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Prostate surgery incontinence

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Last Post: Jun 16 2012 03:14 AMby: UBHappy

concerned
concerned
Member since:
11/13/11

Prostate surgery incontinence

May 29 2012 09:39 AM

I am having prostate surgery next week (robotic). I know I will be incontinent for 3-6 months or so. I will be taking PT and learning to do the Kegel exercises. My questions: "Incontinence" can mean many things. What is the worst case scenario? Constant dripping? Explosive peeing ? What kind of diaper or pads should I get to be safe? I have been on some UK websites and they rate the pads in millilitres, but I don't see any ratings for US diapers or pads. How many can I expect to use per day...worst case scenario? And what about night time? Are there special diapers for that? I have come to grips with the fact that I will need diapers, so any help you can give me will be appreciated.
dustyboy1234
dustyboy1234
Member since:
3/13/11

RE: Prostate surgery incontinence

May 29 2012 01:28 PM

I can't speak to exactly what your worst case would be from experience but I would venture a guess that it would involve little to no control over when your bladder releases. That being the case you would most likely experience a fairly steady dripping or frequent small releases.

I would suggest that for the daytime you start out with an underwear type product but wear it around home for a day or so to make sure it can handle the job. Try not to change everytime you feel slightly wet, but rather try and simulate a real world scenario, IE you might not have a convenient or discreet opportunity to change for 3 or 4 hours.

At night I would recommend a diaper style brief. My experience with underwear type products is that they often shift around and they offer no side protection and little when you sleep on your stomach. The proper diaper briefs provide far more coverage and will help prevent an uncomfortable awakening.
Honeywell6180
Honeywell6180
Member since:
7/11/09

RE: Prostate surgery incontinence

May 29 2012 02:19 PM

I would strongly recommend what dustboy advises. You will be best off with a good, reliable, highly absorbent diaper. My preference would be for Abena, or Dry 24/7. There are many other products available, such as Molicare, Eurobrief, and lesser brands such as Tena and Tranquility. I can't say I'd strongly recommend Attends, and I also question the level of protection that Depend products offer. I would only opt for the Attends or Depends, if the level of protection needed is very light. You want to avoid anything from Prevail, First Quality, or the store brands. Most of those are purchased for home medical use by caregivers, along with a bunch of underpads. The wearer does not venture out, so leaks don't matter as much to the caregiver because of the underpads.
Patrick
Patrick
Member since:
8/26/09

RE: Prostate surgery incontinence

May 29 2012 02:55 PM

Concerned,
I have had a sphincterotomy, which destroyed the valves which control urination. This may or may not happen to you. I hope you do not have to deal with that; however, there is a small percentage of prostate surgeries which do result, inadvertently, in symptoms similar to a sphincterotomy. My leakage is a slow, continual dribble, except after a meal in which I drank too much. When that happens, leakage can be quite forceful for an hour or two, so I need to stay close to a toilet. Good luck and report back.
Puffy Pants
Puffy Pants
Member since:
12/24/09

RE: Prostate surgery incontinence

May 29 2012 03:32 PM

There are many variables involved in your questions, but I would go with the worst case scenerario, and use a higher end absorbancy diaper to be safe then sorry. Takes some of the worry out, and depending on your fluid intake, it may be very necessary! Night diapers are a bit of the same, what you use in the day can be used at night too, some need a bit of help with a liner or such, but no need to buy 2 levels of product. A coverpant can also be beneficial to stop any leaks getting through. Keep us posted on how it goes, Puffy
GymJock
GymJock
Member since:
3/3/12

RE: Prostate surgery incontinence

May 29 2012 04:48 PM

Hello, Concerned. I can jump in here with a little perspective of my own. First, I'm incontinent myself. Second, I have a pretty decent medical background (I'm an ER nurse and have seen and taken care of many, many men in diapers). And finally, one of my best friends just had a total prostatectomy after a diagnosis of stage II prostate cancer. It's been interesting to go through this with him. His experience has been far and away the most common....and it's essentially what you envision.

The first few months after his surgery, he was in full diapers 24/7. His incontinence was uncontrolled dribbling, with occasionally a major flood of urine. After 3-4 months, his dribbling and lack of control decreased to the point where he used pads during the day but diapers at night. Now, about 6 months after his surgery, he has regained almost full control. He still leaks a little bit but he can contain that with a pad. All in all, he feels very lucky to have regained so much control and be almost back to normal. Thankfully for you and for other men, his experience is far and away the most typical. Good luck to you, and let us know how you fare.
Nick
Nick
Member since:
3/31/09

RE: Prostate surgery incontinence

May 30 2012 04:51 AM

You've received good advice about how to deal with the worst possible situation. However, I would like to support GymJock's reply: The odds are that you will NOT be faced with the worst case scenario. Most guys who have prostate surgery recover and have to deal with incontinence issues for only a few months.

