as we age. I complete a couple of good sets of kegels almost daily to try to mitigate the aging/weakening down there. So far so good. My Uro told me they now recommend RP patients continue their kegels for the duration.

[MateoBeach]

As far as the RP effects go, if okay at 2 years then you are out of the woods. But like all muscles with aging it is use it or lose it. Kegels ( or sex) keeps the tone in the urogenital diaphragm.

[TJGuy]

Continually riding my bike keeps my pelvic bed muscles stronger. Also if your on ADT this weakens all muscles in your body including your pelvic bed muscles. So you may leak on ADT but not off ADT.

Alcohol also relaxes your muscles including the pelvic bed muscles, causing leakage.

[clayfin]

Yoga is a good method for maintaining muscular strength as we age and is very good for the core, of which the pelvic floor is part of.

[dadzone43]

I was not incontinent by four weeks after the catheter came out. Coming onto four years since RP and still not incontinent. At 78 I am probably entitled to old man bladder but I do pelvic floor exercises -every day_ . I DO have stress drip/dribbling/whatever you want to call it.

[Teufelshunde]

You need to do your kegels religiously the rest of your life. I try to do 3x day (have reminder alarm go off at 10/2/8pm) but usually do 1x. Like any muscle, if you dont use it, you lose it.

[SteveTheJ]

My prostate was removed in October 2020, no incontinence. I was led to believe I would have to wear a diaper. I did not. Sure, I have stained my pants maybe once a year; I have had to pull over on the side of the road on 2 or 3 road trips but probably would have done that before the removal.

[Bethpage]

My husband had a simple RP in 2014 (Patel in Celebration, FL) at age 71, a salvage RP (Patel) in 2017 at age 74, and 39 RT in 2019 at age 78. He'll turn 80 in December and has zero incontinence unless having problems with CLL. He does kegels and flicks daily.

[Guber in reply to Bethpage]

What was the reason for the simple RP?

[Bethpage]

Husband had PSAs starting at age 51 in 1993. PSAs were normal until 2003 when they started creaping up. From 2003 through 2014, 11 years, TRUS biopsies (we didn't know about 3T mp-MRI then and urologists never mentioned) were always negative. Over the 11 years, the PSA would bounce around up and down. He also had extreme BPH (125 gr at removal), so the rising PSA was attributed to that. The surgery was first planned to be TURP, but then I found out that it would take 2 TURPS to remove enough tissue for husband to be able to live without a Foley and that TURPs would most likely have to be repeated. I contacted Vipul Patel's (Celebration, FL) office and begged for him to accept a simple. Patel works only with cancer patients, but the MDs we had/have in Vero Beach are worse than incompetent. The ones in Vero have to call in a surgeon from a metropolitan area and then they assist - and they only do open prostatectomies. By February of 2014, PSA was at 14, but Patel declined to do his own MRI and proceeded with the simple in August of 2014 (yes, you have to wait that long for Patel). The tumor was found in post-surgical pathology. Patel was convinced he "got it all" with clean margins and a 4 cm tumor (in a 125 gm prostate) at G 3+3. So 11 years of biopsies missed the tumor. Not the end of the story. Three years later, PSA rising again, Patel convinced my husband that he would be "the first man cured of prostate cancer by means of salvage surgery." Patel found zilch with the salvage surgery, post-surgical pathology 100% negative, and then continued to insist that my husband didn't have BCR. Patel would not help me get a sensitive scan for my husband, so I got him into phase II of Pylarify at Stanford. F-18 DCFPyL found the recurrence in the prostate bed at PSA 1.0. So 2 surgeries were followed by 2.5 years of ADT (bical + tamoxifen for gynecomastia) and 39 RT. Husband finished ADT in Sept/Oct 2021. Now we wait. Husband will be 80 in December and was diagnosed with CLL secondary to radiation exposure in February/March of 2020.