Improving Incontinence Post Therapy

I was 68 when I had my RP. I experienced ED and incontinence. If I remember correctly, my incontinence gradually improved to where I was wearing a light pad and playing 18 holes of golf (walking) and I had little leakage. Unfortunately, I later pelvic radiation and my incontinence got worse again.

Urinary incontinence is due to a lot of factors, as you indicated. The book Life After Prostatectomy and Other Urologic Procedures; 10 weeks to Continence by Vanita Gaglani was recommended to me by my urologist. Available on Amazon. Terrific book. She has extensive experience in treating incontinence. The book is very detailed. Recovering is more than just Kegels. I highly recommend it.

I had my RP a year and a half ago at age 71. I was one of the fortunate one in that I had ZERO incontinence issues. I attribute it to doing Kegels religiously before and after my surgery. After reading so many others who did Kegels, At my recent Followup appointment, my Surgeon told me only 10% of RP patients have zero issues, so unfortunately, you are not alone. Based on my experience, Kegels were the answer. BTW, I did 10quick and 10/10 second movements every hour I was awake. This was after the surgery. Before, 10 quick a couple times an hour. Today, I still pee a few times a night while sleeping. But it’s much different than when I had an enlarged prostate. I don’t have that “urge” feeling, if that makes any sense. I drink tons of water which no doubt affects everything. Keep the faith, you’ll get through it!🤞

67 when I had my NS RP. Did kegels before surgery and post. And some progress but limited. Most PT's in the Boston, Mass area had limited experience treating men, post RP. Finally found one and she's been a life saver.

During the day I am dry, and only during hiking and the gym do I wear a very thin pad.

Other tip is know which foods are bladder irritants. Removing these helped with leakage.

Good luck.

I would suggest getting your bicycle seat fitted to your sit bones, if you haven't done so yet. Many local bike shops have sit boxes to assist with that situation. I ride a good quality seat that fits me properly that has a cut out which is easier on the urethra. While tough, movement is too important to not do so. I wish I could nap.

I am using a recumbent exercise bike and put a pad on top of the hard seat that has a cut out (the big pad is sort of horse-shoe shaped). Maybe I will try bike shorts next time. The plan now is to re-try my test in another 3 weeks.
However I am concerned that I may be offsetting progress with continence because the bike riding really sets me back although it feels great
This is one of my questions for this group.
Is it better to try to take it easy. do not push things, try to get a handle on stress incontinence and bladder re-training and just give it time
Or is it just as good to try to do many of the normal things despite leaking a good portion of the time? There is value in doing the normal things. However, i do not want to push things if this will compromise my overall progress. I really want this incontinence to go away or at least significantly diminish. as an example, on days without using the recumbent exercise bike< I can go for a short 20-30 minute walk with minimal leakage (especially if it is in the earlier part of the day) However, if I go on a second walk later in the day, I am leaking fairly regularly. If I had rode the bike. I would leak with every single step

Big trade off for me. I used to start every day with 30-40 minutes on the bike, then a cup of coffee and then nonstop activity all day until after dinner. Now I am going slow, thinking about incontinence half the day
It may be I just have to wait this out and keep going slow.
I would not change anything I have done and do not regret the surgery. It probably added at least ten years to my life

However I remember asking what recovery was like and how soon I could go back to work. I was told that a lot of guys go back to work in two weeks. I was sort of expecting that or maybe 3-4 weeks since I am older. However, three months out and I am really not back to work, maybe 1/4 at this point. I do not want to be around others in public knowing I am leaking

Thanks Kjacko
I appreciate a 71 y.o chiming in.
1. If I thought doing kegels every hour would help I would do them ( no offense) but I have been warned repeatedly that less is better, and I know for a fact that the two sets a day I am doing is fatiguing them some ( they get hot, fixed/stuck and a little painful . THis really is an area that could use some attention. I did some research and discovered that even the urological and scientific community has a recommendation in terms of how many kegels a day to do. I am doing two sets a day, One set of five steps (1/3, 2/3 and 3/3 up and then down, then 6 long ones followed by four sets of quick ones. I also do stretches and care exercises
Like you I had an enlarged prostrate than a cancerous prostrate ( and now no prostrate)
I do have a question about water intake
* prior to my surgery, I drank too little water, sometimes a cup of coffee in the morning and maybe nothing else all day. I remember my PCP telling me she could tell by my labs. I am not saying this is good. I should have been hydrating more. And I was very active.
* now I am told to drink half my weight in fluid ounces ( about 90 ounces a water day and stop a couple of hours before I go to bed. I have tried doing this and spacing it out but my bladder gets full in an hour sometimes. I believe my bladder size is probably normal. I am drinking more than water than before, maybe 40-50 ounces (which is more for me) but not 90 it seems impossible. Haas anyone else had any experience with this. and by the way Kjacko I am really happy that you did not have to deal with the incontinence thanks for taking the time to share your experience

Hi Edin. I am drinking more water than ever. At a couple of my yearly physicals it indicated that I was dehydrated. I never was told to drink half my weight but to increase my intake. I did read one report that recommended 24 ounces when you you wake up in the morning. My recent physical indicated no problem with hydration. My surgeon told me a couple of things: 1. Some people just produce more urine than others(that’s me, been that way since I was a kid). He also told me that my bladder may be a little bit softer since my surgery and that could contribute to my peeing issues. Like I said, I still get up a couple times at night, but it’s because I’m a light sleeper and then just go rather than the urge issue I had with my enlarged prostate. Again, best wishes.

The good news is they wouldn't be aware of it. You must have a great employer.

I am mainly self-employed however I also teach part time. I will not be in a classroom like this. I could do some other things but not that while incontinent

Thanks K
I mkay be like you in some regard

how much water do you think you drink the rest of the day after the 24 ounces?