Leaking now thirteen years later

Since you have not had radiation, you can have the ProACT Device installed to stop your leaking. People who have had it done, in this forum, have found it to be extremely successful.

I’ve had radiation as well as surgery, which hardens the urethra. As a result, I have to use the AUS (Artificial urinary sphincter) Which does the same sort of thing But it is more complex device and requires you squeeze a button in the scrotum in order to pee.

Check with a urologist that does ProACT. You should be very pleased with it. You don’t have to squeeze a button to pee, you do it normally. You do want somebody that is very experienced in installing the device.

I'm 79 y.o. Had a radical Prostatectomy in 1995 followed a year later with salvage radiation. I didn't have urinary issues until around 2017. Then I had to use light drips and dribble pads. When my PSA started to rise in 2022 I was put on Lupron. One of the side effects is muscle loss. As a urinary sphincter is a muscle and leakage became worse. Had to use heavy pads and subsequently a penile clamp along with the heavy pads.
I had AUS surgery in October and couldn't be happier.
It's not a fun trip but what a ya gonna do?
I had pelvic floor rehab that didn't do much but might be something for you to follow up on.
Hope all works well for you.

I had a RARP in 2015. Urinary leakage never got better than one or two pads a day (more on stressful days). From the get go, my urologist offered to perform a urinary sling surgery (outpatient) when I wanted it. Finally had the surgery in 2023. Instantly became 100% continent. Lots of post-op swelling that was pretty ugly, but not painful, and it resolved in a couple weeks. Looking back, I wish I had done that surgery sooner. Changed my life so much for the better

Last fall I went through 8 weeks of radiation therapy for a local recurrence. I have a few drips every now and then, but still don’t wear pads even though I was told to expect some incontinence. So, the sling surgery really was a miracle fix for me.

I’ve attached on information sheet that my urologist provided about the male sling.

There definitely are ways to treat urinary incontinence!

After 13 years, I would be inclined to say that your leakage may be a sign of aging. Do you recall your father's history with leakage after his prostatectomy? If he had it (and shared that with you), did it also start more than a decade after his prostatectomy? Your age of 67 seems a bit young for incontinence to start, but, it could be a normal sign of aging "for you", after 13 years of no issues. It is certainly worth an appointment with a urologist who will write you a prescription for Pelvic Floor Physical Therapy (PFPT), that will help you regain continence. I went through it for eight sessions after my surgery. It helped tremendously. Good luck to you.

@denkea
I am following an extremely similar situation to what you describe. Had surgery in 2010 and in 2014 had salvage radiation. Six years later, I started having some leaking problems, but it wasn’t much. Over the years, it has gotten worse to the point I really don’t want to go anywhere where I’m away for more than two hours without access to a bathroom to change pads.

April 2 I will have an AUS installed, wish it was sooner.

@jeffmarc
Jeff, I know exactly what you are going through. How about years wearing nothing but black trousers/shorts so if I leaked it would show too much.
Once you get the AUS done it will bel like life altering for the good.
Good luck. April is just around the corner.

I do appreciate your thoughts and comments. Have scheduled an appointment with Penn Medicine to discuss. I’m curious what the difference is between a sling and AUS and who is a candidate for the procedures?

@cebakes
If you have not had radiation, a sling may work for you. It is not nearly as effective as an AUS. If you have a serious problem with incontinence using up multiple pads a day, it’s not the solution.

As I mentioned, if you have not had a radiation, then the ProACT Could be preferable.

You really need to find a urologist that specializes in incontinence, even if you have to go some distance to find one.

Thanks to everyone for contributing to this topic. The information is very helpful.

I'm less than 6 weeks post-RP and still have a lot of incontinence (maybe getting a tad bit better, maybe). My goal was to be around as long as possible and to not have to deal with metastatic prostate cancer. So no regrets.

Odds are I will regain continence eventually, but this discussion gives me hope for the future. Thanks, guys!

@jeff1963 I’m sure that you will. Most likely if there were complications, the doctor would discuss them with you and you are experiencing normal incontinence. I was not in great shape when I had my procedure. I’ve since dropped about 70 pounds from exercise and diet. I know being in good shape helps with the recovery. I don’t remember wearing pads for more than 8 to 10 months? It might have been less. It seems like a lifetime ago. I was blessed to have a great doctor and he removed all of the cancer. They were able to spare almost 90% of my nerve sacks. With Viagra, I’m good to go.