Prostate Surgery And Incontinence

[dlj]

Here I am, 9 weeks following Da Vinci Robotic Nerve Sparing surgery to remove my prostate. I am finding the incontinence getting worse rather than better. Prior to the discovery of the cancer (which they caught very early), I was wearing diapers at night, due to becoming a sleepwetter following lithotripsy for a large kidney stone almost a year to the date of the cancer diagnosis. This, coupled with a small bladder that has always been slightly overactive, caused me to wet in my sleep 3 or 4 nights out of 7.

Fast forward to today and now I must wear 24/7. In a follow-up visit to my doctor last week, he asked about the leaking associated with prostate removal. I explained that I was managing it. He asked how many pads per day I was using. Pads? With the amounts I am leaking (remember I must stay hydrated due to kidney stones. I don't want to go through that again), no pad or pull-up on the planet is going to contain what I am putting out. I wear diapers. He seemed really surprised at that answer.

There are times, when I can get up quickly from a seated position and have a full void. I leak quite a bit when walking up and down stairs, when I shift positions in bed, bending over to pick something up, a sneeze... You get the picture.

I wear disposables with plastic pants at work or when I am out, but I prefer cloth, pin on or pull on, when at home. I feel that the medical profession is not as forthcoming with respect to how severe the incontinence will be when discussing the removal of one's prostate. I think, in my case, it is getting worse right now. The more water I drink, the worse it is, of course, but kidney stone prevention and good hydration is important too.

I am comfortable in my own skin and am comfortable with the fact that I may be in diapers for quite a while. I am no longer embarrassed by the fact the people are going to become aware that I wear diapers.

Would love to hear from others here who are dealing with incontinence following prostate removal. My wife is being very supportive throughout all this, but I can see see that it could take a toll over the long term to have her partner in diapers all the time. Not to be too graphic, but I am afraid of peeing while we are being intimate.

Thanks for listening.

[turtlepins]

My incontinence is due to damage to my brain. Being afraid of peeing while having sex is something I think all of us go through. I never did during, but on a couple of occasions immediately following that intimate time I spoiled it by peeing on her and the bed sheets, which then needed to be washed. We were never financially able to have more than one set of sheets at a time. My wife was very supportive because I was devastated to have that happen. After my back surgery I could no longer have sex. I'm much calmer about being intimate with her because I keep my diapers on. I haven't had any prostate problems . . . yet, or a kidney stone. Trust your wife to understand. Hope you found some comfort in this. Life is always a struggle, always throws curves and loves to hurl you off course with storms. Enjoy the time you have together. God bless.

[babykeiff]

Here I am, 9 weeks following Da Vinci Robotic Nerve Sparing surgery to remove my prostate. I am finding the incontinence getting worse rather than better. Prior to the discovery of the cancer (which they caught very early), I was wearing diapers at night, due to becoming a sleepwetter following lithotripsy for a large kidney stone almost a year to the date of the cancer diagnosis. This, coupled with a small bladder that has always been slightly overactive, caused me to wet in my sleep 3 or 4 nights out of 7.

Fast forward to today and now I must wear 24/7. In a follow-up visit to my doctor last week, he asked about the leaking associated with prostate removal. I explained that I was managing it. He asked how many pads per day I was using. Pads? With the amounts I am leaking (remember I must stay hydrated due to kidney stones. I don't want to go through that again), no pad or pull-up on the planet is going to contain what I am putting out. I wear diapers. He seemed really surprised at that answer.

There are times, when I can get up quickly from a seated position and have a full void. I leak quite a bit when walking up and down stairs, when I shift positions in bed, bending over to pick something up, a sneeze... You get the picture.

I wear disposables with plastic pants at work or when I am out, but I prefer cloth, pin on or pull on, when at home. I feel that the medical profession is not as forthcoming with respect to how severe the incontinence will be when discussing the removal of one's prostate. I think, in my case, it is getting worse right now. The more water I drink, the worse it is, of course, but kidney stone prevention and good hydration is important too.

I am comfortable in my own skin and am comfortable with the fact that I may be in diapers for quite a while. I am no longer embarrassed by the fact the people are going to become aware that I wear diapers.

Would love to hear from others here who are dealing with incontinence following prostate removal. My wife is being very supportive throughout all this, but I can see see that it could take a toll over the long term to have her partner in diapers all the time. Not to be too graphic, but I am afraid of peeing while we are being intimate.

Thanks for listening.

dlj,

reading your case history has raised a couple of questions.

Firstly - Was there some major complications with the lithotripsy (focused shock wave treatment aimed at the kidneys/ bladder / urether to break down calcium ) cause the intention adn design of this procedure is focused shocks to the specific location. This is supposed to be non-invasive repair to protect both sexual function and continence of a patient. You stated that secondary nocturnal enuresis (sleep wetting) started following this. For you to sleep-wet, needs the vasprossen levels (chemical that regulates water level within the human body) in your body to be severely reduced, rather than (in simple terms) electric shock therapy to your urinary excretory process. Did your bowel movements become loose / more fluid since the lithotripsy - this would confirm the lack of vasprossen.

