Incontinence after RP and ADT - Advanced Prostate...

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Incontinence after RP and ADT

Runner1957 profile image
15 Replies

I had a RO approximately 2 1/2 years ago with a recurrence 12 months later. I have had 37 sessions of radiotherapy and am in month 16 of 18 hormone therapy in the UK.

My incontinence seemed to solve itself around 12 months after RP but never fully. In the past 12 months I still suffer from minor involuntary incontinence. Although slower due to the ADT I still exercise regularly and am fairly active.

Has anyone had a urethral sling procedure and if so, did it work?

Are there any other options that are successful?

Thank you.

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Runner1957 profile image
Runner1957
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15 Replies
Runner1957 profile image
Runner1957

Thanks for your reply. Yes seems to have got worse with ADT, so hopefully next few months may improve.

NewMan57 profile image
NewMan57

Hi Runner,I had a Postatectomy in 2017, followed by radiation and ADT in 2018. I never fully recovered my continence following those procedures but kind of accepted it. It was manageable but a few drinks could easily cause unnoticed leakage.

I had a further round of radiation last year and am now on lifelong ADT. I still manage to exercise regularly so far so am happy about that, however since the 2nd round of radiation my incontinence has steadily got worse to the point that it is now a hassle to cope with and something I would really like to improve.

I am being assessed next month for either a Sling or AUS implant. I have heard success stories for both plus some failures with the simple slings. There is an ATOMS sling which is adjustable after implant these days which sounds interesting and I have heard some good reports. I think it might be a good option for me and would avoid the more complicated to use AUS . I will see what is recommended.

Regards

John

Runner1957 profile image
Runner1957 in reply toNewMan57

Thanks John information really appreciated. I had only heard of the slung so will look at the others.

marlins1 profile image
marlins1

Yes, I had a similar profile as you had. I had the sling last year despite two Urologists saying it would not work well after salvage RT. It did help about 50-75%. Went from one mod pad a day to one shield daily. Not totally dry, but better. I am happy I did it. Would consider again if got another 50% improvement.

notso2855 profile image
notso2855 in reply tomarlins1

had Rp in 2014 almost back to norm 1 yr late then radiation on bed that led to 10 to 15 pads a day , NO fun . Had artificial urethral put in 4 yrs ago most days totally dry no pads , don;t waste time on a sling . good luck ; by the way had an implant at same time

Runner1957 profile image
Runner1957 in reply tonotso2855

Thanks that's useful. What sort of implant?

garyjp9 profile image
garyjp9 in reply toRunner1957

Artificial Urinary Sphincter (AUS)

Runner1957 profile image
Runner1957 in reply tomarlins1

Thanks marlins appreciated

London441 profile image
London441

I had heavy incontinence so was advised against the sling. It may work for you but I do know its efficacy is inconsistent. I have a AUS. And couldn’t be happier with it. Although NewMan 1957 describes it as ‘more complicated to use’ I can tell you from having it for 2 years it couldn’t be any less complicated to use. You squeeze the tab, you pee, it closes itself.

That said, if my incontinence was light I might well have tried one of the other options.

RMontana profile image
RMontana

I went into RT IMRT with leakage that was less than 'one pad a day,' which is what was recommended to me by my surgeon...bad advise. I now have a permanent leakage of 10-25ml (cc's) a day. So I looked around for what I can do about this low level of leakage. My Urologist told me to not proceed with a sling or AUS...that they would not work for me. The sling is not recommended for RT patients; the Urethra I guess is compromised and the valve will cause erosion over time. The AUS is designed to take men with large leakages to 1 pad, not to make men w 1 pad dry...this is what I was told and what I learned from these two studies...so for me I will plan to have this level of leakage 'for the duration.' Let me know if you find otherwise. TNX

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Runner1957 profile image
Runner1957 in reply toRMontana

Thanks TNX will let you know what options I get offered. Had my last hormone injection 4 weeks ago so need to let that work its way through and then see.

jjpeabody profile image
jjpeabody

Hi Runner1957, I have had similar procedures and results as you. I always ware a pad at night just in case, also during the day if going somewhere important just in case. Extra coffee, cialis and trazodone 25mg for sleep, and fatigue can cause up to 1 or 2 tablespoons during deep sleep occasionally or a little with exercise in morning after coffee. Really is minor inconvenience vs the surgical options (for me it's just not that bad or worth it). I perform kegel exercises regularly whether helps or not at this point. It seems coffee and the few meds I take affect it mostly. Good luck.

Runner1957 profile image
Runner1957 in reply tojjpeabody

Thanks JJ that's where I am, undecided. Will let hormone therapy work its way out of my system and see how I am then.

ron_bucher profile image
ron_bucher

One of my friends who is an avid cyclist and runner had great success with the "male" sling. As with any procedure, I'd find someone who has done at least a couple hundred.

Runner1957 profile image
Runner1957 in reply toron_bucher

Thanks Ron

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