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Medical Forum / Diseases and Disorders / Prostate Cancer / September 2004How do I cope with incontinence
I found this support group by chance some time ago,unfortunately after and not before my RP and Lymphadectomy, done in Sydney Australia on the 12th July.Had I found this group earlier I may have been more informed and better prepared for the operation and its consequences. My cancer was detected as a result of PSA reaching 7, having been 4.5 the year before, and apparently normal prostate following the DRE. Cancer detected only as a result of the Trans Rectal Ultrasound Biopsy, and given the choice of RP and radiation I chose RP. I had complications from the lymphadectomy,in that I drained a lot of lymph and had to stay in hospital for 6 days until the volume in the drain decreased to a satisfactory level,and on the 6th day the catheter was removed , and the staples, before I went home. Biopsy showed the cancer contained and no signs of it outside the prostate, so far so good. My problem is that I am having incontinence problems,which started almost immediately and I dont seem to be able find any method of controlling the problem. I'm walking as much as possible, but all the while I'm walking there is leakage.I'm doing the Pelvic floor exercises, but so far to no avail.If I'm sitting or lying its not such a problem, but as soon as I'm vertical gravity takes over or so it seems, and any movement causes a squirt. Step up stairs, squirt, sit down, squirt,move in the chair,squirt, and so it goes. I keep hearing, and reading that this is going to get better, and what I'm experiencing now is not likely to be how it will be in the future, but frankly I find it depressing and distressing. How often does it happen as I've described?, am I experiencing what many have gone through?, how does it end? gradually, or do we wake up one morning and hey presto we're better? Graham hi graham - welcome to the club you didn't want to join. in response to your concerns - been there - done that. after my RP, the first few weeks, i was able to sit without getting wet. but as you said, if you stood up, walked, sneezed, farted, burped......squirt, or a continuous leak, such as walking. in fact, i would leak everything out and when i would go to the bathroom, i had nothing in the bladder. i felt that it was over as to a normal life, because everyone else dries up fairly fast and my situation did not and far from it. but slowly, things got better. you will notice that you are drier in the morning when you wake up and you leak a lot more at night when you are tired. that is because the muscles gets tired. and that is still my case - 16 months post op. and you will find that you will have good days and then have a set back for a few days. this is normal, because you will improve. i call it the 2 steps forward and one step back. i became about 95% dry 8 months post op and worked up to 99.5% by 12 months. the past 4 months has not gotten any better on the .5%, but i'm quite happy with the situation as compared to where i started from. as to myself and training my bladder muscles, i've found worked for me, was not the walking so much as it was short stress situations. such as standing on a ladder. i was striping off paint on a garage and i had to stand there and scrape off the paint. at first, i leaked, but i seem to get a lot drier in a shorter period than anything else i tried. it might just be a quirk, but it worked for me. yes, i can see where you can be depressed over this situation, but you have to understand, that it is a crap shoot at best when you go into this situation. not everyone is going to get dry. not everyone is going to get their erections back. not everyone is going to be cancer free afterwards. but with all that said, i can tell you that i started out where you are right now and ended up almost 100% dry. you might go through these phases a lot faster or you might go through it slower, but i'm proof that you can get dry and that's what i'm wanting you to know - that there's a rainbow at the end of all this. best of luck. ~ 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." > I found this support group by chance some time ago,unfortunately after > and not before my RP and Lymphadectomy, done in Sydney Australia on [quoted text clipped - 25 lines] > presto we're better? > Graham You've had the catheter out for a bit over a month, so this is still early days. A few people are continent immediately after the catheter comes out, but it is not too common. Half of all patients at a good medical center like Hopkins are continent by three months and almost all are by one year. Continence is defined as not needing to wear pads. Occasional minor stress incontinence