Re: Permanent Incontinence After Radical Prostectomy

[Guest guest]

> My husbad is having a prostate biopsy, and I've been trying to get

> educated reading " A Primer on Prostate Cancer " which I saw recommended

> on this board. A statement in the book is that " In the hands of a

> talented urologist, permanent incontinence of significant degree

> resulting from a radical prostecomy (sic: prostatectomy) is uncommon

(typically less than2%) " .

>

> Based on your own experience, and what you've heard from others, what

> are your thoughts on this statement?

The quotation is from page 81.

My thought is that no one should rely upon anecdotes to make a decision

about anything at all. Simply put, what applied to A may not apply to B

-- and vice versa.

Note that the authors, Strum and Pogliano, specify surgery by a

*talented urologist*. So someone's anecdote about his own experience

would at the very least require that his uro was " talented. " Whatever

that means.

Also on page 81 is a reference to this " excellent resource for those

needing information... " : The National Association for Continence at

www.nafc.org

Regards,

Steve J

" Disregard statistics. They lie. "

-- Young, PCa Mentor

Phoenix 5

[Guest guest]

> My husbad is having a prostate biopsy, and I've been trying to get

> educated reading " A Primer on Prostate Cancer " which I saw recommended

> on this board. A statement in the book is that " In the hands of a

> talented urologist, permanent incontinence of significant degree

> resulting from a radical prostecomy (sic: prostatectomy) is uncommon

(typically less than2%) " .

>

> Based on your own experience, and what you've heard from others, what

> are your thoughts on this statement?

The quotation is from page 81.

My thought is that no one should rely upon anecdotes to make a decision

about anything at all. Simply put, what applied to A may not apply to B

-- and vice versa.

Note that the authors, Strum and Pogliano, specify surgery by a

*talented urologist*. So someone's anecdote about his own experience

would at the very least require that his uro was " talented. " Whatever

that means.

Also on page 81 is a reference to this " excellent resource for those

needing information... " : The National Association for Continence at

www.nafc.org

Regards,

Steve J

" Disregard statistics. They lie. "

-- Young, PCa Mentor

Phoenix 5

[Guest guest]

Hi Calico:I guess it depends on your definitions of "permanent incontinence" and "significant degree". I had LRRP in Jan of '07. I am 98% continent (I leak a little when doing certain exercises at the gym, if I cough or sneeze with a full bladder, and unfortunately, during foreplay). I don't wear a pad, but have to be very cautious when wearing khakis or light colored slacks. I routinely wear boxers over briefs because I'm a little nervous about it. I do kegels exercises every day and will do them for the rest of my life. My private urologist (not the one who did my surgery) tells me that "a little incontinence is to be expected", and that what I have is really minor. To me, it is permanent as I don't see it ever completely resolving, and can be significant in the wrong situation. Do I look back and wish I had not had the surgery? Not at all. My PSA is 0, my physical exams have all been excellent. But I have become very wary of statistics unless the terms are clearly defined. Best of luck with the biopsy.To: ProstateCancerSupport From: mizzes12@...Date: Sun, 18 Jan 2009 09:13:14 -0800Subject: Permanent Incontinence After Radical Prostectomy

My husbad is having a prostate biopsy, and I've been trying to get educated reading "A Primer on Prostate Cancer" which I saw recommended on this board. A statement in the book is that "In the hands of a talented urologist, permanent incontinence of significant degree resulting from a radical prostecomy is uncommon (typically less than2%)".

Based on your own experience, and what you've heard from others, what are your thoughts on this statement?

Thank you!

Calico

Windows Live™ Hotmail®: Chat. Store. Share. Do more with mail. Check it out.

