Bladder control

[CHPA]

Question for those who have undergone prostatectomy: My surgery was 20 months ago and I'm overall very happy with the results; at least as happy as one might be having been diagnosed with cancer. My sexual functioning has returned to about 80% pre-surgery and continues to improve. Daily 5mg Cialis with 20mg on demand. Bladder control cleaned up after a couple of months and I can now take a five-hour road trip with one planned stop versus always tracking where the next unplanned break might be needed. So all good or at least mostly good.

My question though is about others' experience with occasional nighttime wetting. Probably once every three months I have experienced an incident of nighttime wetting. My urologist points to the OH, alcohol, as the cause and he is a smart guy as a professor, department chair, training lead for the regional American Urology Association, and a nice guy as well. I believe him but was just curious about others' experiences.

I'm in the habit of having a glass or two of wine with dinner and this by itself has never caused a problem. Occasionally I've had wine with dinner and an adult beverage later in the evening and experienced wetting. In the most recent case, I had two glasses of wine at dinner and sipped a glass of water an hour before bedtime. If I just have wine at dinner and nothing later in the evening I haven't had any issues.

Although I make a note of when this occurs and note the occurrence of both OH with dinner and additional OH or non OH liquid closer to bed, this by no means causes wetting every time. I could keep detailed records of my liquid intake for a few months but I'm sure the one thing it would point back to is what the doctor says, OH is the main influence, and some liquid closer to dinner the secondary influence.

Wearing pull-ups every night would mitigate the problem but the expense and inconvenience for a very occasional albeit maddening occurrence are not worth it. I do my pelvic floor exercises frequently. I could lose ten pounds but am otherwise in good health at 59.

I'm just curious if anyone has similar observations or thoughts.

[jimreilly]

alcohol at night is a probable culprit; there may be other things--for me, e.g., raspberries (blueberries are fine, cherries are fine, grapes are OK but raspberries, no)

[dadzone43]

Tiresome. I slept with "puppy pads" in the bed for a number of months with no problem. I also had an impermeable barrier between the mattress and the mattress cover. Finally got rid of that this month. Alcohol is both an anti-diuretic (mays you have more urine production) and a brain relaxer. That combo may be just enough to tip your bladder control just over the edge.

[CHPA in reply to dadzone43]

That is quite likely the main cause with a late glass of water the tipping point.

[JPnSD]

Kegels, Kegels, Kegels...use an app. It helps schedule and track. I used Kegel Talent. I never experienced nighttime issues...but started my Kegels even prior to surgery. Other than extreme lifting stress, and hard laughing (a few drops with each lift or guffaw)...all is well at the 22-month post-op point. No pads of any type in 18 months. I might use a light pad if going to a really good comedy night :). I have wine nightly with dinner...usually 2 glasses (Red).

[CHPA in reply to JPnSD]

I do like wine with dinner! I will check out the app. I do mine but more often never hurts. Cheers!

[oldbeek]

Alcohol,, before my AUS would pass right through me.

[Fairway]

Hi CHPA, Don't mean to minimize your discomfort, but to me, some nighttime wetting would be an improvement. I came out of the surgery incontinent and impotent (but five years and no cancer!). I'm also 75 and had some ED going in. So can't really complain. Good luck with this and keep reaching out. I'm sure you'll find a solution.

[CHPA in reply to Fairway]

No cancer…. That is the key!

[Murk]

Yeah alcohol will do that to you -- everything gets a bit relaxed with refreshments!

[jaybojammer]

It took around a year but I finally got my bladder under control. I had my surgery about 20 months ago also - November of 2019. I only had three or four nighttime incidents over a period of 6-8 months. If I drink a lot before bedtime - adult beverages, water, colas, etc. I'll need to go but I do wake up. My issue is a full bladder hurts like hell now - so the pain wakes me before I wet the bed. I do "dribble" a bit if I don't shake the hell out of it and milk it when finished and I now make sure I stand there an extra 10 or 15 seconds after I think I'm done. Kegals helped a whole lot. I use an app like many others mention here. I've actually trailed off on my exercises and still seem to keep it under control. My app crashed so I probably ought to get a different one and start them back up.

My sexual function hasn't returned as well as I had hoped. I'm taking 5 mg daily Cialis and I can only get to 50% of pre-surgery firmness. Doc has authorized a max of 20 mg every other day but he hasn't increased my prescription yet so I've got to skip days to build up enough to hit 20 every other day. Glad you're doing well in that department I'll take wearing diapers at night if that's what it would take to get back to 100% in that most important area!

[CHPA in reply to jaybojammer]

I asked my doc for the 5mg plus a prescription of 20mg. I do okay with just the 5 and better with the 20. I have noticed slow steady progress even as I passed the 18 month point.

[wastead]

Funny how our replies started moving from incontinence to ED...

Incontinence, I definitely agree with all of those who said Kegel, Kegel, Kegel. I was doing Kegel exercises from 2 months before surgery through 5 months post surgery. My Kegel activity, beginning about 2 months post surgery, was measured by chair lift speed. Basically, after every lift tower I would hold Kegels until 5 chairs had past me going the other way - about 10 seconds, every 30 seconds, for 10 minutes, 4 hours a day, 6 days a week (I'm a professional skier.) I reached full control within a month of this - 3 months post-op, except, it took another month before I could lift another adult out of the snow, or land a jump off a small cliff without leakage. Now my only danger of leakage is riding my mountain bike down a root and rock filled trail at speed. Then I'm mentally screaming KEGEL ...KEGEL ...KEGEL ...aargh.

ED: Like others. It's less than I'd like 8 months post-op. My wife says 70% of pre-op, but, "The outercourse is great!" I take 10mg tadalafil/Cialis daily with 20mg "on demand" (20mg Cialis is equivalent to 100mg sildenafil/viagra.) I have a suspicion that my big brain is still getting in the way of my little brain.

[CHPA in reply to wastead]

Big brain in the way…. Very well said! I have had the same sense. What I will tell you from experience at the 20 month point and from talking to my urologist is that nerves recover very slowly no matter which nerve you are talking about. The literature says 6-24 months for returning to sexual health and I have found that about the case. At 6 months things were just starting to return. At a year I was finding some sense of hope. At 18 months I was thinking gee, things are going to be okay. And at 20 they are continuing to improve. Well hello little fellow. Nice to see you back.