Prostate Question

[DaveKell]

I stated in another thread about my PC scare recently with a sudden doubling of PSA number. I've opted to wait 6 months for another lab test rather than have the biopsy. I've been dealing with a very troubling issue for a few months now. The urge to pee comes on like a tidal wave and it's ALL I can do to get to a toilet in time, barely managing to grip myself to avoid peeing my pants. A few days ago I had to pull in off the road and drive behind a shopping center and pee out the door of my van. It always feels like I have I need to void tons more piss than what comes out. I actually awoke a few nights ago after beginning to pee in bed, but strangely, I was having a dream at the time where I was peeing in the dream! I've been given a script for Flomax for this but it isn't helping much if at all.

Is this condition indicative of an eventual PC diagnosis in anyone's experience? My urologist told me statistically I have a 70% chance of not having PC, a 21% of actually having the beginning stages of it, and a 9% chance it could already be headed towards being terminal. Based on that I decided to forgo the biopsy which sounds miserable given that 12 needles would be shoved into my prostate. I'm beginning to think I should go have the biopsy for a definitive answer.

One last question. If your prostate is removed is it a guarantee your either going to become urinary incontinent or at least have a miserable dribbling problem?

These old age issues are wearing on my mind. Up until I had this miserable fusion of half my spine from a car wreck I was an extremely active guy who ran circles around most other men my age. Now I'm extremely hobbled with an incredibly stiff, painful back. The thought of wearing Depends on top of this just isn't sitting well with me. WHile my body gives away how old I am, my mind has failed to keep pace. I still think like I did in my 30's! Even though I'm more than twice that age now.

[bldoink]

I'm obviously not any kind of medical professional so there's that. Follow your doctor's advice.

I've been given a script for Flomax for this but it isn't helping much if at all.

I'm very sorry you're having these difficulties.

Is this condition indicative of an eventual PC diagnosis in anyone's experience?........ I'm beginning to think I should go have the biopsy for a definitive answer.

It wasn't my experience. I didn't really have any symptoms other that a rising PSA and the doctor feeling something with a digital exam.

I strongly suggest getting the biopsy. In the bigger scheme of things the biopsy isn't that big of a deal.

One last question. If your prostate is removed is it a guarantee your either going to become urinary incontinent or at least have a miserable dribbling problem?

It pretty much a guarantee you'll at least suffer through a period of such miserable condition. However, it seems a fair number of guys recover total continence.

I think a larger number of guys are closer to my situation where I've regained 98+% everyday continence. I do get surprised with a small dribble on occasion. Not daily and never more than a quarter sized wet spot in my drawers and never remotely close to showing through to the outer garment. This usually occurs when standing up, lifting or straining. Even these instances can be prevented if I think ahead, but that won't happen 100% of the time. My biggest risk time is when I'm doing hard physical labor and I'm getting fatigued. Overall it's not a big deal and my description probably sounds worse than it is. I'm not even close to needing to wear a pad although I think I still have a stash from when I was still recovering.

Unfortunately, there are some guys that continue to have issues with incontinence. There are surgical options available for those with continued issues.

These old age issues are wearing on my mind. Up until I had this miserable fusion of half my spine from a car wreck I was an extremely active guy who ran circles around most other men my age. Now I'm extremely hobbled with an incredibly stiff, painful back.

I'm sure sorry you're having those difficulties.

The thought of wearing Depends on top of this just isn't sitting well with me.

I don't see that as a strong likelihood, other than during your recovery.

While my body gives away how old I am, my mind has failed to keep pace. I still think like I did in my 30's! Even though I'm more than twice that age now.

Yeah getting old sucks. Heck, it seems like I just graduated High School a year or two ago.

Good luck.

[tomas1]

Dave, I hear you with what you're going through.
One thing I'd recommend is to carry a "Little John" in your van.
Cops love to bust us for public urination.

I got busted once for peeing at the back of an Indian parking lot near Algodones, Mexico.
It wasn't by cops, but we got chased from the lot, but had to pay the $4.
!@@$#$%% Indians.

I didn't find the biopsies too extremely painful.
At least it answers some questions.

I have to take 2, Tamsulosin pills each day so I don't crap myself during urination.

I hope you can get to the bottom of your problem. You really don't need anymore problems.