is not uncommon, but it is also not uncommon in many older men who have not had prostate cancer and many older women. For most of us it is a minor problem we have learnt to deal with. And you won't have to stand in front of a urinal waiting for something to happen. Do your exercises, continue walking, and try not to worry. Improvement comes in stages, which are described in a book like Walsh's Guide to Surviving Prostate Cancer. From what you say it appears you are already past the first stage, which is being continent while lying down. Hi Graham: My Foley came out just about a year ago and I still have leakage. I started out with about six pads a day, but I did not leak lying down. After just a few weeks I was down to 4 to 5 pads (Depends Guards for Men) and it stayed that way for several months. Toward the end of January I went on Prozac for unrelated reasons, and by April I was down to one pad per day. My primary care doctor told me it was coincidence, but when I spoke to the urologist he told me that they did prescribe drugs "in the family of drugs like Prozac" for incontinence. I switched to the medicine the urologist prescribed, Amitriptiline or something like that, but I could not tolerate the side effects. When I went off the Prozac the pad usage went back up to 3 a day over the course of a few weeks. When I went back on the Prozac it took six weeks or so, but I am back to 1 or 2 pads per day. Some days are better than others, and when I am more active, weekends working in the garden for example, I do leak more. I would say that for the most part the change comes slowly. My 70 year old neighbor had surgery the end of June and yesterday told me he was going to give me the rest of his Depends Guards because he is now dry (I am 56). The moral there is that we are all different, and recovery will vary. I do not do the Kegels by the way. I did at first, but when I returned to the crazy house, I mean work, I just never remember to do them. Best of luck to you. Bottom line is my advice to you is to get some Depends Guards, and some zip lock plastic bags for disposal of soiled pads as needed, and get on with your cancer free life. Thank you. David S. P.S. I stay on the Prozac because it helps me with the incontinence. I cannot see where it helps in terms of mood, things that frustrate me, and so forth. > I found this support group by chance some time ago,unfortunately after > and not before my RP and Lymphadectomy, done in Sydney Australia on [quoted text clipped - 25 lines] > presto we're better? > Graham <snip> *My problem is that I am having incontinence problems,which started *almost immediately and I dont seem to be able find any method of *controlling the problem. <snip> I'm going on 16 months post RRP and am about 98% dry, but experience stress leaks occasionally. What you describe sounds like what I experienced. I kept doing Kegels and eventually, I'm much drier now than before. I can appreciate your feelings however. Things should improve as time goes on and you continue to exercise. Al Please be quiet if replying via email, flames will be deleted promptly. I won't even read the whole message... > <snip> > [quoted text clipped - 12 lines] > > Please be quiet if replying via email, > flames will be deleted promptly. > I won't even read the whole message... Thanks. Will just have get on with it all and like the rest of the RP's expect that it will get better with time. Graham Graham, Greetings from Townsville, Nth Qld. We all know what you are going through and have been there, done that! Not that that helps you though. My numbers were similar to your except that I had the catheter in for an extra couple of weeks after I came out of hospital. I had my op in March and a cystoscopy in May. I went back to work a week after the cystoscopy and was using 3-4 pads a day and thought it would never end. I'm now down to one pad a day and don't use a pad at all overnight. Sometimes I'm a bit damp when I wake in the morning (haven't risked sleeping au natural as I used to yet) but it gets better by the day. Keep doing the exercises, I didn't think they were working but now I'm not so sure and they're not that hard to do. My physio told me to do 5 reps (20 sec hold) 5 times a day so it only takes a few minutes. Hang in there mate, it will improve and remember this is a damn sight better that the alternative! e-mail me if you want any other info (just remove the NOSPAM) and I'll reply with my mormal e-mail address. Dave Dec 03 Age 51, PSA 10.8 Jan 04 Dx PCa T2a Gleason 5 Mar 04 RRP, post op path good, all contained May 04 cystoscopy & BNI now pi**ing like racehorse Outlook optimistic > I found this support group by chance some time ago,unfortunately after > and not before my RP and Lymphadectomy, done in Sydney Australia on [quoted text clipped - 25 lines] > presto we're better? > Graham My personal experience is that mine took 6 months. It was a very gradual thing, except there were a couple of quick plateaus at the beginning.  