← Return to Persistent urgency even after urinating, 3 months after prostatectomy

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@trusam1

The nuance I neglected to include is: trying to "hold it" *without a plan* for progressively increasing the time between voids is counter productive. The bladder will fight back, and probably start a cycle of urge incontinence. Starting out voiding on a timed basis, with the initial interval being shorter than what your bladder can currently handle is better then simply trying to bull one's way forward. That latter strategy is what I meant by "holding it". The idea is to teach the bladder who's in control...

Maybe a little review of how I understand the bladder to work would help. The bladder muscle is unusual, in that it is under both voluntary and involuntary control. The voluntary aspect which we learn when young is to increase our intra-abdominal pressure (hold your breath and bear down). This increases the pressure within the bladder, triggering an involuntary reflex causing the bladder muscle to contract, squeezing the urine out. Things can start to go haywire when something triggers that reflex without our conscious desire to have it happen, like an infection, or surgery, or the increasing inelasticity in the bladder which goes along with aging.

Before our prostate was removed, and the bladder neck (the area where the urine exits) was operated on, we had three ways to stop the urine flow in situations like those. Now, we only have one, our "Kegel" muscles. So those have to be strengthened along with teaching the bladder not to be so hyperactive.

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Replies to "The nuance I neglected to include is: trying to "hold it" *without a plan* for progressively..."

@markdebeach, I hope you saw @trusam1's helpful explanation in response to your question. How are doing with Kegel exercises and urination urgency?

One other thing my urologist/surgeon told me. When I asked him if that”urge” to urinate would decrease after my enlarged/cancerous prostate was removed, he answered that it may or may not because some people just naturally produce more urine than others. I may add that I had NO incontinence issues after surgery((I attribute that to religiously doing kegels AND an excellent surgeon). However, I still do pee a lot. I’ve been a pee-er since grade school. My former general physician told me it can be psychological. I believe that. Best to all!