Robotic Prostatectomy 9 months ago total Incontinence still.

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I had Robotic Prostate removal 9 months ago after having a TURP 18 months before that. Advised it could take up to 12 months to get rid of Incontinence but as I still get regular UTI's I think it is getting worse as can fill 6 thick pads a day and have no feeling when I am urinating or need to go, but have to drink plenty to help UTI's. Even when I go to the toilet I am leaking urine out when I remove pads and can soak my trousers, plus can leak even after going to toilet and tests show 60 ml retention that they do not worry about. I do my Kegel exercises and my Physio has checked and they work. Drs think extra stitches put in because of TURP may be infected as UTI's should have disappeared after Prostate was removed. Getting so down with this now and can't see a future, welcome any advice.

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  • Posted

    Hi there,

    I had a TURP in early 1996 which found cancer and this was taken out under the old fashioned Radical Prostatectomy in November 1996. I had to wear a catheter for 3 weeks but when it was removed I was ok. However 6 years later my PSA count started to rise again so I had to undergo 37 visits for radio therapy. It is now stable but I cant hold on to my water very long when needing to go. This is aggravated now having to take tablets to reduce body fluid. Everything I have tried to build up the retention muscles have not worked so its just a case of having to live with it. I understand that you can have a contraption like a catheter but it fits like a sheath rather than being internal. This is worth investigating. Good luck and keep your chin up.

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    • Posted

      Big Teddy, I have used the sheath system but was advised it was not the best way to build control and told that I would be reviewed at 12 months. Just cannot understand why I had better control after the op than now.

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  • Posted

    Hi!!!

    Enlargement of the prostate and Prostate Cancer is now pretty much the most serious medical issue of our day and receives so little research, data collection, equipment spending, proper choices and support. In Australia anyway. There is so much they don’t know and don’t want to. The more you research post-prostatectomy (mine November 2015 at 72) the more disillusioned you get. I am now in my 4th year of incontinency.

    Active I leak almost everything that exits the kidneys without knowledge or feeling. Inactive I am almost normal. I am somewhat overweight and have type 2 diabetes. Knees and many other joints are osteo affected. Kegal physio was pretty useless. I read of internal sphincter devices and external clamps etc but urology made no mention of these. Just “how many pads”. There is slight improvement over the years and I live in hope.

    It seems obvious many things contribute to return of urinary control. Or not. Age, fitness, other complaints, medication history, surgery outcome etc. Post op a straighter, shorter urethra without a prostate and possible damage to sphincter and reconnection to bladder make it all more difficult.

    My BPH went on from 1990 and was treated with drugs to relax sphincter from 2006 to 2015. Dutasteride 2013/14 failed to reduce prostate size as promised and then PCa in 2015. I was not told of the benefits of RARP and a post-op (open RP) blockage was mistreated due to hospital incompetence. Polymyalgia Rheumatica (PMR) followed and they don’t know if this is related to PCa or surgery and treatment suppresses the immune system which is our natural cancer fighter.

    Obviously I converse with other PCa sufferers and most get to an acceptable level of continence. Incontinence is age related though and we will no doubt have lesser prospects in this regard with our reduced bits.

    My PSAs post-op have so far all been 0.01 or 0.02 so I’m lucky so far in that respect. My main worry is a return to untreatable fungal infections and PMR is an issue there too. They also don’t know the full impact of the loss of the prostate gland and the bits that go with it and it’s difficult to know whether the differences we feel relate to that or just another part of the aging process. The one thing that does help is to get it off your chest once in a while and here is the best place as others have a choice to just stop reading and you still get the benefit.

    Good luck and better control going forward.

    Barrie

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    • Posted

      Barrie, Thanks for your reply which is very interesting. I did think removal of the Prostate would rid me of UTI's as I was assured, but not so. Also got another infection from below foreskin and there seems no interest by Infectious Diseases in investigating these problems. Concentration appears to be in Prostate removal but little dealing with bad after effects. There does not appear to be any investigations being done on UTI's and as I have had Sepsis I feel I have never really got rid of it.

      Just have to hope things improve but currently feel as though I am going backwards with night sweats again.

      David

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  • Posted

    I am sorry to hear of your problem.

    Without TURP in the mix, I would say that there are say 10 % of patients who at 12 mths are still incontinent. But adding your TURP procedure, then incontinence at 9 months may be expected.

    You should discuss the following options with a leading urological surgeon, ideally one affiliated with a teaching hospital:

    pelvic floor muscle exercises;

    avoid known bladder irritants, such as caffeine and alcohol; and

    investigate endoscopic management and urethral bulking agents.

    Good luck.

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  • Posted

    Barney, I am dealing with one of the top surgeons in Scotland but frankly I feel they are clutching at straws and hoping things will improve by the magical 12 months.

    I also have a good Incontinence Physio who checks my pelvic floor muscles and they are working. At present waiting for another Colonoscopy, but feel I need help from Drs to eliminate infections as they are holding me back and I don't think having Sepsis has helped me in this area.

    David

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