Stress Incontinence Running after Prostatectomy

It could be urge incontinence.

The detrusor muscle that squeezes your bladder to empty it is involuntary, and it can "learn" to start contracting at the wrong time by association with some external stimulus (some people experience it when unlocking their doors, for example).

There are lots of techniques for mitigating it. There's also a medication, Myrbetriq, that causes the muscle to relax — you might discuss it with your urologist. I had to go up from 25 mg to 50 mg before it helped me, and now (almost a year later) I'm working on titrating off it.

Hello @ssonkin I don't have a good scientific answer for this like @northoftheborder but, my experience was that of all the activities that I became able to do again from my routine, running was the last activity to return to me without causing leakage. I guess there's something about it that makes it somewhat difficult for our new anatomies.

If you're a real runner, as opposed to what I do. I'm more of a "plodder", think military shuffle, stretching out that stride may be the issue. I think I started running around 6 mos, and wore a pad or stopped to pee during the exercise (I limited myself to a treadmill in a gym initially).

On the plus side, I've come to notice that running seems to be "kegel" like to me. If I can't get to the gym for some reason for a while, I seem to slip a little.

It was a good 9 ish mos before I felt like I was really comfortable running again. I don't stretch out my stride though, think 9 min miles or thereabouts.

I'm at over two years now. If I do a flat out sprint for 100 yards, there's still likely to be a small amount of leakage. I've just accepted it as the new me.

As for the slight dribble, I still have that only occasionally now. I just use patience at the urinal and give it a good "shake" when finished to be sure there isn't any "follow up" that comes out.

I can still experience what @northoftheborder describes (urge incon...). I find it's when my body fully relaxes for some reason like after I put something heavy down. It's tough to explain. It's so minimal and my conscious reaction to stop is so fast, I don't really worry about it.

I believe we have to try to get as close as we can to where we were before we "joined the club" but to some degree, we're different now and I think it's something we have to attempt to accept.

Thanks ..north for that answer too. I'll be looking into that to see if I can improve even a little mor.

My recommendation would be to find a pelvic floor physical therapist. Both of the ones I've seen have been extremely knowledgable and understand how to diagnose and treat something like that.

I did not have an issue with prolonged UI after my prostatectomy but did experience some stress incontinence starting a year after my salvage radiotherapy. It only occurs when I get in certain positions and make certain movements, almost always at the gym. The fist episode was when I was doing some chest presses on the bench with dumbells. When I got back up from the horizontal position whatever was in my bladder came out. Fortunately I was wearing some dark colored shorts that day!

I've worn a light pad when I go to the gym since and make sure I empty my bladder when I get there. Very occasionally if I get in similar positions at home and make sudden movements getting up I can get some dripping. The PFPT I'm working with now has me doing a bunch of exercised to strengthen certain muscles thoughout my pelvic floor...not just Kegels. I was astonished to see how weak some of those muscles were when she did functional tests.

Thank you Russ777 for the above information. How does one find a pelvic floor physical therapist? Is there a special certification or designation I should looks for?

There is a certification they get from a particular class. I've forgotten what the name and location of it is but if you Google "pelvic floor physical therapist" in your area then you can see the credentials those providers have. It should be obvious.

My urologist recommended the book "Life After Prostatectomy and other urologic Surgeries; 30 days from incontinence to continence" by Gaglani.

Highly recommended. Available on Amazon. She is an experienced pelvic floor PT. She goes into great detail what to do everyday and how to progress. Achieving continence is a multifold process: 1) strengthening pelvic floor and core muscles 2) weaning off pads 3) taking in enough water/fluids-limiting fluid intake actually increases leakage because of concentrated urine in the bladder irritating the bladder; increasing bladder volume/capacity 4) eliminating the foods liquids in your diet that cause bladder irritation and promote incontinence.

I like all the examples I just saw above. Thank you.

Thank you for your information, because I don't live in the United States. Can there be online books?

Amazon Kindle version is what I read.

I also include abdominal strength exercises. I do Pilates. There are lots of good YouTube videos. It’s been 2 1/2 years since my surgery. It’s been a long journey; however, I’m grateful I’m continent and can run again, to include marathons, without any leakage. Good luck on your recovery.