Fixing Urinary Leakage After Prostate Cancer Surgery | Ask A Prostate Expert, Mark Scholz, MD

[@thomasfreed-ph2zp]

I found some very absorbent pull ups at Wal mart called assurance. They are 10 times better than depends. Pick you size s-m m-l large and x-large. My control has improved tremendously using kegle exercises. Physical therapists can teach the correct way to do them.

[@steve122140]

I had no incontinence or leakage worth mentioning after my Davinci RP. Being fit: walking, weight training and yoga all help tremendously. I have more urinary control and comfort than before my RP.

[@jackie6903]

Great for you. Wish we were all the fortunate.

[@RH-xd3nx]

Sphincter size is very important , preferably 1cm long is ideal ,if you have a good surgeon they can actually retain your control.

[@davidbasara1265]

Did same, however no improvement,,,,,,☹️

[@RH-xd3nx]

@@davidbasara1265 are you fit my friend just curious?

[@davidbasara1265]

@@RH-xd3nx yes, excercise every day but about 10 lbs. overweight

[@seant6154]

This is very informative! I wish my dad had done prostatectomy surgery. He passed away from Prostate Cancer in December 2021.

[@ronaldolamont]

Sorry to hear that! Are you concerned that you may some day be diagnosed with it? My father also died from it just several years ago, at age 65, I wasn't very close with him so I really have no idea why he didn't seek the treatment! I myself have recently been diagnosed with it at age 55. I'm just 8 days out of my prostatectomy surgery and doing well so far.

[@thejaswi3364]

@@ronaldolamont hey is there any chance of cancer getting spread during surgery?

[@seant6154]

@@ronaldolamont I am going to ensure that I check on myself earlier. That’s good you successfully removed the Prostate.

[@jwalderman]

I have had an artificial sphincter inserted 6 weeks ago. My urologist has advised that I wait 8 weeks prior to activation because I had radiation treatment following the removal of my prostate. My question is: What is involved in the activation of this device? And what is the follow up procedure when using this device to urinate?

[@artmaltman]

Excellent series. Thank you.

[@steve122140]

Thank you for this site! Keeps me in the loop. God Bless

[@stanknowlton7043]

I ended up making my own catheter carrying contraption, the flimsy hospital issue device was designed for the bed ridden, now how do I make this available for other patient.

[@ferdinandblose5922]

Artificial sphincter sounds like another problem on top of existing problem. Kegel exercise never cure urinary incontinence

[@ProMachinist]

There's much truth to what you said Ferdinand. I speak from experience! I've had a few related surgeries since my prostectomy in 2019 and each one made my incontinence noticeably worse. But then again, having numerous cystoscopies and about two dozen catheters also clealry took its toll on my urethra. My prostate cancer also brought about every complication possible including 100% incontinence. I haven't talked to anyone yet that found Kegal exercises at all helpful, including me. Actually, if anything, these exercises made my incontinence much worse, and yes, I did them correctly. In regards to the AUS implant, I'd stay away from that even as a last resort. Why, I had one installed over two years ago and had to have it removed just a few months later. What a nightmare! Immediately my body rejected it! Who knew that my body rejects silicone and latex, I didn't. We had to wait until my health was better and my body strong enough to take on yet again another surgery after the infections from the implant was cleared up. Assisde from the rejection and constant infections, the implant was most uncomfortable in the scrotum and perineum area. If your a "small build" guy, there really isn't much room to put in extra things here and there if you know what I mean. Also, forget about sitting on a bar stool or bicycle seat or sitting for periods of time. This type of urine control isn't the gold standard like they say. I am an advocate for prostate cancer and haven't spoken to anyone yet that is happy with this device. They are happy with being mostly dry. It is a trade off. Its uncomfortable in all sensitive areas! Give it serious thought and do your research before going down this road. You do have other options less severe.

[@jimbrew4529]

Presurgery, my Mayo surgeon predicted I'd be continent after 4 months. The surgeon didnt mention kegels. I thought it was a rather bold prediction. However, I'm currently at 3 months and pretty much there. The exception would be alcohol use.

[@ThePCRI]

Hello Jim, here is a presentation regarding erectile function preservation. He mentions kegels towards the end of the video: kzbin.info/www/bejne/bWiyg594d7qLlZYfeature=shared

[@jimbrew4529]

​@@ThePCRISorry... I meant the Mayo surgeon didn't recommend kegels.

