Persistent urgency even after urinating, 3 months after prostatectomy

Posted by bcer85 @bcer85, Aug 20 6:48pm

My prostatectomy was 3 months ago. My incontinence has been complicated by an unrelenting urgency to pee. Oddly, it's most acute right after emptying my bladder. Throughout the day I can't help feeling the need to rush to the toilet, so I think about it all the time. I fall asleep only with a sleep medication. It seems to be getting worse. It's debilitating. I never had this problem prior to surgery. I've been told this kind of urgency is not normal. My urologist performed a cystoscopy but found no physical cause and had no explanation. He recommended I double my dosage of Mirabegron for an overactive bladder. I'll do that, but frankly I've noticed little, if any, relief from this med. He also suggested seeing a pelvic floor therapist (I've already been doing kegels) and considering botox injections for the bladder. Has anyone else had a similar experience? Did you find a way to get some relief? Should I seek a second opinion from another urologist?

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Sorry for your situation. There is hope!

I strongly and respectfully suggest pelvic floor therapy. I’m in the middle of it right now and it’s already made a huge difference. I thought I was doing kegels correctly and I found out I wasn’t. I was getting up 3-5 times a night and only get up once. I also had horrible urgency that made life difficult. Now I can last over 2-1/2 hours and seldom have urgency,

You’re going to do great! Good luck!

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I had a similar reaction a year after radiation. A urinary-tract infection could cause that (among other things).

I hope you feel better soon.

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Yes I to have had this problem feeling to need to pee all the time. Even right after going 5 minutes later feel need to go again. I to had the camera into the bladder and everything was good even said I have good muscle control. My bladder is smaller doctor said. Medication including mybetriq helped but only a little. I am now on Gemtesa it helps quite a lot I would say it helps a lot. The next step for me would be bladder Botox if Gemtesa did not work but I am do well on Gemtesa. Prostatectomy was 14 months ago. Hope this helps

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@robertmizek

Sorry for your situation. There is hope!

I strongly and respectfully suggest pelvic floor therapy. I’m in the middle of it right now and it’s already made a huge difference. I thought I was doing kegels correctly and I found out I wasn’t. I was getting up 3-5 times a night and only get up once. I also had horrible urgency that made life difficult. Now I can last over 2-1/2 hours and seldom have urgency,

You’re going to do great! Good luck!

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Rob, Does your therapy consist of pelvic tilts? I’ve read that it’s the ‘best’ type of therapy.
Also, how can you do a kegel wrong? I was told to make believe you don’t want to fart in a crowded elevator - although it makes more sense if there’s only ONE other person in there with you.😆
So am I doing it wrong as well? It’s basically the contraction and relaxation if the external anal sphincter, isn’t it?

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Bladder spasms can be like this. They make meds to help. Twice per day stopped mine. Ask urologist about spasms and if you may have them and how to control them.

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@heavyphil

Rob, Does your therapy consist of pelvic tilts? I’ve read that it’s the ‘best’ type of therapy.
Also, how can you do a kegel wrong? I was told to make believe you don’t want to fart in a crowded elevator - although it makes more sense if there’s only ONE other person in there with you.😆
So am I doing it wrong as well? It’s basically the contraction and relaxation if the external anal sphincter, isn’t it?

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Hi Phil. No pelvic tilts. The way, I understand it, there are a bunch of small muscles in the area. The ones that control urine flow are not the same ones that control the anal sphincter but they are in the vicinity. They are the ones that allow you to stop your flow of urine. Those are the ones that have got to be worked on to get the best results and they fatigue easily until they get stronger. My PT also had me learn diaphragmatic breathing and incorporate that into the Kegel. That’s when I got the most benefit when I incorporate diaphragmatic breathing into doing a Keagle. She gave me a set of exercises to do that include long twitch and the short twitch muscles. That has been a game changer. She also gave me strategies to retrain my bladder to overcome emergency. That’s been helpful too.

My PT was able to put her fingers carefully on a couple spots on my perineum an could tell what muscle groups were being activated in a Kegel And guide me towards making certain that I was activating the correct ones.

Good luck on your journey!

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@robertmizek

Hi Phil. No pelvic tilts. The way, I understand it, there are a bunch of small muscles in the area. The ones that control urine flow are not the same ones that control the anal sphincter but they are in the vicinity. They are the ones that allow you to stop your flow of urine. Those are the ones that have got to be worked on to get the best results and they fatigue easily until they get stronger. My PT also had me learn diaphragmatic breathing and incorporate that into the Kegel. That’s when I got the most benefit when I incorporate diaphragmatic breathing into doing a Keagle. She gave me a set of exercises to do that include long twitch and the short twitch muscles. That has been a game changer. She also gave me strategies to retrain my bladder to overcome emergency. That’s been helpful too.

My PT was able to put her fingers carefully on a couple spots on my perineum an could tell what muscle groups were being activated in a Kegel And guide me towards making certain that I was activating the correct ones.

Good luck on your journey!

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Thanks Rob, good to know!

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@budisnothome

Bladder spasms can be like this. They make meds to help. Twice per day stopped mine. Ask urologist about spasms and if you may have them and how to control them.

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Just to second the note about bladder spasms. I had similar problem after Robotic surgery. Meds reduced the urgency.

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@robertmizek

Sorry for your situation. There is hope!

I strongly and respectfully suggest pelvic floor therapy. I’m in the middle of it right now and it’s already made a huge difference. I thought I was doing kegels correctly and I found out I wasn’t. I was getting up 3-5 times a night and only get up once. I also had horrible urgency that made life difficult. Now I can last over 2-1/2 hours and seldom have urgency,

You’re going to do great! Good luck!

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I can't tell you how encouraging your text is. My urologist had recommended this type of therapy, but I wasn't at all optimistic. I was really discouraged. Your experience gives me new hope. So, I Immediately made an appointment with a specialist. May I ask how long your program is supposed to be?

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Good for you! I bet it will make a positive difference for you.

A total of eight sessions lasting one hour each is what the plan is. They are one week apart. I finished session 2 yesterday and I cannot tell you how amazed I am at the progress that I’ve made in that short period of time.

I just came home from a 2 mile hike in the woods on very hilly terrain. This is the first time I was able to walk the whole thing without leaking or wearing a pad for safety.

Keep us posted on your process and don’t hesitate to post a message. If you have any questions. Good luck on your journey. I bet you’ll do great.

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