Secondly - the robot procedure was designed to be extremely accurate - so on its own, shouldn't affect continence, but the addition of certain medication will. Since you doctor was aware of your need for protection, he/she must have prescribed either water pills OR a muscle relaxant. If so, that incontinence will self cure over 3-6 months.

Prostate removal is a normally a six hour hospital stay

[dlj]

dlj,

reading your case history has raised a couple of questions.

Firstly - Was there some major complications with the lithotripsy (focused shock wave treatment aimed at the kidneys/ bladder / urether to break down calcium ) cause the intention adn design of this procedure is focused shocks to the specific location. This is supposed to be non-invasive repair to protect both sexual function and continence of a patient. You stated that secondary nocturnal enuresis (sleep wetting) started following this. For you to sleep-wet, needs the vasprossen levels (chemical that regulates water level within the human body) in your body to be severely reduced, rather than (in simple terms) electric shock therapy to your urinary excretory process. Did your bowel movements become loose / more fluid since the lithotripsy - this would confirm the lack of vasprossen.

Secondly - the robot procedure was designed to be extremely accurate - so on its own, shouldn't affect continence, but the addition of certain medication will. Since you doctor was aware of your need for protection, he/she must have prescribed either water pills OR a muscle relaxant. If so, that incontinence will self cure over 3-6 months.

Prostate removal is a normally a six hour hospital stay

I'll try to answer to best of my ability. No major complications from the litho. That said, the stone (my first one) was almost 10mm in size. I passed some seriously large fragments over the course of about 3 days. One possible answer to the sleepwetting may have do with the fact that I could have had the stone for quite some time before it shifted, causing the severe pain that caused me to seek medical help. I suffered vague back ache for quite a while causing me to sleep lightly. following the litho, I began sleeping deeper than I had in years, my body not waking when the signal to urinate occurred. From a historical perspective, prior to any of this, I have a small bladder to start with compounded with urge incontinence to some degree since childhood (I wet the bed until about age 7 or so). when the urge to go hits, it's immediate.

Da Vinci IS in and of itself, designed to be incredibly accurate. I was told to expect some incontinence that would lessen over time. I had the surgery performed at one of the countries leading cancer treatment centers. I was hospitalized for 48 hrs. In addition, I went home with a catheter that was left in for 12 days. I was on pain meds for a week or so as well as Viagra therapy to improve blood flow: 50 mg/day M-F. Erectile function is, so far, non-existent. The daytime incontinence appears to be the stress type: getting up, walking down stairs, sneeze, cough, lifting... It is enough that guards/pull on type is not enough to contain everything.

I appreciate everyone's comments so far. Being new to all this, I am somewhat curious as to what patterns to expect. In addition, I read your comments regarding kegels, and must agree that they have no effect on urinary incontinence as it relates to prostate removal.

[babykeiff]

I'll try to answer to best of my ability. No major complications from the litho. That said, the stone (my first one) was almost 10mm in size. I passed some seriously large fragments over the course of about 3 days. One possible answer to the sleepwetting may have do with the fact that I could have had the stone for quite some time before it shifted, causing the severe pain that caused me to seek medical help. I suffered vague back ache for quite a while causing me to sleep lightly. following the litho, I began sleeping deeper than I had in years, my body not waking when the signal to urinate occurred. From a historical perspective, prior to any of this, I have a small bladder to start with compounded with urge incontinence to some degree since childhood (I wet the bed until about age 7 or so). when the urge to go hits, it's immediate.

Da Vinci IS in and of itself, designed to be incredibly accurate. I was told to expect some incontinence that would lessen over time. I had the surgery performed at one of the countries leading cancer treatment centers. I was hospitalized for 48 hrs. In addition, I went home with a catheter that was left in for 12 days. I was on pain meds for a week or so as well as Viagra therapy to improve blood flow: 50 mg/day M-F. Erectile function is, so far, non-existent. The daytime incontinence appears to be the stress type: getting up, walking down stairs, sneeze, cough, lifting... It is enough that guards/pull on type is not enough to contain everything.

I appreciate everyone's comments so far. Being new to all this, I am somewhat curious as to what patterns to expect. In addition, I read your comments regarding kegels, and must agree that they have no effect on urinary incontinence as it relates to prostate removal.

The primary problem, - sleep wetting is directly in result to your small bladder.

Your daytime wetting - stress incontinence - was caused by the catheter.

The cure to both involves re- toilet-training you. Your mind and body has currently reverted to the autonomic voiding or late infancy - when it feels pressure within the bladder it releases. You need to relearn to control your external sphincter. Daytime continence can be achieved with a rigerous training schedule, which will, in time, stretch the bladder. It will not be until that has happened, can you start to gain some night-time control.

This is making the assumption that you regain erectile function. Failure here means that certain specific nerves may have been damaged, and if that is so, you will slowly loose all urinary control.

I suggest that you talk to a medical professional - ie a urologist - who is familiar with your history and one who hasn't performed any work on you before - ie an independent.