Not Good News after prostate biospy when MRI didn't look too bad

Thanks, those numbers seem to match instructions I got from doctor's office and Cleveland clinic website. I can't believe what my doctor's APRN said 300 a day, but not instructions she handed me.
Really getting old and only a little over a day on Depends. I dread sitting down, because I know when I get up a stream will shoot out. Then I can pretty much hold it until I make it to bathroom. I try going prior to sitting-nothing happens. Sit for awhile and get up, open the flood gates, I try holding with little success. Did go walk for half mile walk today and not much leakage and decent stream afterwards. Still sit a few minutes and read, get what I think they call stress incontinence when standing up. I guess others have been through this, I just whining!

@diverjer Hate to say it yet again, but everybody’s different. Expect nothing and realize this healing process can take many months.
And your particular case was by no means routine, so throw in a few more months for good measure. Take the time to heal…
Phil

@diverjer
Get yourself a Wiesner Clamp from Amazon. You can at least wear it for a couple hours, It will stop The problem standing up. You can take it off for a few hours and put it back on again.

At least it’ll give you some mental and physical relief from this problem.

@diverjer - just wanted to add a little here, based on what my care team told/tells me:

Kegels - definitely don’t do too many in a day. I go to an NCI COE center, and their recommended range is 30-80 a day. You can start out with quick ones, just a flex really, and then work up to holding them longer, with a goal of being able to hold one for 10 seconds.

Finding the muscles - you can try the “interrupt the stream” method to find it, but it’s not recommended to continually interrupt your stream. It’s basically a “retract your penis” motion, and it’s easier done sitting or lying down, and after breathing into your stomach - that seems to help the movement of the muscle, according to my PT.

To find the other muscle, around your anus, just imagine you have to break wind during an interview, so you’ll squeeze that little muscle right around your anus. It’s not squeezing your cheeks shut, and it’s not squeezing your thighs. You’ll actually feel your anus tighten up.

My care team started me on pelvic floor PT two months after my surgery. I’m now at 4.5 months, and am still doing PT, but cut back to every other week. I do the exercises she assigns me three times a day, and each round takes me about 20 minutes. It’s a mix of kegels in various positions, and core exercises, to strengthen the muscles around my pelvic floor.

Incontinence - the first two months for me were the worst. No sensation of having to go, really, it just dripped, squirted, and streamed constantly, and standing up from sitting…yes, like a raging river, and up 5-6 times a night, and as soon as I’d stand from the bed…WHOOSH!!!

For me, it got better at two months, and it was sudden. One night, like above, and the next night, I stood up and…nothing. I was able to walk to the bathroom and pee in the usual manner, and I leaked (and continue to leak) maybe 15-30ml a night (1-2 tablespoons), which one pad or one pull-up handles easily.

Daytime has improved. I have no more of the whoosing when I stand, but I still have stress incontinence and occasional regular short streams. I get the urge to go and can go to the toilet, and I do that a few times a day, but I still leak just under 600ml (about 20 ounces) in my pants. It doesn’t stop me doing anything, though. I go about my day as before, it’s just going to take time, and 4 months out from having my catheter removed is still consider early days for bladder control to return, so I’m not sweating it or getting impatient. I’ll start worrying when 18 months goes by with no improvement from today.

Hang in there, every day is a day closer to recovery, just put in the work with the exercises, steer clear of the bladder irritants, monitor your fluid intake, and it should get better, but on its own schedule.

Thanks for the info I wonder how do you know how much you are leaking I just know the diaper gets wetter and heavier. But don't have a clue as to how much actually leaks.
Last night was really weird but it was only my second night. I got up seven times and each time peed a little bit of a stream but my overnight diaper was so wet I still had to change it at 4:00 a.m. so I'm leaking but still get the feeling I need to get up and pee. This feeling of needing to pee never happens during day unless bought on by stress like getting out of chair and then it's mostly too late, already running out. Wish I would get that feeling of needing to go through the day. I guess I am moving so much that the stress incontinence is not letting pressure build up. Thanks all for information, I am really down and can see this having affect on family.
Still bloody urine also, but sometimes normal. Wish that doctor hadn't went to Greece on vacation, have lots of questions about this and pathology report. Not sure what that < 3mm liner means, was that all around what they took out or on spot on edge was < 3mm.

@diverjer - fortunately, determining how much you’re peeing into a pad/pull-up is pretty easy.

