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Medical Forum / Diseases and Disorders / Prostate Cancer / August 2004Post RPP urine flow
Hello out there! My question............ I had an RRP done 8/20/04. Still have incontinence problems...up to 5-6 Depends super-absorbancy pull-ups daily, although 1 of these, probably, is elective, rather than being forced to change it, from being totally wet. I am on Ditropan XL-10mg daily. Detrol was deemed ineffective, & this 1st med that i tried, was D/C'ed, in favor of the now 2nd choice Ditropn. When i get up in the early AM (~~3-4-5AM), and go off to the bathroom, i usually squeeze around the penile shaft to avoid "gravity winning out" over sphincter control, on the way to the john. When i get there, i usually sit on the seat, rather than standing. The thing is, is that i don't have a big stream, as one would expect. Even though the overnight Depends i'm wearing is almost dry, i can't get up a good stream. I just squeeze repetitively in numerous small squirts. I feel no "full" bladder pains, as existed before the RPP, and, as you can see, have some decent flow during the day, resulting in the use of so many Depends. Would this be a sign of scar tissue that would, in the future, have to be addressed? To date, i have not been successful in standing up & urinating, like in the "good ole days". I always immediately default to sitting on the seat. When i stand at the sink washing up sometimes, i have a lot of passive dribbling, but no real flow...just the multiple, semi-effective squeezes/spurts, at best. SHOULD i be drinking a lot to force the issue, & start to try to stand up, as i mentioned, in the "good ole days?" Lastly, when i DO get up at 3-4-5AM, & sit down to "go", within 3-4 seconds, i get some "creeping upwards" bladder pain, starting from the upper shaft to where i feel that my bladder is. Is this BLADDER SPASM? It feels almost like what the feeling used to be when i was holding off my urinating, and the bladder was expanded, sending me "full" signals. Yet now, this same "full signal" feeling results in no real flow...just the multiple squirts. Just to make this more understandable...i have no "full bladder' discomfort signals, as a generality...only the spasm type pain a few seconds after i try to push/urinate forcefully. Any ideas...feelings...inclinations...experience to be shared...etc???? My sincere thanks, in advance, to all responders. I wish you all well!! Jerry R From: jermyrauto@verizon.net (gerald rubackin) Hello out there! My question............ I had an RRP done 8/20/04. Still have incontinence problems... The thing is, is that i don't have a big stream, as one would expect. Would this be a sign of scar tissue that would, in the future, have to be addressed? It feels almost like what the feeling used to be when i was holding off my urinating, and the bladder was expanded, sending me "full" signals. Yet now, this same "full signal" feeling results in no real flow...just the multiple squirts. ----------------------- hi jerry - first, i think you meant to type 7-20-04. otherwise, this would be a first before the surgery. this is a 15% chance of scarring. i was one of those "lucky" ones. i had good flow right after surgery. then, it went back to what it was before surgery. the feeling of having to go "right" now - in my case - was lesions inside the bladder that pull giving you the feeling you have to go, when in fact, you are almost dry. frequency is what you will notice if you are getting that. i have gone to the bathroom as high as 15 times in 90 minutes. i had to have 2 surgeries after the RP to finally correct everything. and they did a wonderful job. the last surgery cured it all. outstanding flow, went from taking over 2 minutes to go, to less than 15 seconds, none of the gotta go feeling anymore, and 99% dry. i telling you this, so if, by chance, you happen to be the "lucky" one this time, there's a super good chance of success to correct everything. at the time i was going through it, i felt like i was the only one because everyone else wasn't having these problems that i've described. that is why i'm writing this now. i hope you are having a normal recovery and not the type i had. just sit back and relax for now and enjoy the grass grow. ~ curtis knowledge is power - growing old is mandatory - growing wise is optional "Many more men die with prostate cancer than of it. Growing old is invariably fatal. Prostate cancer is only sometimes so." Jerry, I think you mean May 20, 2005. At that, I'm surprised the doc is introducing you already to meds for the problem. Hopefully, this is not a case of, "pharmacist, heal thyself." In any case, I know some incontinence is usual and no continence sometimes occurs and either often works itself out. As to standing, I would stand. As to drinking water, I would drink a lot in any case. But, as to manually controlling your urination and having trouble doing so, it does sound like some blocking and the most likely cause, if what I've read here is correct, is scarring. I'd see your uro about a cystoscope.  SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .07 .05 Lupron 7/03, 8/03, 12/03, 4/04 non illegitimi carborundum > Hello out there! > My question............ [quoted text clipped - 33 lines] > I wish you all well!! > Jerry R Howdy! I thank you, gentlemen, for your input. Respectfully Jerry R > Jerry, > [quoted text clipped - 59 lines] > > I wish you all well!! > > Jerry R Hi JerryR from JerryW, I've been "lurking" on this newsgroup for a couple of weeks or so. I'm one of those who found this group after my decision had been made. (By the way, I agonized over the options, as we all did I'm sure...no regrets at all and no looking back!) A little background on this newcomer to the group. I was diagnosed with PCa in the middle of February of this year at age 62 initially by digital rectal exam (PSA of 2.6), biopsy on 2/23 revealed a stage T2a tumor (that turned out to be T2c post op) with a Gleason of 3+4=7 (that turned out to be 4+3 post op). I had RRP on May 18, 2004. All went well with no capsular penetration, no involvement of the lymph nodes or seminal vesicles. One bout of bladder infection after coming home from the hospital, but otherwise no real problems. Catheter out 14 days post op. I leaked a little for about two or three weeks, then almost completely continent. I've been extremely fortunate in this regard, I realize. I currently wear a light pad that I change once a day when I change underwear. I am virtually dry, except for the occassional "come from nowhere" sneeze or energetic noseblow. I use the bathroom about the same now as before