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 > I found this support group by chance some time ago,unfortunately after > and not before my RP and Lymphadectomy, done in Sydney Australia on [quoted text clipped - 25 lines] > presto we're better? > Graham Same story, next verse. I an 49 and it has been about 8 months since my RRP. I tried to go a day without a pad a couple weeks ago and spotted my pants, so went back on the pads. I just thought they wheren't needed any more, oh well. I leak under a stress situation especially when kneeled down. Or when a push out a big fart. And then a little dribble when I finish taking a leak. It just does not pinch off like it did in the old days. I still do Keagels when I think about it, but that is not very offen. I think I am just getting used to adjusting to the pads. Except in the morning when I get dressed and put on a fresh pad, I get a little pissed off at the situation (no pun intented). I think these things are for girls, not men. Just keep active, you have only been a month since surgery. It WILL get better. MrBill age at diagnosis 48 PSA 1.4 Gleason 3+3=6 T2a robotic RRP 12/15/03 PSA 4/2/04, 7/8/04 = <.1 age 49 > I found this support group by chance some time ago,unfortunately after > and not before my RP and Lymphadectomy, done in Sydney Australia on [quoted text clipped - 25 lines] > presto we're better? > Graham Graham, I'll chime in as well. I'm just over 3 months post RP (May 18th). I had pretty much the same experience as you, and most everyone else. My catheter was in 14 days, though. Leaked a fair amount after the catheter came out. It was a nuisance! This gradually got better and better until I got down to wearing just one pad a day, and it was staying pretty dry (there is that little dribbling thing after taking a leak to pay attention to). Yesterday, a Sunday, I decided to go without the pad after I got back from playing golf and while I was just puttering around the house. No problem. So, I decided to go without a pad overnight. No problem. Not confident enough to go without at work, yet, so I wore a pad today at work. Took it off when I got home this evening (it was dry). I will carefully experiment with ditching the pad. I imagine that strenuous activity, etc. may still require a pad for awhile. I'm betting your experience will be a lot like mine, and will improve soon. Over these past three months, my spirits have been kept up by the fact that many of the very serious negative side effects that could have happened to me have not. I confess I feared permanent or long-term urinary incontinence, or worse yet the opposite, almost as much as the cancer itself. I'm not home free, mind you. But, I remain positive each day about the progress I'm making and I humbly give thanks for my blessings. Sounds like everything else is working out well for you...good luck and good health. SignatureJerryW jweindel at flash dot net > I found this support group by chance some time ago,unfortunately after > and not before my RP and Lymphadectomy, done in Sydney Australia on [quoted text clipped - 25 lines] > presto we're better? > Graham Post RRP 14 months. 2-4+ pads first 10 months, then suddenly went almost completely dry when it seems I tricked my nerves into working - I tried holding in as much as I could one night (about 250 cc's), within two days voila, I was dry. Went from drip to no drip, a veritable rewiring of the urinary diagram. A miracle. Next three months only very minor leakage, only one pad a day needed, and only filled a little. Boy, was I happy! Then one evening about three weeks ago I did Kegels (in order to finish it off, get off pads, etc.) and afterward I'm not continent anymore. Am back on 2-3 pads a day, and it seems to be getting worse, and I don't know whether I should do Kegels, not do Kegels, do them lightly or not. Walking has never helped, skating may have a little. The "hold" routine doesn't work anymore. I have serious doubts about Kegels. Attribute part of my problem to pre-op BPH, which resulted in weaker PFM's, and no nerve-sparing surgery (Doc didn't warn that this could also affect continence, which was the only thing besides PCA I was interested in). Oh, well. :-[ Can you spell S-L-I-N-G? I'll wait till about 36 mos post-op B4 doing the latter. I wouldn't use the same surgeon again, not just because of the continence problem, but because after about 10 visits (pre-op and post-op ) with him (Northwestern in Chicago), I now realize, from everything he has said, that he's not a good doctor. You