[Guest guest]

Hi Calico:I guess it depends on your definitions of "permanent incontinence" and "significant degree". I had LRRP in Jan of '07. I am 98% continent (I leak a little when doing certain exercises at the gym, if I cough or sneeze with a full bladder, and unfortunately, during foreplay). I don't wear a pad, but have to be very cautious when wearing khakis or light colored slacks. I routinely wear boxers over briefs because I'm a little nervous about it. I do kegels exercises every day and will do them for the rest of my life. My private urologist (not the one who did my surgery) tells me that "a little incontinence is to be expected", and that what I have is really minor. To me, it is permanent as I don't see it ever completely resolving, and can be significant in the wrong situation. Do I look back and wish I had not had the surgery? Not at all. My PSA is 0, my physical exams have all been excellent. But I have become very wary of statistics unless the terms are clearly defined. Best of luck with the biopsy.To: ProstateCancerSupport From: mizzes12@...Date: Sun, 18 Jan 2009 09:13:14 -0800Subject: Permanent Incontinence After Radical Prostectomy

My husbad is having a prostate biopsy, and I've been trying to get educated reading "A Primer on Prostate Cancer" which I saw recommended on this board. A statement in the book is that "In the hands of a talented urologist, permanent incontinence of significant degree resulting from a radical prostecomy is uncommon (typically less than2%)".

Based on your own experience, and what you've heard from others, what are your thoughts on this statement?

Thank you!

Calico

Windows Live™ Hotmail®: Chat. Store. Share. Do more with mail. Check it out.

[Guest guest]

Hi Calico:I guess it depends on your definitions of "permanent incontinence" and "significant degree". I had LRRP in Jan of '07. I am 98% continent (I leak a little when doing certain exercises at the gym, if I cough or sneeze with a full bladder, and unfortunately, during foreplay). I don't wear a pad, but have to be very cautious when wearing khakis or light colored slacks. I routinely wear boxers over briefs because I'm a little nervous about it. I do kegels exercises every day and will do them for the rest of my life. My private urologist (not the one who did my surgery) tells me that "a little incontinence is to be expected", and that what I have is really minor. To me, it is permanent as I don't see it ever completely resolving, and can be significant in the wrong situation. Do I look back and wish I had not had the surgery? Not at all. My PSA is 0, my physical exams have all been excellent. But I have become very wary of statistics unless the terms are clearly defined. Best of luck with the biopsy.To: ProstateCancerSupport From: mizzes12@...Date: Sun, 18 Jan 2009 09:13:14 -0800Subject: Permanent Incontinence After Radical Prostectomy

My husbad is having a prostate biopsy, and I've been trying to get educated reading "A Primer on Prostate Cancer" which I saw recommended on this board. A statement in the book is that "In the hands of a talented urologist, permanent incontinence of significant degree resulting from a radical prostecomy is uncommon (typically less than2%)".

Based on your own experience, and what you've heard from others, what are your thoughts on this statement?

Thank you!

Calico

Windows Live™ Hotmail®: Chat. Store. Share. Do more with mail. Check it out.

[Guest guest]

> My husband is having a prostate biopsy, and I've been trying to

> get educated reading " A Primer on Prostate Cancer " which I saw

> recommended on this board. A statement in the book is that

> " In the hands of a talented urologist, permanent incontinence

> of significant degree resulting from a radical prostecomy is

> uncommon (typically less than2%) " .

>

> Based on your own experience, and what you've heard from

> others, what are your thoughts on this statement?

Calico,

If you do a Google search or a Pubmed search on terms like

" incontinence rate radical prostatectomy " you'll find radical

differences in the reports made by different doctors and in

different studies. The differences in reports range from near

zero rates of incontinence (like the claim you cited above) to

more than 50%.

I think there are a number of reasons for these discrepancies,

including:

- Different age patients, younger men recover better than older.

- Different followup times, patients often improve over time.

- Different definitions of " incontinence " or " significant

degree " of incontinence.

- Different skill levels in the surgeons (but how do you find a

" talented urologist " , and how do you know when you've found

one?)

- Bias in the reporting.

There have been so many studies reporting incontinence rates

higher than 2% that I just don't believe that 2% is correct,

though I'm no expert and it's possible that I'm wrong.

