Advice request for dealing with expec... - Prostate Cancer N...

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Advice request for dealing with expected incontinence after prostate removal by Da Vinci

Fox2018
Fox2018

Hello all

I am looking for some detail on what supplies i should stock up on at home prior to having my catheter removed after my surgery on 11-21-19. I have never had a catheter in before and have never had a leakage issue at age 66. Any advice on dealing with this side effect is appreciated. Been doing kegels for two months

Mike

13 Replies
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Make sure that you have bleach on hand for cleaning out the collection bag each time you empty it and its associated tubing. The last thing you would want is to catch an infection. I would buy Depends to last you at least 3 months. I would start doing the Kegal exercises now so that you will be well primed to be able to control your urination once the catheter is removed. Take advantage of any bathroom you happen to be nearby. Do not act all manly and pass up a bathroom simply because you think you can hold it (you can't). I know it is a hard adjustment to make. Men are born with two sphincters, one on the bladder and one in the prostate. With the prostate removed, you are left with the bladder sphincter. You have to do kegal exercises to strengthen your bladder sphincter. By itself, the bladder sphincter is not initially up to the task of holding back the flood waters. The prostate sphincter did most of the heavy lifting, with the bladder sphincter as backup. You will also find yourself sitting in a chair fat, dumb, and happy. You stand up and realize you suddenly have to pee. Ignore this at your peril. I cannot stress this enough. Do not push your bladder sphincter too far for it will quit at a most inoportune time. With pee running down your leg, you will realize you made a mistake bypassing that bathroom at the restaurant. Yes, I have done all of the things that I mention in this post. It took me 3 months to learn how to pee again. I was 52 when I had the RP done. I am 61 now and still have to be aware of where the nearest bathroom is.

Fox2018
Fox2018 in reply to David1958

Thanks - I appreciate your advice!

Mike

Talk to your URO about penile rehab with a Physical therapist after the operation. I had about 8 sessions every 2 weeks. I healed very quickly. But still leak and use depends guards, a lighter pad 2 yrs later. PT also guides you through the impotence problems that will work on your mind.

Important questions, often overlooked or brushed aside by the surgeons according to my experience and the experience of the men in my support group.

-The pelvic floor exercises you have started are the most important step

-Make sure to ask them to shave a patch of hair on your thigh if they are using a catheter lock. It will inevitably come loose from the skin and dangle by the hairs. Not fun.

-I have a case of Willow incontinence briefs I will happily give you. I did not need a diaper after the first night.

-you will leak. Buy a case of puppy pads at your local discount store. These go on top of the sheets and maybe on your favorite chair

-you will leak. Fabric stores sell a vinyl sheet with fabric on both sides. A half yard will give you a nice protector on top of your mattress cover and for double protection another one under your mattress cover. Mattress covers can be washed. Mattresses cannot.

-Kegel, Kegel, Kegel. There is an app you can put on your phone to remind you twice a day to do them.

-vinegar is very useful for rinsing out the collection bag. I was told not to wash it out but I think that is bad advice. I know how to handle things to keep them clean. I think vinegar is better than bleach not only as a cleanser but also as an antiseptic. I disagree with David1958 on that advice.

-alternate collection bags every day and hang the one in the shower to drain dry after a vinegar rinse.

-tube of Neosporin or triple antibiotic ointment. Put a tiny dollop where the tube enters your penis. This will help lubricate the tube and decrease irritation at the tip while reducing the risk of infection. Your medical team will tell you not to do this. Again, I think they are wrong about that. I understand their concerns about infection, but they have never worn a catheter for two weeks and, again, I know how to do things sterilely.

-Shields. I had good control after three months and was able to stop using incontinence briefs. That is why I have case to share. Shields inside my regular briefs. I like the ones from CVS or Walgreens. Name brands are more costly.

-Chill. It is after all, only urine. There will be accidents. I even wrote a essay on that after I pissed myself while laughing my head off at the episode on prostates on "Kaminsky Method."

I suggest you might want to just buy an initial supply of the Guards and not the full size protection until you see what your level of incontinence. I never used anything other the pads. The thicker ones at first and the lighter ones. I also bought pads to sleep on and never had to use them. You shouldn't have leakage from the catheter, but I would take some protection with you, when it is removed. If you stock up on supplies in advance, save the receipts and hope for the best. Wishing you well.

Marty

Excellent detail - thanks!

Mike

What is Kegel exercise and how is it done?

Tighten your pelvic floor muscles, hold the contraction for three seconds, and then relax for three seconds. Try it a few times in a row. When your muscles get stronger, try doing Kegel exercises while sitting, standing or walking.

Depends by the carton (mail order only, less expensive) from Costco.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 10/31/2019 6:08 PM DST

Be positive! Expect the best! Don't make leakage a a self-fulfilling prophecy by being convinced that you will be incontinent. If you have been doing Kegels for two months you might not leak at all! That was the case for me, dry from day one. Good luck!

I had to wear Depends briefs with my cath. I had *a lot* of leakage, it even shot out from around the tube in a stream a few times. My uro said I was having bladder spasms and suggested a drug to help. It didn't do much and I didn't like the SE's. Hopefully you won't have any issues, I'm just offering my experience.

Fox2018
Fox2018 in reply to jctaylor

Thanks - I appreciate your advice!

Mike

Stock up on male guards...the generic from the grocery store or Wal-Mart will do.

Give it a few months. I went back to work and had to dive into the restroom a couple times a day to make a change in pads until things settled down. Now, 7 years later, I still wear a pad each day. I get leakage if I do a lot of walking or drink adult beverages.

Fox2018
Fox2018 in reply to tallguy2

Thanks for your advice - doing OK with PSA tests?

Mike

tallguy2
tallguy2 in reply to Fox2018

I can’t manage based on PSA right now. The reason is I just completed Provenge immunotherapy and I expect that next week’s PSA number will be much higher than the pre-Provenge number. I have a PET/CT scan with Axumin next week that may prove useful in determining my next steps.

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