Immediately after your surgery, you are likely to have what is called stress incontinence. In this case, the term stress does not refer to anything psychological but to the effect of pressure on your bladder. The surgery will weaken the sphicters (valves) that control the flow of urine out of your bladder. As a result, any activity that squeezes the bladder (coughing, lifting something even slightly heavy, even getting up or down out of a chair) will cause leakage. However, the sphicters are basically muscles, and you will do Kegel exercises to strengthen them. And those exercises work for most guys. You will likely regain complete or nearly complete bladder control in six months or so.

Anyhow, GOOD LUCK WITH THE SURGERY! We'll all be cheering for you!
concerned
concerned
Member since:
11/13/11

RE: Prostate surgery incontinence

Jun 03 2012 04:13 AM

Thank all you for the replies and information. I am having surgery in a couple days and will be happy when that is behind me (I have had a catheter in for one and a half months!). Your answers have been very helpful.
HKS
HKS
Member since:
6/6/12

RE: Prostate surgery incontinence

Jun 05 2012 04:09 PM

Concerned.....I had the robotic prostectomy myself 2 weeks ago and it was the best decision for me. As a nurse, I knew of the other procedures and this was the way to go. The incontinence, well it will happen. My urologist certainly prepared me for it and I did the keigel exercises regularly, every day and I do believe that it has made a difference. After sitting for a period of time and then standing is probably when the flow is the strongest. I have been wearing the Depends mens underwear and have to say so far, so good. I know it will take several weeks into months to regain control but even after just 2 weeks, I can tell a difference and am able to empty my bladder standing at the john. Which is a big plus.

You may have to try several products to see what you are most comfortable with and how they fit. We are all different and I am thankful that there are options out there for us.

Again,,,Good Luck and let us know how it goes for you.
UBHappy
UBHappy
Member since:
6/16/12

RE: Prostate surgery incontinence

Jun 16 2012 03:14 AM

Concerned,

I had robotic prostate surgery at Johns Hopkins Hospital in Baltimore on May 31st and I agree with HKS that it was the best decision. Temporary incontinence is a side effect of this procedure that you will have to deal with in phases.

You will have a Foley catheter in place for about two weeks after robotic surgery and you will first need to deal with the occasional leakage from the catheter where it emerges from the tip of the penis. This happens mainly when you are walking around. The Johns Hopkins hospital supplied each patient with Sir Dignity™ underpants that securely holds an absorbent insert pad (i.e., Depend™ Guards for Men) in place. This worked very well for me while the catheter was in place.

The folks at Johns Hopkins instruct their patients that urinary control will return in three phases after the catheter is removed: (1) your are dry when lying down at night, (2) you are dry when walking around, and (3) you are dry when you rise from a seated position. When my catheter was removed on June 13th, I assumed that I would begin my journey at a pre-phase 1 stage so I switched to Depend™ diapers (Depend™ Protection with Tabs - Maximum Absorbency). It took a little bit of practice to put the diaper on by myself and I found that the diaper could be better held in place when I wore the Sir Dignity™ underpants (without an insert pad) over the diaper. I was fortunate in that I had reasonably good urinary control after the removal of the catheter and actually started my journey back to full urinary control in phase 2. I found that you can help your recovery of urinary control by regular Kegel exercises and by starting/stopping your urinary stream every time you void. My plan is to switch back to the Sir Dignity™ underpants with the Depend™ Guards pad when I am in phase 3, hopefully in a few weeks. At the end of phase 3, I plan to return to regular briefs.

The folks at Johns Hopkins told us that each man’s journey back to full urinary control is different, but their statistics indicate that 70% of their robotic surgery patients complete phase 3 within 6 months and 90% of their patients complete phase 3 within 12 months. This is very encouraging news and gives men who are facing robotic prostate surgery hope for a full return to a normal life!

I would like to pass on a few other pieces of practical advice. At the start of your journey you should be prepared to regularly use a diaper for a few weeks (in a pre-phase 1 stage) and plan to change the diaper before it fills up. In the worse case, I was prepared to have 2-3 diaper changes each day before reaching phase 1. I also had a reusable protective/absorbent pad ready for my chair and bed in case there was leakage from the diaper. When using diapers before reaching the phase 1 stage, plan to protect your scrotum and groin area from irritation by urine in the diaper with Desitin™ Rapid Relief Cream or a similar product.

Finally, you will probably not find some of the recommended incontinence products (i.e., Depend™ Protection with Tabs - Maximum Absorbency, Sir Dignity™ underpants, protective/absorbent pads for chair and bed) at your local pharmacy such as CVS, Walgreens, etc. I was able to find many of these specialty incontinence products at Amazon or other reputable online merchants.

I wish you all the best.

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