The issue of " significant degree " of incontinence is important,

not only in measuring outcomes but in measuring satisfaction. I

have encountered men who drip a little bit when exercising and

consider it a disaster. Some men spurt a little urine when

having an orgasm have given up sex as a result. Other men wear

diapers and go through several incontinence pads a day and

consider it a minor nuisance in the grand scheme of things, not

worth getting upset about. What is significant to one man is

not to another.

As I understand it, radiation has a much lower incidence of

incontinence than surgery. The usual problem with radiation is

the opposite, urinary retention. However radiation can have

other unwanted side effects and it is claimed by some that the

rates of long term impotence are about the same for radiation

and surgery.

I suggest the following:

Find the best surgeon you can for a consultation.

Find the best radiation oncologist you can for a consultation.

Read as much as you can stand.

Hope for the best.

Prepare for something less than the best. In my personal view,

we can deal with a lot of difficulties in life if we are

prepared for them and ready to face them squarely. It's better

to know that things can go wrong and be ready than to believe

the doctors that say everything will go right, don't worry.

Incontinence, if it occurs, can often be reduced by careful

exercises, treated with various procedures, and dealt with

effectively with pads, diapers, and sometimes even with special

clamps.

I'm not urging your husband to accept surgery regardless of the

risks, nor am I urging him to get radiation, or to get any

treatment at all. Some men who are treated, especially older

men or men with insignificant cancers, really don't need

treatment. But if you and your husband do decide that treatment

is appropriate, make the best choice that you can, find the best

doctor that you can, be as realistic as you can, and stay as

upbeat as you can.

Best of luck to both of you.

Alan

[Guest guest]

> My husband is having a prostate biopsy, and I've been trying to

> get educated reading " A Primer on Prostate Cancer " which I saw

> recommended on this board. A statement in the book is that

> " In the hands of a talented urologist, permanent incontinence

> of significant degree resulting from a radical prostecomy is

> uncommon (typically less than2%) " .

>

> Based on your own experience, and what you've heard from

> others, what are your thoughts on this statement?

Calico,

If you do a Google search or a Pubmed search on terms like

" incontinence rate radical prostatectomy " you'll find radical

differences in the reports made by different doctors and in

different studies. The differences in reports range from near

zero rates of incontinence (like the claim you cited above) to

more than 50%.

I think there are a number of reasons for these discrepancies,

including:

- Different age patients, younger men recover better than older.

- Different followup times, patients often improve over time.

- Different definitions of " incontinence " or " significant

degree " of incontinence.

- Different skill levels in the surgeons (but how do you find a

" talented urologist " , and how do you know when you've found

one?)

- Bias in the reporting.

There have been so many studies reporting incontinence rates

higher than 2% that I just don't believe that 2% is correct,

though I'm no expert and it's possible that I'm wrong.

The issue of " significant degree " of incontinence is important,

not only in measuring outcomes but in measuring satisfaction. I

have encountered men who drip a little bit when exercising and

consider it a disaster. Some men spurt a little urine when

having an orgasm have given up sex as a result. Other men wear

diapers and go through several incontinence pads a day and

consider it a minor nuisance in the grand scheme of things, not

worth getting upset about. What is significant to one man is

not to another.

As I understand it, radiation has a much lower incidence of

incontinence than surgery. The usual problem with radiation is

the opposite, urinary retention. However radiation can have

other unwanted side effects and it is claimed by some that the

rates of long term impotence are about the same for radiation

and surgery.

I suggest the following:

Find the best surgeon you can for a consultation.

Find the best radiation oncologist you can for a consultation.

Read as much as you can stand.

Hope for the best.

Prepare for something less than the best. In my personal view,

we can deal with a lot of difficulties in life if we are

prepared for them and ready to face them squarely. It's better

to know that things can go wrong and be ready than to believe

the doctors that say everything will go right, don't worry.

Incontinence, if it occurs, can often be reduced by careful

exercises, treated with various procedures, and dealt with

effectively with pads, diapers, and sometimes even with special

clamps.

