Bladder issues.

Posted by dkrepid @dlkreps, Jun 9, 2023

Hi, my name is Doug and I had RALP 6 weeks ago and have had good success with recovery. My question is how long after a prostatectomy does it take for the bladder recover? I’ve been fully continent since the catheter was removed on day 10. The problem is I go small amounts more frequently and I have the sensation that my bladder still needs to be emptied after going. It’s almost the sensation of a bladder infection yet I don’t believe I have that problem. I’ve googled the issue and it comes up with such general answers.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

It’s been a long time since my surgery but as I recall I was like you, I gained full control after the catheter was removed and remain continent. It took about 3 or 4 months for my bladder to calm down and the urgency to subside. So I needed to go less often and I felt more normal. I think it’s because you spent two weeks with a plastic tube irritating your bladder. The muscle overreacts and spasms once the catheter is out and that takes time to heal.

That being said I do not have the same pattern as before surgery. I go more often during the day, especially if I drink a lot of liquids or drink alcohol. I get a sense that I have to go and I can’t wait too long or it will be a problem. I get up once or twice at night and that’s it. I have never needed a pad.

Give it time, you are healing normally. Talk to your doctor about it on your next visit. You will settle into what’s normal for you now. It sounds like you are on the way to a good recovery.

REPLY

Thanks Tony! There are so many questions that have come up after a major surgery like this and I’ve grown uncomfortable with calling the urologist as well as confused at times when googling.
I suffered for about 5 years with BPH and planning my day around finding a bathroom. Nighttime I would get up some nights every hour. Since the surgery it’s been better yet not as good as I had hoped yet. I understand the body is still healing and it’s very early in the process yet but still wondered.
I have recently reintroduced coffee into my morning routine(2-cups) and I wondered if the caffeine has had an affect.
I will keep on keepin on but appreciate the information. Have a wonderful weekend!

REPLY

I've had a pretty similar experience as @tonytiger .

I'll add this. I'm at about 18 mos since surgery. I find that if I feel like I've gone just a few minutes/half hour ago, and get another urge, I hold off. Most times the urge goes away and I can go for hours at this point without urinating. In other words, I seem to FEEL like I need to urinate when there is LESS urine in my bladder.

Sounds very counter intuitive as I'm writing it.

So, say I have an hour car ride to work, I want to pee right before I leave, I notice that within 10-20 minutes I FEEL like I have the urge. 10 minutes later that urge is gone and I'm good for a couple hours.
(I hope that made some sense)

It may be too early for you to incorporate what I'm saying but just file it away for later as a possibility.

PS, Caffeine has a definite effect on me! In my work getting to a bathroom can be a hassle for a few hours at a time. I avoid coffee for at least 90 minutes before work. It helps tremendously.

REPLY

Experience similar to above replies.
I think we evolve to a new normal.
One addition: my kegel pt expert suggested that I try to resist peeing shortly after emptying bladder, or everytime that I awake at night, to retrain the brain.
Bit of a balancing act, but it has been helpful to me (10 mos post RP and blessed with very good continence post catheter removal).

REPLY

I agree. I'm now 9 weeks post-RALP, losing minimal urine (but not zero). While I can wait 3+ hours between voids, I do consistently have a niggling urge to void about 10 minutes after fully emptying. I previously had bladder stones removed in 2018 and 2021, which would cause the same sensation. In the case of RALP, the bladder and urethra have to be sewn back together at the point where urine exits. My suspicion is that as the new urine enters the empty bladder and finds its way to that spot where the stitching was done, the area is still sensitive as it is healing (inflammation, nerve regrowth) and sends its signals of irritation to the brain. This irritation is basically the area feeling first liquid, then raw tissue as the new urine sloshes back and forth. Once it is continually covered by urine (it is the most dependent portion of the bladder), the brain gets habituated to the stable feeling of liquid and the urge sensation goes away.

I must caution you that that I'm a retired physician. I used to make up stories like this to tell my patients, which made sense to me from what I know of anatomy and physiology. But that doesn't make it true, just plausible. Another possible theory: the bladder must contract to empty. As it slowly relaxes, stretching the smooth muscle fibers, after voiding, that might mimic the sensation of a full bladder with fully stretched muscles. If the urge were persistent, or it frank bleeding were occurring it's probably worth perusing with one's surgeon. Otherwise, I suspect we're more aware of it now because we're more focused on our bladder function than we were before surgery.

REPLY

Thanks for all the positive input! I suspect I will have to retrain my brain and bladder again. I have also noticed as @web265 mentioned that I’ll have the urge to pee several minutes after peeing and if I ignore it and try resist it usually gets better and the sense disappears.
One other caveat to add was that I had had the TURP procedure 4 months before I had RALP. This was what lead to the discovery that I had prostate cancer thru the biopsy of that tissue.
I suspect being I had the two procedures within a 4 month span that the tissue of the urethra and bladder wall were still healing and that all of this may play a role.

REPLY
Please sign in or register to post a reply.