Do you have urinary incontinence after prostatectomy & radiation?

Posted by hmctgraybill51 @hmctgraybill51, Apr 16, 2022

Hello, I underwent a prostatectomy in Sep 2017. Gleason score of 9 with a positive margin. 8 months later began radiation tx with rising PSA. As of this date my PSA's have been undetectable however, I continue to have moderate to severe incontinence. I have seen two urologists with one suggestion the male sling and the other the artificial urinary sphincter for relief. I'm looking for any men with experience in either of these procedures and your comments. Thank You

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@carver

I just completed 45 ,nine weeks of radiation treatments. Now dealing with total incontinent issues. I progressively loss controls over the last few weeks of treatment. Any real hope of regaining some controls as recovery progresses. Do any of the exercises I am reading about help? Any suggestions would be appreciated.

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There is an operation that kind of put a plug in and stops incontinence Usually after surgery but can be from radiation as well

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@carver

I just completed 45 ,nine weeks of radiation treatments. Now dealing with total incontinent issues. I progressively loss controls over the last few weeks of treatment. Any real hope of regaining some controls as recovery progresses. Do any of the exercises I am reading about help? Any suggestions would be appreciated.

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@carver I can hear the distress in your post and imagine this is terrible for you.

My brother had surgery and radiation for prostate cancer. On a follow-up appointment he talked with his physician about incontinence who referred my brother for pelvic floor physical therapy. It took some time but my brother is doing much better now and no longer has incontinence.

There are surgeries for incontinence and medications. It's something to talk with your doctor about. I know my brother wanted to start with the least invasive treatment for incontinence before he tried anything else.

Are you willing to call your oncology surgeon's office and make an appointment?

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@carver

I just completed 45 ,nine weeks of radiation treatments. Now dealing with total incontinent issues. I progressively loss controls over the last few weeks of treatment. Any real hope of regaining some controls as recovery progresses. Do any of the exercises I am reading about help? Any suggestions would be appreciated.

Jump to this post

Hi @carver, I moved your question about urinary incontinence after prostate cancer radiation treatment to the discussion @hmctgraybill51 started here:
– Do you have urinary incontinence after prostatectomy & radiation? https://connect.mayoclinic.org/discussion/urinary-incontinence-1/

I did this so you can read the previous helpful posts by @jonbuuck @jerryegge @itterac @scullrower and connect with them and others like @maxvt @web265 and others.

Carver, has your oncology team talked to you about pelvic floor exercises? They seem too simple, but they can help.

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@carver

I just completed 45 ,nine weeks of radiation treatments. Now dealing with total incontinent issues. I progressively loss controls over the last few weeks of treatment. Any real hope of regaining some controls as recovery progresses. Do any of the exercises I am reading about help? Any suggestions would be appreciated.

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I did 4 weeks (twice weeklyY of Pelvic Floor PT at a Baylor Scott & White clinic (Texas) working with their trained and designated Prostate Cancer specialist. This was prior to my RALP.

After learning how to Kegel properly, she had me do many types of exercises with the “stretchy bands.” Kegel in, pull and hold, release Kegel and release band. Three times 10-15 reps each. Facing in, facing out. Arms stretching out, arm stretching down. Legs facing forward and facing away. Right leg then left leg. Many reps, many kegels. Easily about 250 kegels per hour of PT.

From Amazon, I bought the “Whatafit Resistance Bands Set, Exercise Bands with Door Anchor, Handles, Carry Bag, Legs Ankle Straps” at $40US regular price. I repeated the same exercises at home least twice a week. That’s a lots of Kegels. Then add in the ones done while watching TV or reading.

After the surgery, I had a some “spotting.” I did have two bladder spasms one afternoon. The on-call nurse said those were normal.

This regimen definitely strengthened my muscles. Starting prior to surgery was a definite plus for me.

I offer this as a possible help, and I wish you the best.

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I thank you all for you responses. No one said any thing about these exercises you have shared with me. Before or after treatment. I will fined a resource here as soon as I can. I hope you all had a great Thanksgiving.

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I am still wearing dribble pads ten months after RARP. Discouraging! At this time last year I was already working with a PT pelvic floor specialist. In my case a high tone pelvic floor contributes to urinary incontinence. I've done more than twenty PT visits and invested more than two hundred hours in exercises at home, with an emphasis on pelvic floor relaxation and building core strength.

My surgery was unilateral nerve sparing due to nerves being entangle in mesh from a hernia repair six years prior. Hence, I am also doing acupuncture with an eastern medicine doctor who has a history of helping patients with pelvic health concerns.

I am 70, active, walk 3-5 miles daily, have normal BMI.

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I am now 5 yrs. Post surgery and 4 yrs. Post radiation tx. I have been thru 2 cycles of kegel therapy sessions with no relief. I believe the radiation tx really
Put me over the edge as far as incontinence is concerned as it is very bad. On the positive side my cancer is undetectable as we speak, as my cancer was an aggressive one and that’s how the oncologist treated it. I am going to meet with my surgeon this week for another cystoscopy with the intent of having the artificial urinary sphincter surgery as maybe a last hope for relief. It is said to be the gold standard of procedures when you are faced with my situation. I will let you know what happens. In the mean time I am still alive and enjoying life as much as possible. Good luck to all.

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@colleenyoung

Hi @carver, I moved your question about urinary incontinence after prostate cancer radiation treatment to the discussion @hmctgraybill51 started here:
– Do you have urinary incontinence after prostatectomy & radiation? https://connect.mayoclinic.org/discussion/urinary-incontinence-1/

I did this so you can read the previous helpful posts by @jonbuuck @jerryegge @itterac @scullrower and connect with them and others like @maxvt @web265 and others.

Carver, has your oncology team talked to you about pelvic floor exercises? They seem too simple, but they can help.

Jump to this post

Hi @carver. My RP was May of 2019. I faithfully did my Kegels for 10 months, but it was determined that I was not going to gain continence. Since I needed to have adjuvant radiation, my radiation oncologist and my surgeon both recommended surgery for an artificial urinary sphincter (AMS800). Dr. Patrick Walsh in his Guide to Surviving Prostate Cancer (which I highly recommend) and the urology team at Mayo Clinic, Rochester, said this is the gold standard in controlling incontinence. It takes a few weeks to heal from the surgery, but when the device is activated, it is truly remarkable. I could not have gone through radiation without this device. The only downside is that the radiation did weaken it a bit, but all I need is a thin pad once a day, and I'm good to go. I had a couple of doctors say that if you go this route, make sure your surgeon does a lot of these surgeries, and my understanding is that the Mayo Clinic Rochester does one of the most–if not the most–in the world. My research is that the other options are a poor substitute to the AUS. I'm glad I have it.

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@hmctgraybill51

I am now 5 yrs. Post surgery and 4 yrs. Post radiation tx. I have been thru 2 cycles of kegel therapy sessions with no relief. I believe the radiation tx really
Put me over the edge as far as incontinence is concerned as it is very bad. On the positive side my cancer is undetectable as we speak, as my cancer was an aggressive one and that’s how the oncologist treated it. I am going to meet with my surgeon this week for another cystoscopy with the intent of having the artificial urinary sphincter surgery as maybe a last hope for relief. It is said to be the gold standard of procedures when you are faced with my situation. I will let you know what happens. In the mean time I am still alive and enjoying life as much as possible. Good luck to all.

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had the procedure your thi about . I still
have major leaking. Friend had it don he is doing much better

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So you're telling me that there is no improvement. How long has it been since the surgery? Do your doctors have any other plans for you? Either way I wish you good luck and thanks for your response.

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