I'm not urging your husband to accept surgery regardless of the

risks, nor am I urging him to get radiation, or to get any

treatment at all. Some men who are treated, especially older

men or men with insignificant cancers, really don't need

treatment. But if you and your husband do decide that treatment

is appropriate, make the best choice that you can, find the best

doctor that you can, be as realistic as you can, and stay as

upbeat as you can.

Best of luck to both of you.

Alan

[Guest guest]

The figure I was quoted by my urologist was 80% no incontinence, 10% minor incontinence, 10% moderate incontinence. I had robotic prostatectomy 09/11/08, in diapers for 3-4 weeks with major leakage, then decreased to 2 pads/day, now no leakage unless I sneeze or cough hard. I don't wear pads anymore. I probably could get even more continent if I would just continue the Keagels but I've gotten lazy lately...............mizzes12 wrote: My husbad is having a prostate biopsy, and I've been trying to get educated reading "A Primer on Prostate Cancer" which I saw recommended on this board. A statement in the book is that "In the hands of a talented urologist, permanent incontinence of significant degree resulting from a radical prostecomy is uncommon (typically less than2%)". Based on your own experience, and what you've heard from others, what are your thoughts on this statement? Thank you! Calico

[Guest guest]

The figure I was quoted by my urologist was 80% no incontinence, 10% minor incontinence, 10% moderate incontinence. I had robotic prostatectomy 09/11/08, in diapers for 3-4 weeks with major leakage, then decreased to 2 pads/day, now no leakage unless I sneeze or cough hard. I don't wear pads anymore. I probably could get even more continent if I would just continue the Keagels but I've gotten lazy lately...............mizzes12 wrote: My husbad is having a prostate biopsy, and I've been trying to get educated reading "A Primer on Prostate Cancer" which I saw recommended on this board. A statement in the book is that "In the hands of a talented urologist, permanent incontinence of significant degree resulting from a radical prostecomy is uncommon (typically less than2%)". Based on your own experience, and what you've heard from others, what are your thoughts on this statement? Thank you! Calico

[Guest guest]

Calico- I had radical prostecomy 4 years ago at Hopkins, I have no problem with Incontinence y- age may be a factor? I was 48. My surgeon was a big factor, I believe. My urologist where I live preformed maybe a 20-25 of theses surgery a year, I wanted a surgeon that would perform this type of operation at least that many times a month. One that could perform it "with his eyes closed" I wore a pad once-(felt it was too bulky) leakage was so minimal I would wrap my penis with toilet paper. As for an update, I had a penile implant, although my sex drive has never been the same after operation--If I were to rate it before (1-10) --before-8...after 3--doesn't bother bother me (does my partner) Unfortunately my cancer has spread (also went thru 38 treatments of Tomo-thearapy-Radiation) Saving hormone treatment for later-(I've

been on Casodex & lupron at different times) And I have stopped getting PSA tests (too upsetting). Last PSA test was 8 months ago & my PSA was around 6--my PSA started going up about a point every4-6 weeks. When my cancer was first detected I had a PSA of 28.2 Best of luck with your decisions. Ralph-Subject: Permanent Incontinence After Radical ProstectomyTo: "Prostate Cancer Support Group" <ProstateCancerSupport >Date: Sunday, January 18, 2009, 12:13 PM

My husbad is having a prostate biopsy, and I've been trying to get educated reading "A Primer on Prostate Cancer" which I saw recommended on this board. A statement in the book is that "In the hands of a talented urologist, permanent incontinence of significant degree resulting from a radical prostecomy is uncommon (typically less than2%)".

Based on your own experience, and what you've heard from others, what are your thoughts on this statement?

Thank you!

Calico

[Guest guest]

Calico

Much depends too on where the tumour is, if it is close to the urethra then the surgeon has a more difficult job to do.

You might ask the question about the biopsy result - this may affect your choice of treatment. I say your I mean both of you.

I had a tumour close to the urethra and have had slight incontinence for 12 years ( it improved after 6 months) , recently it has slipped back and I have gone back to wearing an external sheath catheter.