[Dave52]

I wouldn’t worry about the biopsy or the incontinence issue three weeks after I had my prostate removed I was fully in control.
Kegel exercises and coaching from pelvic floor therapist is what you need to do after you have a prostate removed if you want to be continent
Dave

[DaveKell]

Thanks for these replies. With what I've endured for nine months now since this horrid spinal fusion surgery I'm sure you'll understand I'm nowhere near ready for another big medical issue of any sort. I'm sure as hell not onboard with the idea of a 22nd major surgery. If a biopsy reveals cancer at least I already have an implant to prevent shrinkage. If I end up incontinent my urologist is a recognized expert at treating that with an artificial urinary sphincter, which would mean another implant surgery. I'd have two pumps in my sack along with my balls. Like my urologist says at seminars we do together, I'll just have to remember one is for coming and one is for going. What the hell, I'm already a legend within my extended family for the many surgeries I've bounced back from, including having been on a death bed twice now. I recovered by sheer willpower over an expectation I wouldn't make it. I've never heard of anyone dying from a prostatectomy but had one friend who was in the ground 5 months after his diagnosis of PC. I'm gonna stop waffling about this and go have the biopsy. I'll call next week after my trip to my primary doctor on Monday. I admit I'm gonna thoroughly despise the idea of another surgery if it comes to that but, like Homer Simpson always says, "what're ya gonna do?". I despise the idea of premature death above all so if I indeed do have PC maybe we'll catch it in time. Thanks again.

I always taught my 3 kids growing up the value of maintaining mental toughness in whatever they face. I guess this is no time for me to show them anything less!

[tomas1]

Dave, when I went to the cancer center, the radiologist really recommended external radiation. I guess if it's not too widespread, it's a way to go. She didn't recommend the seeds at all. I asked if the radiation would shrink the prostate. She laughed and said everybody wants to know that. She said the answer is no, but occasionally happens.

The treatments are Monday through Friday for 39 days. Each treatment takes minutes. They even tattoo targets for the zapper.

[David_R]

I was able to regain bladder control in 4½ months, and it was great to get rid of diapers and pads. After a year I began trying solutions for ED and finally settled on an implant, which has made my wife and me very happy.

(This is just my story. I know other guys have different stories.)

[radioradio]

Dave,

Get the biopsy. Don’t fuck around with prostate cancer. I was put to sleep for my first biopsy (it pays to have your fraternity brother as your urologist ). So that one wasn’t bad at all. For number two, I got the regular, wide awake deal and honestly, the worst part was having my naked ass up in the air for all in the room to see while things were being shoved up my ass. The sting from the biopsy sampling wasn’t that bad. Oh, also, I took a fair dose of Valium before I left the house, and more right before the procedure, so I really didn’t give too much of a shit about any of it.

I wouldn’t worry about the biopsy or the incontinence issue three weeks after I had my prostate removed I was fully in control.
Kegel exercises and coaching from pelvic floor therapist is what you need to do after you have a prostate removed if you want to be continent
Dave

Start doing kegels BEFORE a prostatectomy, if that lies in your future. A few months after my prostatectomy I had regained practically all of my continence, but still wore a pad for a while, just in case. Gave them up at about 9 months. Of course, I never regained my erectile capability, but I never expected to for two reasons: My erectile capability was fairly compromised before my diagnosis, and I knew that no one comes out of a prostatectomy with better erectile function than they had going in (except those rare few who had the prostatectomy and the implant done at the same time). Reason two: I was pretty sure urologists have a tendency to flat out bullshit about how erectile function usually returns.

If you have to have a prostatectomy, pick a doctor who has performed literally thousands of them. My doc (David Lee, PennMedicine) was closing in on number 5,000 when he did my robotic procedure. You want someone who has seen it all, done it all, and could do it all in his or her sleep. Look into a Supra-pubic catheter and ask your doc if he will give you one. All of my friends who had that procedure said the worst part wass the damn catheter in their dick for up to a week. I asked for and got a suprapubic catheter (a tube About 2” above your dick that goes straight through your bladder wall. It was great compared to the catheters I had experienced in the past.

Wish you the best. The best outcomes come from the earliest interventions and the best doctors.

Bob
Bob

[Artist]

I responded to your earlier question about PSA doubling. I agree with a previous comment about having the biopsy done. Don’t mess with cancer. My biopsy found cancer and the prostate was removed, radical not robotic. Robotic was not an option in my town 15 years ago. I chose this treatment method for piece of mind. The advice about kegals is spot on. I have been lazy about kegal workouts lately and experience minor leakage especially when walking with a full bladder or lifting weights. When I play golf I always wear a pad.

[Bionic Richard]

Good advice from all. Sorry you are in this situation! Read on the US TOO website, a prostate cancer support group. The MRI guided biopsy is becoming the normal. Talk with you urologist and oncologist about your current health issues and the best treatment plan for you, but ultimately it is your decision!
A pelvic floor therapist can help before and after with incontinence. Take care of yourself!