incontinance

[brmrazy]

about incontinence after surgery

[cpcohen]

Expect to be at least _somewhat_ incontinent, for weeks or months after surgery. Long-term, serious incontinence isn't common, but it happens occasionally.

Practice Kegels before surgery, and after surgery (after initial healing has occurred, and the catheter is out). Get a physiotherapist or uro nurse to check your technique -- it's easy to do them wrong, and get no benefit.

. Charles (who has mild incontinence 13 years after surgery, and wears about 1 pad per day).

[gamma909]

Unfortunately I am one of the men with long-term incontinence and it has had a major impact on my QoL. Not trying to frighten you - just trying to say that it does indeed occur. 15 months post-RALP from a highly qualified surgeon and I still wear multiple pads daily, experience a lack of predictability, etc. My surgery went fine and MD did not see any reason I would not regain continence. I worked with PT on Kegels , have never missed doing my exercises, and have no issues with sphincter strength at this point. However, Kegels only help with stress incontinence not overt incontinence. Long-term incontinence can result from tissue damage, nerve damage, or a sphincter muscle that just cannot get strong enough. My hope is that much more research will be done on specific surgical techniques that assure continence. And I certainly hope that you will be one of the many men who quickly recover continence and may only need a pad for confidence. Good luck.

[Mischa3 in reply to gamma909]

I think that might be my situation as well. Exactly 1 year post-RALP as of yesterday, and still at ~4 pads a day. QoL not so hot. Urologist can only say "re-engage PT". My only real hope at this time is that it has gotten better than it was at first, so maybe? It seems like "overt incontinence" is rarely mentioned, like it doesn't exist, and everything is tree incontinence. At some point I'm going to have to think about either the sling or artificial sphincter.

You & I certainly seem to be in the outlier group.

[gamma909 in reply to Mischa3]

So sorry to hear you are going through this. QoL can really be miserable but don't give up hope. Went through PT for 6 months and verified that I was doing exercises correctly and that sphincter was strengthening but PTist said that there was nothing more she could do. I am extremely active so it's a major issue. By about 2 years, I was able to go from your situation to 1 pad per day and the pad is not overly saturated. What I find a bit maddening is that there are good days and bad days with no apparent rhyme or reason. I am a runner so I also wear a shield when I run (doesn't get too wet) - seems to be no way to hold back urine when running although I sometimes do some 30-second Kegels while running (it can't hurt). I found a study where a man recovered continence after 4 years (yes, it's rare), so who knows. Do your research-just like researching PCa, see what you else you can learn that may help. There are more muscles involved that what they usually cover in PT so it's important to find them and feel all of them when doing Kegels. I went to a urologist who specialized in resconstructive surgery so that I could gather all of the facts. Went through urodynamics and cystogram just to make sure there are no obvious issues. As expected, urologist said I would be a good candidate for sling or the AS. I have no interest in either one. Do not want to go through another surgery. From the research I've done, slings don't always seem to work well. For the AS, do not want a mechanical device inside of me, especially one that needs to be replaced periodically. Finally, as a lifelong runner, there is no research on whether either of these solutions will hold up under the stress of running. No one knows why some men end up incontinent so unfortunately, every situation is unique and we go through a lot of trial and error in the hopes of finding things they may help. That's pretty much my current approach - learn to live with it, mitigate as best I can, keep up the Kegels and try to do more of them in situations where I tend to leak, hope for the best. I get a bit angry with the notion that "if only you'd do more Kegels and better Kegels" which puts the blame on the victim. There just isn't a ton of research being done on how to modify RP technique to minimize incontinence. What's most important is that PSA is still undetectable after 2.5 years. BTW, I know men who go through 10 pads per day so helps me keep it in perspective. Good luck and stay hopeful.

[Mischa3 in reply to gamma909]

Thank you so much for this detailed response. Truly. I've looked at surgery as well, and my wife is against it as much as you are! If I could go from now to 1 pad in another year, I would actually be ecstatic, so thank you for a glimmer of hope!

[j-o-h-n]

Tell us more about yourself (add it to your profile). All info is voluntary.

Best price for depends is Costco online - by the case in unmarked carton.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 02/02/2020 3:40 PM EDT (The Palindrome day)