A funny thing happened today - we had taken my daughters dogs for a long walk. We returned to Jude and Tom's 's house at Wistow, I took off my boots and was sat is her (fortunately wooden floored) sitting room, drinking Dandelion and Burdock fizzy drink. The Patterdale terrier jumped on my lap and in a while decided she wanted to be near Jude, in jumping down she caught the tap on the legbag and let out about 100 to 200 mls of urine, the dog got the blame as we mopped up and returned back to Hambleton to change.

Indications this week is that the Zoledex/Diethylstilbesterol combination isn't working any longer - PSA gone up from 20 to 40 - will discuss a scan before I see the consultant with the Macmillan Urology specialist nurse

Permanent Incontinence After Radical Prostectomy

My husbad is having a prostate biopsy, and I've been trying to get educated reading "A Primer on Prostate Cancer" which I saw recommended on this board. A statement in the book is that "In the hands of a talented urologist, permanent incontinence of significant degree resulting from a radical prostecomy is uncommon (typically less than2%)".

Based on your own experience, and what you've heard from others, what are your thoughts on this statement?

Thank you!

Calico

[Guest guest]

I had LRP in late October at s Hopkins. Post op, I had some difficulty with the catheter clogging up many times. One time in an emergency room, less than a week from surgery, I had the "nurse from hell", try to unclog the catheter. She GREATLY extended my bladder and the muscles down there to where I was in great pain. The urologist in the ER said she should not have done it. Anyway, I am 58 and was in good health with both urinary fuinction and sexual fiunction prior to the surgery. ( post surgery gleason 3+4

=7, negative surg margins, and negative lymphnodes, and first PSA <.1. )

I am now almost 3 months out and am incontinent. I have some control when in bed or sitting, but need to go immediately to the bathroom on standing. During the day I have little to no control. It is disturbung to say the least. Diapers are not my ideal.

As far as impotence, I feel I will do better over time. Yes I have shrinkage like everyone else. However, with viagra I can get an erection - not great but OK. Mainly get it best and hardest while standing up. Hopefully it will improve over time. Wondering if frequent attempts at mastubrbation would help. Even if it doesn't, can I try anyway?? (lol)

Anyway, my surgeon has not offered any help post op.. My local urologist wants me to take viagra 2x a week and try a pump. Not much for gadgets, but will give it a try ....sometime soon.

Anyway, everyone should realize the facts. Everyone is different and everyones results will be different. Yes it is the skill of the surgeon, but that is just one part of the many factoral equation. Factoring everything in, some of us do better and some of us don't.

I am hoping I will continue to improve. Right now I am keeping the depends people employed and allowing some Pfizer people to keep their jobs.

Subject: Permanent Incontinence After Radical ProstectomyTo: "Prostate Cancer Support Group" <ProstateCancerSupport >Date: Sunday, January 18, 2009, 12:13 PM

My husbad is having a prostate biopsy, and I've been trying to get educated reading "A Primer on Prostate Cancer" which I saw recommended on this board. A statement in the book is that "In the hands of a talented urologist, permanent incontinence of significant degree resulting from a radical prostecomy is uncommon (typically less than2%)".

Based on your own experience, and what you've heard from others, what are your thoughts on this statement?

Thank you!

Calico

[Guest guest]

> As far as impotence, I feel I will do better over time. Yes I

> have shrinkage like everyone else. However, with viagra I can

> get an erection - not great but OK. Mainly get it best and

> hardest while standing up. Hopefully it will improve over

> time. Wondering if frequent attempts at mastubrbation would

> help. Even if it doesn't, can I try anyway?? (lol)

There is a theory that says Use it or Lose it. Some people

claim that atrophy can set in in any organ that is never used.

If your urologist is suggesting viagra and a pump it sounds like

he believes in that theory as well.

Alan

[Guest guest]

> As far as impotence, I feel I will do better over time. Yes I

> have shrinkage like everyone else. However, with viagra I can

> get an erection - not great but OK. Mainly get it best and

> hardest while standing up. Hopefully it will improve over

> time. Wondering if frequent attempts at mastubrbation would

> help. Even if it doesn't, can I try anyway?? (lol)

There is a theory that says Use it or Lose it. Some people

claim that atrophy can set in in any organ that is never used.

