Leakage after Radical Prostatectomy

My leakage comes out of the blue. Move a certain way or just wait a little too long. I walked a couple of miles today, no problems. But we were inside and had a bathroom.

Oh, that's me. I went to see the physio a week after the catheter came out. Struggled to get out of the waiting room chair & struggled to walk. "Are you in pain?" "No... I just pee every time I take a step".

It's taking quite a toll on my mood, to be honest. So disheartening. And after 3 visits, I still can't do Kegels. Trying to do them at home, I first pulled a muscle in my back & after the second visit, I have major pain right at the muscle above the sit bones. I can barely move, have pain any time I try to sit & had Tramadol last night just to get to sleep.

Sorry I couldn't be more positive, but know that you're not alone & it's normal.

It can take months and months to regain continence. Persistence with PROPER Kegels is the key. It took me a year to regain and it was slow but steady improvement

I am on my 10 th week post surgery. Leakage happens when I lift something up and walking.
Laying down not so much. It is a slow and steady process.
Good luck!

I had surgery almost 2 years ago. About 4 months post-surgery, continence began to improve rapidly for me. At that time, my surgical team told me that 4-5 months was the typical time for incontinence to begin improving. I wish they had told me sooner.

Be patient, and good luck !!
Jim

thanks Jim - good to hear there is hope down the road -

My LRP was 08/23/2023... (63 years old) ... catheter out 10 days later... immediate leakage. Ended up with UTI - probably had it when catheter was still in. Antibiotics. It cleared up. Leakage was a big problem. Purchased depend products - full pant initially, then guards, then shields... used Depends brand and Tena (more comfortable), but I generally dislike all of them as they have to have plastic backing which causes sweat, chafing, discomfort.... When I went for walks (avid hiker and mountain biker with 2 large, exercise-hungry dogs) I tried a bunch of crazy stuff - including using a ziplock bag zipped tight around penis in loosely-worn, but supportive underwear (not a great solution). Also used a small yogurt container positioned strategically inside supportive underwear (also not a great solution).. They sort of worked - but this lets you know how bad my leakage was and how desperate I was for a solution.
I went to a pelvic floor physiotherapist to ensure I was "kegel'ing" properly. I was - but this visit was well worth it. I purchased a red light therapy panel and use it daily while doing kegel exercises.
Slowly... very slowly it seemed, things began improving. I now rarely use any Depends products. I bought several "Uri_Male" fabric inserts (on amazon) for underwear (which are more comfortable and washable). It has been 13 months since catheter removal and I am back riding mountain bike (I had considerable perineum pain for MONTHS after surgery and couldn't sit on a bike seat), hiking and travelling. There is still some minor leakage, but controllable and manageable for the most part. I have never stopped kegels. I still use the red light panel almost daily. I drink lots of water to keep things moving. I sleep all night with no pads or anything (gravity doesn't kick in the same way when lying down, or sitting - I find). Walking/hiking is always a minor challenge. I use "timing" (i.e., I drink tons of water, etc., first thing in the morning and allow a couple hours for processing before heading out. And I go when I feel I need to. There is still some "stress incontinence" - but when I think back to a year ago, when I was trying ziplock bags and yogurt cups - I have come a thousand miles. It will get better - but it is work - and I don't think the work or management ever ends. You'll be good. Hang in. It gets better!

Bottom line is it depends... Both on your age and your physicality, but based on what i was told after my RALP, yes, you're expecting too much too soon. According to what i was told, this can be an issue for several months (for me, it gradually improved over the course of 2 to 2.5 months, im 52 and in good health). Kegels work, but dont overdo them. Take your time and dont let it frustrate you. You'll notice it gradually improving.

RALP 12-2024.

There's an app for that - KPFL

I was really disheartened for the first few months - it gets better.

Still not out of the woods, but thankful for so many things.

Good luck & happy recovery!

I am 71 years old and had a RP at age 69. Was recommended the following book by my urologist: Life After Prostatectomy by Vanita Gaglani RPT. It's available on Amazon. It is a very detailed book to give you a 10 week step-by-step guide in how to become continent again. There is no guarantee that any of us will achieve total continence but it can be improved. It helped me.

She explains the reasons for incontinence and how to overcome each of them. Doing proper Kegels is only a small part of the process. The pelvic floor muscles strengthened with Kegel's are only a part of the body core and all need to be strengthen in unison. She also talks about diet and its role in maintaining continence. Some fluids and foods are irritating to the bladder and promote incontinence.

One aspect of gaining continence surprised me. She talks about getting enough water intake per day-more than most people think, It's counterintuitive to think that actually taking in more water promotes less leakage. Most people try to limit fluid intake to avoid leakage. But concentrated urine causes bladder irritability and increases leakage. Also, by increasing fluid intake you are training your bladder to have a larger capacity so you don't feel to urge to go as often.

There are many other pearls and discussions. It is comprehensive. What have you got to lose? It helped me.