[@cordfortina9073]

Hi Jim, did your continence return naturally as part of the healing process, or did you require further treatment?

[@jimbrew4529]

@@cordfortina9073 It returned naturally.

[@cordfortina9073]

@@jimbrew4529 Thank you for your reply. That's reassuring.

[@kevinmedic12]

I used to work with spinal cord patients teaching them how to use a leg bag with condom catheter after my surgery I used the same technique I'll buy a condom catheters and connect them to a leg bag. My leakage is. About a 6 out of 10 I found that the condom catheter and leg bag give me back my life

[@jamesmeyer5366]

Is the reason that incontinence happens is the spincter inside of the bladder gets damaged when the urethra is reattached or or is it more due to nerve damage? I have slow drip or two at times and yet during sex the only thing that comes out is precum so does that mean my bladder spincter shuts off for urine for sec then why can't it shut for other times like when I cought or relax while standing?

[@cactusstudiossouth]

I am 3 months post Prostindectomy! Inconvenience is at level 10! I switched to wearing Swimming Trunks full time now, at least the Florida heat dry's me up in between leaks! Please, some one Advise me?

[@ThePCRI]

Jimi, There are urologists who specialize in treating incontinence after radical prostatectomy, and the optimal treatment depends on the specific cause(s) of the incontinence which can vary after radical prostatectomy, but can be diagnosed by a urologist with experience treating post-RP patients. If you have any questions, feel free to contact our helpline here: pcri.org/helpline

[@94121sf]

With successful nerve sparing RP how soon till one can start "TriMix"(etc) injections while nerves repair and return ? Thank you.

[@ThePCRI]

Hello Bill, our prostate cancer helpline may be able to ​help with your question. Please feel free to contact us here: pcri.org/helpline

[@Keith80027]

I had Dsavici RP two years ago had still have leakage. I tried the pills and they didn't work and now trying botox . It has been two weeks now and i leak more than before. Maybe another couple of weeks might make a difference, but I little faith in botox now.

[@Keith80027]

I had the same results with botox.

[@kenemmens6281]

@@Keith80027 I had an artificial urinary sphincter (AUS) placed about 20 months ago which has lessened the amount of leakage but not prevented urgency, stress, or nocturia incontinence, and since then had two bladder Botox procedures 6 months apart, the first one eight months ago. The first "dose" was 100 units, and the second 150 units. The first procedure lasted about 4 months before my leaking worsened again (apparently 6 or more months is usual), and I'm now 2 months into my second procedure but that is proving ineffective already and I'm currently saturating 2 pull-ups (diapers) a day. It took 11 days for the first Botox procedure to "kick in" and 14 days for the second procedure despite it being a higher amount. I have a great urologist and she said she will obtain funding for a sacral neuromodulation device once the Botox has fully worn off (I live in a country where these can be funded by our health system if a urologist puts up a valid case). I have previously tried medications (Solifenacin and Oxybutynin) but the side effects (dry mouth, constipation, and higher risk of dementia) and limited effectiveness meant these were not a long-term option for me.

[@greasemonkeybd]

had prostate removed but no robot also had radiation after surgery-leaking piss very bad got worse with time. so do you dr. mark can tell me who you would send me to for the mechanical contrivance called the so-called artificial sphincter?? I live in Louisiana

[@robprotz3218]

Jeff, you need to find a "reconstructive" urologist. These are urologists who are Fellowship trained (an extra year) after urology residency and specialize in reconstructive procedures like the AUS.

[@greasemonkeybd]

@@robprotz3218 thanks for that info

[@nestordupo845]

Its 1 year next month and I have still incontinence not much and its not bother me anymore butbI still take betmiga tablet though. I have incontenence during my arousement because I take also diff meds for my ed.

[@georgeminus4789]

What pills can I take for leakage

[@ThePCRI]

You can call our helpline if you have questions about this. You can find our contact information at pcri.org/helpline. There are not any medication for "leakage" itself, but if the leakage is caused by an issue that could be treated with a medicine, then there could be a medicinal solution for the leakage. Otherwise, there are options like Kegel routines and surgical options that the patient advocates on our helpline could tell you about.

[@raytucker6568]

Hope