If your urologist is suggesting viagra and a pump it sounds like

he believes in that theory as well.

Alan

[Guest guest]

Don't give up, I had major leakage after my robotic prostatectomy on 09/11/08. I was in diapers for at least a month, called the surgeon/urologist to complain, he said, "be patient." I kept doing Keagels daily, gives you something to do to keep your mind off of your problem. GRADUALLY the leakage decreased, gave up the diapers and went to 2 pads/day after about a month, then it went down to nothing at all in December! I thought it was never going away but it did. As for ED, doing penile rehab, daily small dose of Viagra, penile injections 2x/wk. Can have sex with wife with orgasms 2x/wk with bimix/trimix. Ye old penis seems to have a slight curve to it, somewhat concerned with Peyrione's Disease. First post-op PSA=.01. Second PSA this month. Things do get better with time..............direkcom wrote: I had LRP in late October at s Hopkins. Post op, I had some difficulty with the catheter clogging up many times. One time in an emergency room, less than a week from surgery, I had the "nurse from hell", try to unclog the catheter. She GREATLY extended my bladder and the muscles down there to where I was in great pain. The urologist in the ER said she should not have done it. Anyway, I am 58 and was in good health with both urinary fuinction and sexual fiunction prior to the surgery. ( post surgery gleason 3+4 =7, negative surg margins, and negative

lymphnodes, and first PSA <.1. ) I am now almost 3 months out and am incontinent. I have some control when in bed or sitting, but need to go immediately to the bathroom on standing. During the day I have little to no control. It is disturbung to say the least. Diapers are not my ideal. As far as impotence, I feel I will do better over time. Yes I have shrinkage like everyone else. However, with viagra I can get an erection - not great but OK. Mainly get it best and hardest while standing up. Hopefully it will improve over time. Wondering if frequent attempts at mastubrbation would help. Even if it doesn't, can I try anyway?? (lol) Anyway, my surgeon has not offered any help post op.. My local urologist wants me to take viagra 2x a week and try a pump. Not much for gadgets, but will give it a try ....sometime soon. Anyway, everyone should

realize the facts. Everyone is different and everyones results will be different. Yes it is the skill of the surgeon, but that is just one part of the many factoral equation. Factoring everything in, some of us do better and some of us don't. I am hoping I will continue to improve. Right now I am keeping the depends people employed and allowing some Pfizer people to keep their jobs. From: mizzes12 <mizzes12>Subject: Permanent Incontinence After Radical ProstectomyTo: "Prostate Cancer Support Group" <ProstateCancerSupport >Date: Sunday, January 18, 2009, 12:13 PM My husbad is having a prostate biopsy, and I've been trying to get educated reading "A Primer on Prostate Cancer" which I saw recommended on this board. A statement in the book is that "In the hands of a talented urologist, permanent incontinence of significant degree resulting from a radical prostecomy is uncommon (typically less than2%)". Based on your own experience, and what you've heard from others, what are your thoughts on this statement? Thank you! Calico

[Guest guest]

Besides doing the Kegels exercises, my urologist prescribed

Vesicare 5mg daily and it seems to be working very well.

Domenico

mizzes12 wrote:

Thank you to everyone who weighed in on this. It sounds

like the concensus is, if surgery has to be done, get the most

experienced surgeon you reasonably can, do your Kegels, keep reasonable

expectations, be patient, and hope for the best. All good and reasoned

advice.

Thanks again!

Calico

[Guest guest]

I also did Kegels before and after surgery and had only minor problems for a few months. A friend who had an RP in April 2008 was in diapers since.

I received the following yesterday -

" Just a quick note to let you in on the great news Dr. Oakes put me on Detrol la it will be 3 months in Feb/09 & around the 5 & 6 of Jan. I started getting bladder control it's not all back but it's slowly getting there. "

Besides doing the Kegels exercises, my urologist prescribed

Vesicare 5mg daily and it seems to be working very well.