don't pick it up in just one, two or three sessions. What he says tells me he's more interested in protecting against malpractice liability and keeping in good with the insurers, than in taking care of his patients. People say use a good medical center bla bla bla but what difference does it make when it's the surgeon who does the handiwork, not the hospital? I'm not a doctor so I have no clue if this is possible or not but from what I do know I'm beginning to wonder if after a RP the bladder might just shift or droop a wee bit. This is very common with childbirth so why would it not be possible for the same thing to happen after a RP? Here's my idea. If you remove the prostate then you've left a "hole" in the pelvic area so the bladder drops down into that void. If it tilts or shifts then maybe the valve that controls the bladder might not work real well because it is angled or possibly compressed so it doesn't close completely. The "fallen" bladder doesn't always empty completely and could add to the sensation of a full bladder causes the patient to use the bathroom more frequently. Of course this would also set up a situation where UTI's would probably be more frequent. Anyway my point behind this is - it's a fixable situation. Yes, it would be more surgery but it would solve some problems. Carrying a baby seems to shift the innards of a female - so why would this not be possible for a male? And if it is possible then the "fix" should be about the same for the male or the female. The surgeon goes in and tacks things back up into place. Wondering if they still are suggesting that women lie in a frog-like position several times a day after childbirth so that everything falls back into the proper position. (Head and shoulders on the floor, butt in the air, on the knees) _/\_ And would that be helpful for males after a RP? Just my rambling mind wondering off. Bev > Post RRP 14 months. 2-4+ pads first 10 months, then suddenly went > almost completely dry when it seems I tricked my nerves into working - [quoted text clipped - 23 lines] > what difference does it make when it's the surgeon who does the > handiwork, not the hospital? Bev: This is exactly what my uro told me. He said: "The prostate is gone, bladder drops down. The goal of kegels is to strengthen the pelvic floor muscles to help hold the bladder up, and thus take pressure off of the sphincter." This is probably one of the reasons we stay dry while lying down - no pressure on bladder and sphincter. I think I'll try your suggestion about elevation. Maybe gravity boots can make a comeback as a required postop recovery aid!! If this makes sense to you, try lying flat on your tummy on the floor or bed. Raise up on your knees, so your butt is high in the air, and then do kegels while sucking in your tummy muscles. A most becoming position. LOL! After childbirth the uterus is rather floppy and we were told to do this to make it go back to the right position so it didn't flip the wrong way, AKA a prolapsed uterus. I'd love to know if it works. Wouldn't be fabulous if it did? Bev > Bev: This is exactly what my uro told me. He said: "The prostate is gone, > bladder drops down. The goal of kegels is to strengthen the pelvic floor [quoted text clipped - 3 lines] > suggestion about elevation. Maybe gravity boots can make a comeback as a > required postop recovery aid!! The way the Dr. explained it to me: A healthy person (male or female), where the urethra tube enters the bladder there are muscles that squeeze the tube close and there is the sphincter muscle at the pelvic floor that is the secondary muscle for flow control. After PCa surgery, the urethra tube is whacked off when they remove the prostate and then plugged the urethra back into the bladder. That is why the catheter must remain for at least 7 days. The muscles that would normally pinch off at the bladder are now gone, is simple is a hose for draining the bladder now. The sphincter muscle at the pelvic floor is now the only muscle left for control. It is no longer the backup muscle, but the primary one. That is why Kegels are so important at getting continence back and becoming dry. Kegel exercises strengthen this muscle. Also, ask your Dr. how to do Kegels properly. If done wrong, what you think is helping is doing absolutely nothing. Everybody "assumes" they know how and few people ask. A specialist that deals with incontinence explained it to me and what I thought was Kegels, was not. Make sure you do them right. 