 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / Diseases and Disorders / Prostate Cancer / March 2005This is really strange (incontinence)
Went to uro today to get urodynamics in prep for AMS 800 implant Tuesday. The nurse practitioner (nice guy at NWU Hospital, Chicago) couldn't get the catheter type thing past the bladder neck into the bladder, because of scar tissue at the juncture. (Boy was I in pain, as he tried several times to "poke it through" - they can't use anesthetics for this 'cause that would interfere with the test.) Funny thing is, it seems to have caused my sphincter to kick into gear - need I say "I'm back baby!!" (as George Costanza on Seinfeld would say), or need I jump for joy (as he would do running thru Central Park after the hand photo shoot where the stylist, a hot luscious blonde, asked him out, resulting in him dancing/running along a C.P. path afterwards, hands victoriously waiving in the air)? So I'll see how it goes over the weekend; have appt Mon afternoon for cystoscopy, but if things remain good I may say "if it's not broke let's not try to fix it", cause a scope requires a Foley afterward, and that's what makes it difficult for me to get back to "normal" - the nerves and muscles then think it's ok to just drip, drip, drip, like a faucet (wouldn't you be happy doing this if your host was nice and kept you dry by replacing pads frequently?). It hurt to pee for a few hours after the attempted urodynamics procedure today (i.e., from the poking) so I think the nerves kicked in and told the sphincter to "hold tight" even while upright, because if it didn't pain would ensue. This is consistent with my previous experience, that it has as much to do, if not more to do, with the nerves than the muscles, and that Kegels are dangerous because they can confuse the nerves. Stay tuned. The first day after the attempted urodynamics procedure yesterday was practically spotless, I didn't get the urge to pee, and had practically zero leaking, and the whole mechanism felt and worked perfectly and naturally; second day (today) it seems to be going back to its old deficient ways (now that the pain is gone from the aforementioned "poking" procedure yesterday, which resulted in "pain" in the bladder neck that caused the nerves to (naturally) instruct the sphincter to clamp down) - now it starts feeling the need to pee too soon - it seems that today fluid is getting past the bladder neck, where yesterday it wouldn't go because of the pain caused by the "poking" during the attempt at urodynamics. When it goes beyond the bladder neck (i.e., the sphincter doesn't hold back from this point) it gives a feeling of the need to pee, even though the bladder isn't anywhere near full. So now I understand my incontinence: a) it has nothing to do with the strength of the sphincter (after all, it sprang into action yesterday with no problem as soon as the nerves said "don't go into the bladder neck, else pain", after the "poking" procedure), and b) (this I am not sure about, but will consult with the doc:) because the uro surgeon took out too many nerves during the RRP, I can't normally feel it when fluid starts past the bladder neck into the urethra. My assumption at this point is that if I was able to feel it, the nerves would send an appropriate signal to the sphincter to "tighten up/hold back". So tentatively I'm blaming the uro surgeon for malpractice, because when I told him not to spare the nerves he didn't warn me that it could affect continency, which he had a legal duty to do. If he had done this I would have said, "save enuf so that I won't be incontinent, because that's all the functionality I really care about". Instead, it appears he went in to remove the prostate and didn't make the effort, and take the time, to examine the surrounding tissue for PCA, and instead removed tissue and nerves willy nilly, in a wholesale manner, leaving me incontinent for life. Care to enlighten us why you told the surgeon " not to spare your nerves"? Re the incontinence, I have had a lot of success since I gave up kedgels a month ago. A poster here recommended ,no kedgels, but gentle pressure while doing anything that causes leaking, as well as drinking lots of water and trying to hold it for more than an hour, a few times a week. I have given up wearing pads the last week and am 97% incontinent (sneezing needs crossed legs to hold it back!) Now when I pee , I have to bear down constantly to keep the flow going, so my muscles must have re-educated themselves. Ronaldo. Great news for you, robr! (that was yours truly who offered those ideas to the group). I told the uro surgeon not to spare the nerves because a) I had a gleason 7 based on the biopsy (+8 psa) (i.e., somewhat aggressive PCA), and b) longevity far outweighs sexual function in terms of my priorities/interests - the doc said removing the nerves would increase longetivity. I'm single. When I am aware of leaking, which is not always, what I feel is in the penis, so it is already too late to "clamp down" to prevent the wetness. > Re the incontinence, I have had a lot of success since I gave up > kedgels a month ago. A poster here recommended ,no kedgels, but gentle [quoted text clipped - 5 lines] > > Ronaldo. Egggggzackly! That's why I'm becoming convinced we need to do TWO things: 1) keep the Kegel muscles strong enough that 2) we can learn to subconsciously maintain some backpressure every standing moment. My docs thought I'd be dry within days to weeks, and only after 4.5 months -- two months after I passed that suggestion along from Tdub -- did they admit that maybe constant light pressure may help. I.P. "David S." <buttercupsdad@dog.net> wrote .. > When I am aware of leaking, which is not always, what I feel is in the > penis, so it is already too late to "clamp down" to prevent the wetness. As I've said B4, "strong back and forth type Kegels" may be more harmful than helpful, 'cause it confuses the nerves controlling the sphincter - instead, you want to send the message to hold easy and consistently. In my case, Kegels of the former variety sent me into a deep spiral of heavy incontinence after a 3 month period of less than one pad a day continence. I'm off for an appt in an hour with the "continence uro" at NWestern Hospital, Chicago. Since my bladder neck was abraded Friday from an attempt at urodynamics (nurse couldn't get the thingy through to the bladder 'cause of bladder neck scar tissue) my continence has substantially improved - I think it's because it exposed some nerves in the bladder neck that (now) senses fluid (urine) and (to some extent) stops it from going down into the urethra. If my theory is correct all I will need, after heavy incontinence, is to have a cystoscopy remove the scar tissue and expose more nerves in the bladder neck, so it can sense urine and stop it, which is what it did like I've never seen before Friday after the failed procedure. After that it was obvious that my problem is nerves, not muscle, because the sphincter had absolutely no problem (all of a sudden) completely shutting down fluid flow from the bladder, once the nerves in the bladder neck could sense fluid there about to pass into the urethra. A day after, after the abrasion healed the (previously exposed) nerves weren't as sensitive and the continence since hasn't been perfect like it was Friday. Stay tuned. I doubt that "exposing nerves" has anything to do with it. All the poking around irritated the area causing swelling which aided continence. As the swelling subsided over the next couple of days, the incontinence returned. It's similar to injecting collagen into the area resulting in swelling around the uretha. This has been tried with women with limited success (the injections need to be repeated). Dave Perry > As I've said B4, "strong back and forth type Kegels" may be more > harmful than helpful, 'cause it confuses the nerves controlling the [quoted text clipped - 19 lines] > weren't as sensitive and the continence since hasn't been perfect like > it was Friday. Stay tuned. That's what the doc said he thought it more than likely was caused by, but said it could also have been nerve stimulation from the abrasion, although there is little understood in the uro community about how the nerves affect continence. I'm going to have the bladder neck cleaned up in a couple weeks to see if removing scar tissue helps. Obviously, scar tissue doesn't contain nerves, it's just dead tissue. Nevertheless, I feel it was nerves rather than a bulking up from swelling, but "we'll see". |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.