Domenico

mizzes12 wrote:

Thank you to everyone who weighed in on this. It sounds

like the concensus is, if surgery has to be done, get the most

experienced surgeon you reasonably can, do your Kegels, keep reasonable

expectations, be patient, and hope for the best. All good and reasoned

advice.

Thanks again!

Calico

[Guest guest]

I also did Kegels before and after surgery and had only minor problems for a few months. A friend who had an RP in April 2008 was in diapers since.

I received the following yesterday -

" Just a quick note to let you in on the great news Dr. Oakes put me on Detrol la it will be 3 months in Feb/09 & around the 5 & 6 of Jan. I started getting bladder control it's not all back but it's slowly getting there. "

Besides doing the Kegels exercises, my urologist prescribed

Vesicare 5mg daily and it seems to be working very well.

Domenico

mizzes12 wrote:

Thank you to everyone who weighed in on this. It sounds

like the concensus is, if surgery has to be done, get the most

experienced surgeon you reasonably can, do your Kegels, keep reasonable

expectations, be patient, and hope for the best. All good and reasoned

advice.

Thanks again!

Calico

[Guest guest]

I also did Kegels before and after surgery and had only minor problems for a few months. A friend who had an RP in April 2008 was in diapers since.

I received the following yesterday -

" Just a quick note to let you in on the great news Dr. Oakes put me on Detrol la it will be 3 months in Feb/09 & around the 5 & 6 of Jan. I started getting bladder control it's not all back but it's slowly getting there. "

Besides doing the Kegels exercises, my urologist prescribed

Vesicare 5mg daily and it seems to be working very well.

Domenico

mizzes12 wrote:

Thank you to everyone who weighed in on this. It sounds

like the concensus is, if surgery has to be done, get the most

experienced surgeon you reasonably can, do your Kegels, keep reasonable

expectations, be patient, and hope for the best. All good and reasoned

advice.

Thanks again!

Calico

[Guest guest]

Hi Calico,

I had surgery over 2 years ago, Dec 76. I was very incontinent for a very long time. At first I could hardly stand without feeling like a water fall. But over time I have greatly improved. Although I do still have incontinence, I am learning to live with it, and I'm still improving even after such a long time. As of right now, I can generally go through most of the day pretty dry. By evening, if I do much standing, I will start leaking and can't stop unless I set down for a short period of time. I also have stress incontinence when I pick up heavy objects etc...

My doctor is an experienced surgoun. But everyone heals differently, and at different rates. I hope that one day (soon) I will be able to leave the pads behind.

Good luck to you both

Jack

Permanent Incontinence After Radical Prostectomy

My husbad is having a prostate biopsy, and I've been trying to get educated reading "A Primer on Prostate Cancer" which I saw recommended on this board. A statement in the book is that "In the hands of a talented urologist, permanent incontinence of significant degree resulting from a radical prostecomy is uncommon (typically less than2%)".

Based on your own experience, and what you've heard from others, what are your thoughts on this statement?

Thank you!

Calico

[Guest guest]

The statement is probably true.

Most of us have some level of incontinence shortly after surgery. It

usually improves with time, and pelvic-floor-muscle exercises ( " Kegel

exercises " ).

We usually don't return to " full pre-surgical continence " . And

conventional bicycle seats are a problem for many of us.

I'm 13 months post-surgery, and I can hike or take fitness classes

without worrying. I think that's typical. " Good enough for jazz " , as

the musicians say.

>

> My husbad is having a prostate biopsy, and I've been trying to get

educated reading " A Primer on Prostate Cancer " which I saw recommended

on this board.  A statement in the book is that " In the hands of a

talented urologist, permanent incontinence of significant degree

resulting from a radical prostecomy is uncommon (typically less

than2%) " . 

>  

> Based on your own experience, and what you've heard from others,

what are your thoughts on this statement?

>  

> Thank you!

>  

> Calico

>

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Incontinence...