2 months after having it explained to me I am now dry. Coincidence? Maybe. I was 6 months post op, and still leaking. I had it explained and now I am dry. But 8 months, most people are dry anyway. I'll lean towards a little knowledge helped. MrBill age at diagnosis 48 PSA 1.4 Gleason 3+3=6 T2a robotic RRP 12/15/03 PSA 4/2/04, 7/8/04 = <.1 no more pads: 8/15/04 age 49 > I'm not a doctor so I have no clue if this is possible or not but from what > I do know I'm beginning to wonder if after a RP the bladder might just shift [quoted text clipped - 48 lines] > > what difference does it make when it's the surgeon who does the > > handiwork, not the hospital? > Also, ask your Dr. how to do Kegels properly. If done wrong, what you > think is helping is doing absolutely nothing. Everybody "assumes" [quoted text clipped - 5 lines] > and now I am dry. But 8 months, most people are dry anyway. I'll > lean towards a little knowledge helped. I think it would be helpful if you could describe what are "proper" Kegels. My Doc acts like it's easy to do, but obviously isn't very good at this type of assitance, and even discouraged me from seeing an incontinence specialist or support person. To me it is the same muscles you exert when you stop or hold back urine flow, you just concentrate while you are doing this and you can feel them, so you know what they are. What say you? Kegels have been used for women for ages. (Actually probably just since the late 50's, early '60's) It's a name given to a form of exercises for the pelvic floor muscles. If my memory serves me right it was a doctor by the name of Kegel who isolated these exercises. If a woman has strong pelvic floor muscles she does a better job expelling a baby from the birth canal. It also helps her get back into shape again after childbirth by tightening the pelvic floor muscles. Prior to that I guess most women we so knocked out they had no knowledge of pushing a baby out nor did it matter if we were "nice and tight" afterwards. But with the "new" emphasis on natural childbirth and women's newfound sexuality, came awareness of the pelvic floor and the importance of good physical strength. Someplace in history these exercises were borrowed for the guys. Now how to explain this so it is suitable for mixed company. Okay, the biggest screw-up with Kegels is using the wrong muscles. You know that feeling when you have the incredible urge to empty the bowel and you hold on so tight to get to the bathroom and you squeeze real hard. Wrong set of muscles!!! That will give you nice strong cute buns if you practice that a few hundred times a day! That's the back set - you need to get the front set. Since I'm not a guy and there is a difference in the anatomy the best way I can explain the proper area to exercise is: think about trying to suck all the important parts up inside and don't use the leg muscles to do it. It's an internal thing. Now to be quite honest some people can't seem to isolate the muscles and so they use the "bun" muscles, leg muscles and the tummy muscles. That's probably quite alright as long as you are getting the pelvic floor muscles. Actually if you pull up really hard you'll almost automatically use the leg muscles, tummy muscles etc. Just make sure you are getting the right muscles. Don't feel bad if you can't seem to locate the right muscles in the beginning. You can also "push" as well as "pull" these muscles. Doing it both ways might just be helpful. It's not easy! Many a female has tried to push a baby out using the wrong muscles. Yep, it can happen!! So if you can image a female screwing up trying to push a baby out you can understand how easy it is to foul up some simple Kegels. (I know you are thinking how could any female screw up pushing a baby out. There comes a point during childbirth where you really don't care what muscles it takes to get that baby out!) I'm sorry but I have no idea what muscles you use to stop and start your urine stream. There is no muscle on the external plumbing of a male so maybe that would be the right set of muscles on a guy. I would think if you were lying down and put you hand between the base of the penis and the scrotum you should be able to feel the tightening of the muscles when you contracted them. Imagine trying to suck up the family jewels so they don't hit freezing cold water. If you can do that you probably have the right set of muscles. You should be able to do these exercises every time you think about it without anyone realizing you are exercising. Gosh, I hope that helps. Bev > > Also, ask your Dr. how to do Kegels properly. If done wrong, what you > > think is helping is doing absolutely nothing. Everybody "assumes" [quoted text clipped - 14 lines] > know what they are. > What say you? >Kegels have been used for women for ages. (Actually probably just since the >late 50's, early '60's) It's a name given to a form of exercises for the [quoted text clipped - 48 lines] >Gosh, I hope that helps. >Bev ________ Wonderfully put. Marshall Great post Bev. I tried to post