I am a bit over a year post RP. (3/23/23) My 8 and 12 week PSA were .31 and .49. I started 8 weeks of radiation completed in 11/23. My question is to those who suffer from incontinence after 1 year of surgery. I have been to a specialist, and he requested I record how many pads I use per day. The answer was 2.
Does anyone have any experience with the sling method to control incontinence or the other which they call the gold standard. The latter involves installing some hardware which makes me very dubious.
I’d appreciate any input you can provide!!
thx ,
Joe S
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Pharm1125
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I’m 11 years out. My incontinence is getting worse. Kegels don’t seem to help. Went to a pelvic floor therapist. That didn’t help much either. Loath to consider the surgery.
Prostatectomy Jan 2019. Kegel worthless. Got up to 4+ pads per day. Artificial Sphincter in 2022(?) and major improvement. Depending on activity 1-2 per day pads. Still an issue for me and have scheduled a smaller urinary cuff to improve. Overall the AUS is a significant improvement from before. Would highly recommend.
Well, I am in the same boat...remember, the "Incontinency Effective Rate,' reported by surgeons for treatment of PCa (prostate cancer) has a criteria that considers a man "dry" if they use one pad or less...yeah. See this;
So, I went into IMRT using 1 pad...at that time I had no idea that I was using 1 pad only because I was sitting down most, or all of the time. So I was radiated leaking. I then found out that what you go into radiation with is what you come out with, permanently! So I am going to leak for the rest of my life. So many surprises in the treatment of PCa...so many great ways to learn from experience, which is why we write here!
If you get radiated and you are not "dry-dry," not 1 pad dry, you likely never going to be "dry-dry." That is the bad news...now, I have a lot of research on what to do next. I am now in my 3d attempt, 4 years out from surgery, in my attempt to have Kegels help...its never worked. I hope this time that it can cut down my leaking by 25-50%...that would be great....so far it has not had any impact. What to do next?
Slings are generally not considered for men who have had RT (radiation); our tissue has supposedly been 'compromised,' and as such may erode, or be damaged by the sling over time...in fact the medical journals predict a 32-33% drop in effectiveness at treating incontinence in men post RT, vs those without RT...see here;
The 'gold standard,' is the AUS, or artificial urinary sphincter. Interestingly enough the AUS is also less effective for treatment men post RT for PCa...and its up to 40% less effective with similar side effects. So, I dont understand why a simple SLING with a chance of failure of 32-33% is not recommended, when a much more evasive AUS at a predicted failure rate of 40% is! See here...
For me I am going to meet with my URO this month to discuss this. I walk around with pockets full of Pads...I have pads in the car, in my gym bag, in my glove box...stashed everywhere...I never understood how wonderful it was to be able to drink liquids and not seek out a bathroom constantly to check my pads...is a pain in the a##. AND I am a level 1 leaker! I can only imagine men with my higher rates of incontinence...
P.S.A: for you men out there going into RT for PCA this condition is totally, or mostly avoidable...DO NOT get radiated until you are dry...I mean "dry-dry," not '1 pad dry,' as my surgeon recommended. What you go into RT with you will have, "for the duration," as we used to say in the Army...
Good luck...I have also published a lot on this issue and my links are here...TNX Rick
I have experienced incontinence since my surgery , it got even worse after 39 radiation treatments. I have tried kegel exercises and have been to physical therapist. Nothing really seemed to make a difference. I also had 40 treatments in a hyperbaric chamber. I am still very incontinent unless I’m laying on my back .
Recently I have begun using condom catheters and a leg bag , and it has actually improve my control and ability to hold my urine. Atleast with this system if I do have an incontinent episode it does not require a change of clothes, I never had any luck keeping the pads in place so they always leaked. I now find myself able to hold quite a bit of urine and can use the restroom as needed. I’m practicing not filling the bag but it’s there if I needed. Much better , no odor, leaky pads ect.
This is just what is working for me now . So I’m putting it out there as an option. This was my own idea and I suggested it to my urologist
my experience is similar. Can you tell me more about the condom catheter? Which one? Where does the bag go? How often do you have to empty it? Do you wear it all the time? Have you considered a surgical solution? Thanks.
I use the Conveen Optima condom catheters. They come by size so you measure yourself and then get the appropriate size. During the day you use a leg bag which is very discrete unless of course you are wearing shorts. If you leak at night you can wear a night bag but that’s not an issue for me if I’m laying down. I empty mine 2 or 3 times a day,. The convenience factor is you can always disconnect the bag tubing and urinate normally leaving the condom catheter in place.
You do need to remove the catheter every day or two to prevent skin irritation but these are so much better than the incontinence pads cause you don’t get wet , have to change clothes or worry about odor.
No I’ve never really considered the surgical option. My father had the artificial sphincter and he still had to where a pad because of possible leakage if he sat down wrong or something inadvertently activated it. Besides I’m over having surgeries, that what got me into this situation in the first place. Still didn’t cure the cancer
I don’t think I was clear about the leg bag. It is strapped to your leg between your calf and ankle . The drain valve is at the ankle. I wear mine oven if I am wearing shorts cause I don’t care if I offend someone’s sensibilities. If they don’t like the way it looks they can look away
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