Weigh a new one (in grams) of whatever you’re using. I cook a lot, so I have a few digital scales, and I just repurposed one of those for the bathroom.

A new pad might weigh about 25g. Now, the next time you change out a pad, weigh the new one. If it’s pretty full, it might weigh 250g. Then just subtract the empty weight from the full weight, in this case 250-25=225, and that’s your amount, because for this purpose, 1 gram is equal to 1 ml.

Just keep track of that during the day and you’ll know.

One other thing…those first two months, where I was going only in my pants, I was naturally sitting down on the toilet, just to do the pad changes.

Once I was able to pee standing up, I was understandably pretty thrilled. I mentioned it to my PT, though, and she said that yes, that was great, but to minimize leaking later, I should stick with sitting down to pee, if my manly ego could stand it ( 😉 ). Apparently, sitting down while peeing allows the bladder to descend a little and lets it more fully empty. Something like that, anyway.

@turtbean
I was told about this theory, that sitting down your bladder can empty better. I find if I’m sitting down my bladder cannot empty completely, If I stand up, I always can pee some more. Had that exact experience this morning. Tried to pee before standing so I could get on the scale and see what I weighed. Stood up, turned around, peed a some more. With water weighing 8 1/3 pounds per gallon. I didn’t want extra urine in me.

Two times I’ve been in urologist office where they’ve checked how full my bladder was after peeing. In both cases, it was empty after I peed standing up.

Not sure exactly what the difference is here, but it sure doesn’t work well sitting down, for me.

I don't think we have any digital scales, but know if we do I wouldn't dare use them for weighing a full diaper.
It seems about 80 kegels a day is what most of my research says, don't know where that APRN come up with 300, when their own form says way less. I think I got the right muscle as when I am standing at toilet testing out if doing right, I can see penis pull back getting shorter. BTW it seems that surgery made things get a lot shorter!!
Is the anus exercise different than kegels?
I did just finish a one mile walk, I read somewhere that is suppose to strength that pelvic floor muscle. However, if that is really the case, I should really have a strong one already as I use to do 3 miles a day prior to surgery, but they said to cut back and do smaller walks. Also, had to stop weight lifting. Boy, I bet if I tried to lift weights now, I really let loose a stream. Started all that walking and weight lifting couple years ago when we moved to the city from our country life. Tried peeing after the walk, only a drip or two, thought a walk would shake things loose.
I have to agree, I can think done peeing while sitting and get some more out if stand up. However, I can see what they mean by sitting down.
Well guess I will close, and bet when I stand up from this keyboard, things will let loose. The walk didn't do it, but sitting here most likely will.

@diverjer - as far as your question about the anus muscle, my understanding is that “pelvic floor” refers to two distinct muscles: the one you engage when you retract your penis and the one that engages when you tighten your anus.

For me, when I retract my penis, it also tightens my anus (usually), so they’re both getting a workout. I try and concentrate on making sure both are engaged when doing my kegels.

I’ll say that lying kicked back in a recliner is the position that allows for really easy/noticeable kegels, while standing is the most difficult. As long as I’ve been doing these, I still struggle with doing them while standing (let alone while stepping up on a little platform or while squatting, both of which my PT has me do).

@diverjer -

“I don't think we have any digital scales, but know if we do I wouldn't dare use them for weighing a full diaper.”

I have a few sets, so it was easy enough to grab one and designate it my pee scale. It’s not as bad as you’d imagine, I have a paper plate that sits on it, and whatever I’m weighing sits on that. No direct contact with the scale.

My current equipment “down there” is usually a pair of regular boxer briefs fitted with a high-capacity guard (not the thin shields they sell). I can normally get about three hours out of one of those.

That’s when I’m staying home. If I’m going out, I feel more secure with either a pull-up (if I’m out for no more than two hours or so), or a pull-up fitted with a guard (if I’m out for more than two hours) - that way, I have the safety net of the pull-up, but I can still do quick changes of guards when I need to.

I have a whole convoluted system worked out. Yesterday, for example, we had a 35 minute drive each way to talk to our financial planner, and those meetings usually last two hours.

I wore a pull-up with a guard on the drive over, ducked in the restroom and disposed of my guard and sat through the appointment and the drive home with the pull-up only, no guard. The pull-up was more than capable of handling that.

The things we learn to do thanks to PCa…