last night and the server knocked me out when I tried to post and I lost my message. I gave up and went to bed. Good job, "Imagine trying to suck up the family jewels so they don't hit freezing cold water." That is perfect. I was told ideally to use a slow count (1001, 1002, 1003, etc.) to 20 and relax for 40. Most healthy people can't do it that rigorous so keep the count where you can handle it, to 5 and relax 10, or to 10 and relax 20. Keep the tension equal and steady. Relax twice the count that you used for tightening it. Do 10 to 20 of these about 3-4 times a day. I would do it in the truck while I drove to and from work. That took care of 2 sessions for the day, then a time or 2 sometime else through the day. Since the sphincter is the only muscle left for control, it is easy to get it tired and then it seems like you have worse control that you had before. Lay off a while , the sphincter is tired and over worked. (my disclaimer) I am not a Dr. so do not take my word for gospel, consult your Dr. before starting any excersize program. MrBill age at diagnosis 48 PSA 1.4 Gleason 3+3=6 T2a robotic RRP 12/15/03 PSA 4/2/04, 7/8/04 = <.1 no more pads: 8/15/04 age 49 > >Kegels have been used for women for ages. (Actually probably just since the > >late 50's, early '60's) It's a name given to a form of exercises for the [quoted text clipped - 54 lines] > > Marshall Hey Bev, As I was reading your post, (following a 70 mile drive home), I tried some exercises, my plumbing said GO NOW! All kidding aside, what you've said makes a lot of sense. Tom > Kegels have been used for women for ages. (Actually probably just since the > late 50's, early '60's) It's a name given to a form of exercises for the [quoted text clipped - 69 lines] > > know what they are. > > What say you? > Kegels have been used for women for ages. (Actually probably just since the > late 50's, early '60's) It's a name given to a form of exercises for the [quoted text clipped - 71 lines] >>know what they are. >>What say you? Not to be confused with a Kegger! Also been around since the 50's (yeah, right!) Philski I agree with Beverly that there is some merit to the "pullling up" the pelvic floor muscle routine (I did that early on after RRP), but I would add some qualification to it. As I mentioned in a prior post, I got dry for three months last summer (by "holding-really-tight-as-much-as-I-could-before-peeing" one night (June 1), 3 days later I was dry), then after trying to perfect the quality of dryness (i.e., no more pads) 3 weeks ago I all at once over a couple hour period one evening did a lot of Kegels of the general "pull up" Beverly type. As I was doing it it felt good, I could feel the muscles getting stronger, but unfortunately it caused regression thereafter, and it got worse as time went on, so that I went from basically continent to incontinent. After three weeks of dejection and visions of slings and artificial sphincters, I then got Dr. Walsh's book and read what he had to say (in response to Al Sherman's post, thank you). Dr. Walsh basically says only exercise by stopping and starting urine flow while urinating. So I tried that (two days ago) and it is helping, the first bit of progress after the big regression. So I think I'll be able to get back to where I was last summer, but in my case I'm going to have to limit my "Kegels" to "Walsh type Kegels", either stop-and-start-urine-flow or "hold real tight" before letting go and urinating. Both of these exercises work directly on the exact muscles needed, it appears. My guess is that what happened when I did the aggressive "generalized" Kegels (pulling up, etc.) I broke a nerve connection that was directing my sphincter to do its job. This is just a guess. It fits with my surgery. I chose not to spare the nerve bundles cause I don't really care much about sex at the age of 54 (been there, done that), and don't have a wife and partner. So I'm suspecting that I don't have as many nerves addressing the external sphincter as others because of the lack of nerve sparing, or the nerves I have are more delicate. Another thing I noticed is that Walsh says to tighten by pretending you're trying to hold a quarter between your butt cheeks. I think this is odd - not because it isn't involved, but because he says this is the only way to work the muscles. My experience is that this is not true. I did try it and noticed that adding that technique (those muscles) to the otherwise more-urethra-localized-muscle-contraction did help stop urine flow somewhat. We are pioneers, aren't we? > I agree with Beverly that there is some merit to the "pullling up" the > pelvic floor muscle routine (I did that early on after RRP), but I [quoted text clipped - 13 lines] > starting urine flow while