At age 56, Robotic RPP 7/06 at s Hopkins. Pre-op PSA 3.2

Post Op analysis: gleason 3+3. Severe incontinence immediately post op.

leakage around the catheter. Kegels, bio-feedback, physical therapy, and still

lost ca 1 quart of urine per day. Generally a mess.

12/07, AdVance Sling installed at Duke U Hospital.

94% immediate improvement. Gradual decrease in continence currently.

Am scheduled for second sling installation in May, 09. Can always go to artificial

sphincter if it comes to that.

PSA <0.1 since surgery. That's the one redeeming factor in this otherwise wet world I live in.

Family, relationships, business are all good. So in the overall scheme of things, I'm going to be grateful.

Every success with your surgery. Fortunately, there are remedies available to deal with the ancillary effects.

Best,

Hans

To: ProstateCancerSupport Sent: Monday, January 19, 2009 2:10:23 PMSubject: Re: Permanent Incontinence After Radical Prostectomy

Hi Calico,

I had surgery over 2 years ago, Dec 76. I was very incontinent for a very long time. At first I could hardly stand without feeling like a water fall. But over time I have greatly improved. Although I do still have incontinence, I am learning to live with it, and I'm still improving even after such a long time. As of right now, I can generally go through most of the day pretty dry. By evening, if I do much standing, I will start leaking and can't stop unless I set down for a short period of time. I also have stress incontinence when I pick up heavy objects etc...

My doctor is an experienced surgoun. But everyone heals differently, and at different rates. I hope that one day (soon) I will be able to leave the pads behind.

Good luck to you both

Jack

[ProstateCancerSupp ort] Permanent Incontinence After Radical Prostectomy

My husbad is having a prostate biopsy, and I've been trying to get educated reading "A Primer on Prostate Cancer" which I saw recommended on this board. A statement in the book is that "In the hands of a talented urologist, permanent incontinence of significant degree resulting from a radical prostecomy is uncommon (typically less than2%)".

Based on your own experience, and what you've heard from others, what are your thoughts on this statement?

Thank you!

Calico

[Guest guest]

Incontinence...

At age 56, Robotic RPP 7/06 at s Hopkins. Pre-op PSA 3.2

Post Op analysis: gleason 3+3. Severe incontinence immediately post op.

leakage around the catheter. Kegels, bio-feedback, physical therapy, and still

lost ca 1 quart of urine per day. Generally a mess.

12/07, AdVance Sling installed at Duke U Hospital.

94% immediate improvement. Gradual decrease in continence currently.

Am scheduled for second sling installation in May, 09. Can always go to artificial

sphincter if it comes to that.

PSA <0.1 since surgery. That's the one redeeming factor in this otherwise wet world I live in.

Family, relationships, business are all good. So in the overall scheme of things, I'm going to be grateful.

Every success with your surgery. Fortunately, there are remedies available to deal with the ancillary effects.

Best,

Hans

To: ProstateCancerSupport Sent: Monday, January 19, 2009 2:10:23 PMSubject: Re: Permanent Incontinence After Radical Prostectomy

Hi Calico,

I had surgery over 2 years ago, Dec 76. I was very incontinent for a very long time. At first I could hardly stand without feeling like a water fall. But over time I have greatly improved. Although I do still have incontinence, I am learning to live with it, and I'm still improving even after such a long time. As of right now, I can generally go through most of the day pretty dry. By evening, if I do much standing, I will start leaking and can't stop unless I set down for a short period of time. I also have stress incontinence when I pick up heavy objects etc...

My doctor is an experienced surgoun. But everyone heals differently, and at different rates. I hope that one day (soon) I will be able to leave the pads behind.

Good luck to you both

Jack

[ProstateCancerSupp ort] Permanent Incontinence After Radical Prostectomy

My husbad is having a prostate biopsy, and I've been trying to get educated reading "A Primer on Prostate Cancer" which I saw recommended on this board. A statement in the book is that "In the hands of a talented urologist, permanent incontinence of significant degree resulting from a radical prostecomy is uncommon (typically less than2%)".

Based on your own experience, and what you've heard from others, what are your thoughts on this statement?

Thank you!

Calico