surgery...still get up once or twice during the night most of the time. No unusual urgency or difficulty voiding. Since the surgery, I have been able to have erections, but not sufficient for intercourse. I did have some ED problems before surgery, so was expecting trouble under the best of circumstances after. I've not used Viagra or pump aids yet. Since I had a heart attack in April 2001, I carry nitroglycerin tablets in case of chest pain. I haven't used one in over two years, but I need to huddle with my Cardiologist before using Viagra or Levitra, or especially Cialis. Taking a nitrate with any of these drugs is contraindicated. My Urologist suggested I look at the pump. Anyone out there with experience, good or bad, with this device? I'm not too enthused about the concept, though. Jerry, I know I haven't provided much help in light of your situation with incontinence. I was a little confused about how far post op you are, but I think your situation should improve with time. I have talked with others who did have a certain amount of scarring postoperatively that interferred with their ability to empty their bladder, and probably contributed to their incontinence. At least one required further surgical intervention to correct the problem. Again, as others have indicated, I would suggest you talk to your Urologist about it. Good luck, and keep us posted on your progress. SignatureJerryW jweindel at flash dot net > Howdy! > I thank you, gentlemen, for your input. [quoted text clipped - 77 lines] > > > I wish you all well!! > > > Jerry R > My Urologist suggested I look at the pump. Anyone out there >with experience, good or bad, with this device? I'm not too enthused about >the concept, though. There are several members of this NG that use, or have used a pump, I am one of those. Nothing beats a good natural erection, but other than the bother of "Time Out" from foreplay to use the pump, it is a good alternative to doing without. The pump is also a good way to keep "Limp Willie" from wasting away from not being used. I would doubt there would be as much shrinkage from the RP if the pump was employed as soon as feasible. Anyone that has, or has had ED should be elated over the fact that the erection is there until the compression ring is removed. That makes up for some of the tradeoff. My guess is there would probably be a lot more happy men and women if following an RP the pump was seriously discussed. Bob Austin >>My Urologist suggested I look at the pump. Anyone out there >>with experience, good or bad, with this device? I'm not too enthused about >>the concept, though. I used a pump for 18 months successfully. There are a few tricks you have to learn to use it properly. I got my pump from the Timm Company, which has an 800 help line, which I consulted several times. > I agonized over the options, as we all did I'm sure...no regrets at all and > no looking back!) One of the very few things we ALL agree on is "don't look back." > A little background on this newcomer to the group. I was diagnosed with PCa > in the middle of February of this year at age 62 initially by digital rectal > exam (PSA of 2.6), biopsy on 2/23 revealed a stage T2a tumor (that turned > out to be T2c post op) with a Gleason of 3+4=7 (that turned out to be 4+3 > post op). I had RRP on May 18, 2004. All went well with no capsular > penetration, no involvement of the lymph nodes or seminal vesicles. 2.6 with a 4+3.... sounds like you caught it really early! > My Urologist suggested I look at the pump. Anyone out there > with experience, good or bad, with this device? I'm not too enthused about > the concept, though. I highly recommend using the pump. We don't use one to satisfy perversion. It is almost a necessary tool, in most cases, to keep the penis pliable for future use. I use one (not as often as I should) even though I'm on Lupron. That means, I use one even though it is more or less a chore, just so that when I'm not on Lupron a couple of years from now, I might have an erection again. SignatureProstate Cancer Survivor (so far), not a doctor PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Erection 05/12/2003 @ 48 HTbegins 07/21/2003 @ 48 PSA .07 .05 Lupron 7/03, 8/03, 12/03, 4/04 non illegitimi carborundum Steve, Thanks for your reply, and thanks to the rest who replied to my question about the pump. I may have to give that route a try. > One of the very few things we ALL agree on is "don't look back." and, > 2.6 with a 4+3.... sounds like you caught it really early! Your're right about the second-guessing aspect of this whole process. I've never tackled any problem in my life with so many different "solutions" and so few really definitive answers. After much study and reading (thank you Dr. Patrick Walsh, et al.) and soul-searching, my wife and I made our decision and plowed ahead. I've been heartened by all the success stories I've read about here with every conceivable treatment option. I confess I wasn't even aware of the "robotics" surgery. I am also saddened by the few not so happy outcomes. Actually, I guess we did catch it early, but I really don't know. My PSA in January 2003 was 2.6, and 2.6 again this February. If it weren't for DRE, I guess I'd be merrily going along without a clue right now. As an aside, my primary care doctor is a woman. You should know that I was probably more than a little "squeamish" and did not relish this exam from anyone, much less a female doctor. Well, by now, there is almost no indignity I won't tolerate. She tells me that she uses my case (without using my name, of course) as an example to her other male patients who shrink from having a digital rectal exam as part of their annual physical. It may well have saved my life! One fact I left out of my initial bio, my first post op PSA on July13 was <0.1, the result returned by this Lab for an undetectable level. Am looking forward to many more of the same, I hope. SignatureJerryW jweindel at flash dot net > As an aside, my > primary care doctor is a woman. You should know that I was probably more [quoted text clipped - 4 lines] > digital rectal exam as part of their annual physical. It may well have saved > my life! My family doctor is easily 6'3" with big hands. I ended up in the ER during 1999 and a Chinese female resident did my DRE there. I told my doc that I was switching to a female doctor for all my DREs. > One fact I left out of my initial bio, my first post op PSA on July13 was > <0.1, the result returned by this Lab for an undetectable level. Am looking > forward to many more of the same, I hope. Aren't we all! Congratulations. |
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