urinating. So I tried that (two days ago) > and it is helping, the first bit of progress after the big regression. Have to agree with you on this one, Tom. I did Kegels early on. Even got a great booklet mailed to me from the NAFC based on a suggestion in Michael Korda's book. And I did them correctly based on feedback tests noted in the booklet. I had already read Walsh's recommendations which I was somewhat skeptical of at the time. Well, at my 4 month visit to my Uro, I asked his advise. He didn't even agree with Walsh! He noted that the remaining sphinster was very fragile and "holding it when I felt the urge" was the best approach. Based on that I concluded that holding it as long as I could was the best approach -- maybe with a little of Walsh's start/stop suggestion. Seems to be progressing well now. Sadly I now feel like I may have delayed progress early on by doing Kegels excessively. IMHO, whoever suggested getting the bladder full and holding it as long as possible was right on! My surgeon suggested that holding urine also stretches the bladder (which shrinks when the catheter is in), decreasing urinary frequency. On 9/25/04 12:04 PM, in article KGg5d.50698$wV.22230@attbi_s54, "Don Coon" <coondw_nospam@hotmail_dot_.com> wrote: > IMHO, whoever suggested getting the bladder full and holding it as long as > possible was right on! I am just 5 months post RRP, but this discussion raises some questions I've had after a similar experience. > Post RRP 14 months. 2-4+ pads first 10 months, then suddenly went > almost completely dry when it seems I tricked my nerves into working - [quoted text clipped - 7 lines] > seems to be getting worse, and I don't know whether I should do > Kegels, not do Kegels, do them lightly or not. I was making irregular but somewhat steady progress in recovering control. I had not been doing Kegels on a regular basis. I understood there was some controversy about their effectiveness and my urologist did not encourage my doing them. However, I decided to resume doing Kegels about 6 weeks ago. They seemed to be helping considerably and I almost posted my "success story" here. I thought if they were helping a little, doing stronger Kegels would help more. After a few days of this the bottom fell out <grin> and I too lost much of the control I had gained. At about that time I got a copy of Dr. Walsh's book and was surprised to find him saying (on pg 247): "....if you keep contracting these muscles during the day, you'll overdo it -- the sphincter tires easily -- and you'll end up wetter than you would otherwise." That appeared to be a reasonable explanation of what I had experienced. I decided to follow Dr. Walsh's advice to "only perform these exercises when you are urinating". So far this strategy seems to be helping although it took a week or two to notice (or imagine) that I was again making improvement. I realize I probably have a long way to go but I am not discouraged. -Al Post RRP 14 months. 2-4+ pads first 10 months, then suddenly went almost completely dry when it seems I tricked my nerves into working - I tried holding in as much as I could one night (about 250 cc's), within two days voila, I was dry. Went from drip to no drip, a veritable rewiring of the urinary diagram. A miracle. Next three months only very minor leakage, only one pad a day needed, and only filled a little. Boy, was I happy! Then one evening about three weeks ago I did Kegels (in order to finish it off, get off pads, etc.) and afterward I'm not continent anymore. Am back on 2-3 pads a day, and it seems to be getting worse, and I don't know whether I should do Kegels, not do Kegels, do them lightly or not. Walking has never helped, skating may have a little. The "hold" routine doesn't work anymore. I have serious doubts about Kegels. Attribute part of my problem to pre-op BPH, which resulted in weaker PFM's, and no nerve-sparing surgery (Doc didn't warn that this could also affect continence, which was the only thing besides PCA I was interested in). Oh, well. :-[ Can you spell S-L-I-N-G? I'll wait till about 36 mos post-op B4 doing the latter. I wouldn't use the same surgeon again, not just because of the continence problem, but because after about 10 visits (pre-op and post-op ) with him (Northwestern in Chicago), I now realize, from everything he has said, that he's not a good doctor. You don't pick it up in just one, two or three sessions. What he says tells me he's more interested in protecting against malpractice liability and keeping in good with the insurers, than in taking care of his patients. People say use a good medical center bla bla bla but what difference does it make when it's the surgeon who does the handiwork, not the hospital? |
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