Postrate surgery

[superb_h]

Have anyone had postrate surgery. Can you share your experiences. Did you have any incontinence isues? If so, how did you deal with it? Thanks

[LGXDownunder]

Have anyone had postrate surgery. Can you share your experiences. Did you have any incontinence isues? If so, how did you deal with it? Thanks

Yes, in 2022 I had a radical robotic prostatectomy with 100% bilateral nerve sparing for Gleason Grade 7 Prostate Cancer.
Results were complete removal of the tumour, which was wholly contained within the prostate gland itself. Hadn't spread anywhere else.
Thankfully I'm still here and currently cancer free. All PSA tests since surgery have been zero/undetectable for PC. That's the good news.

The bad news is that the side effects have been awful, despite the nerve sparing procedure. I was 100% continent and had good erectile function before the surgery. But I had terrible urinary incontinence immediately after, with extremely heavy leakage requiring up to 7 heavy duty pads per day.
Didn't want to go anywhere or do anything much as a result. It took about 18 months to get it to a more or less manageable level but I still often required pads. Tried various approaches to fix it, mainly pelvic floor exercises and medication for overactive bladder, which had limited effect. Eventually the leakage became trivial but very persistent, and it still really bothered me. I'm very active and was always pretty fit prior to my RRP, and I'm very intolerant of any leakage however small. So I went to a urologist specializing in post prostatectomy incontinence. After urodynamics testing I was formally diagnosed with overactive bladder. I wanted to get a urethral sling fitted, but was told it wouldn't be possible to get the tension correct due to the trivial level of leakage. It could either cause urinary retention or might actually make the leakage worse. So I was put on a further course of a different overactive bladder medication, which had zero effect. In the end I was offered a procedure to inject Botox into the wall of my bladder. I had that done in July 2024 and the symptoms have mostly disappeared. I still occasionally get some trivial leakage but it's usually manageable, although it still really affects my self esteem when it happens. I'm basically 100% pad free but sometimes I'll wear a very lightweight one, just in case, for strenuous sustained activity, or if I'm going somewhere important where even the smallest accident would be embarrassing.

I also had absolute zero erectile function after the RRP. For 3 years I put up with that and tried all of the more conservative treatments - pills, Trimix injections, focal shockwave therapy and using a medical grade VED. I had no improvement whatsoever and nothing provided a workable solution for me.

Finally, 9 weeks ago I had an inflatable implant installed and it's going really well. In addition to regaining control over my erectile function, I've also noticed some incidental positive effect on the residual incontinence. When active I seem to now have very few instances of any leakage at all, fingers crossed. I read a study done some years ago in South Korea where post RRP patients with significant incontinence were given penile implants. The premise was that they should leave them partly inflated at all times to prevent leakage. It was a very small study but the results were promising, with most patients reporting zero or dramatically improved incontinence. I don't leave mine inflated but wonder whether the same effect is happening due to increased pressure on the urethra from the implant cylinders. There is a lot of gear down there now and it noticeably takes up some space.

[doctuth]

I did not have surgery but had proton beam therapy radiation. I had ED for a long time before this treatment due to cardiovascular disease so that was no surprise. I got an IPP which was great. I wish I had not waited so long. About a year and a half after the IPP I developed severe urinary incontinence. I tried a penile clamp with some success but could stand it for only about 2 hours. Then I found the same study from Korea where men who had undergone radical prostatectomies with resultant incontinence and ED received IPPs. Various inflation levels resulted in 72% of the men obtaining successful control. I thought, I can do that! I found 30% inflation was optimal for me. It did not significantly increase my bulge and was quite manageable. I also thought that the success was due to the added pressure on the urethra which acts like a sling. Then I came upon the idea of going to 100% while sleeping at night. I discovered that this was effective, and I did not need to inflate during the day. I still maintained control. I think this is a sort of toning therapy for the urethra. At any rate it works for me. Two other FT member have reported to me that they also have success with this protocol. 100% inflation at night does not bother me and waking with morning wood has erased many years. Plus, I am ready for any opportunity that might present itself. Try it. You'll like it. Let us know how it goes.

doctuth

[LGXDownunder]

I did not have surgery but had proton beam therapy radiation. I had ED for a long time before this treatment due to cardiovascular disease so that was no surprise. I got an IPP which was great. I wish I had not waited so long. About a year and a half after the IPP I developed severe urinary incontinence. I tried a penile clamp with some success but could stand it for only about 2 hours. Then I found the same study from Korea where men who had undergone radical prostatectomies with resultant incontinence and ED received IPPs. Various inflation levels resulted in 72% of the men obtaining successful control. I thought, I can do that! I found 30% inflation was optimal for me. It did not significantly increase my bulge and was quite manageable. I also thought that the success was due to the added pressure on the urethra which acts like a sling. Then I came upon the idea of going to 100% while sleeping at night. I discovered that this was effective, and I did not need to inflate during the day. I still maintained control. I think this is a sort of toning therapy for the urethra. At any rate it works for me. Two other FT member have reported to me that they also have success with this protocol. 100% inflation at night does not bother me and waking with morning wood has erased many years. Plus, I am ready for any opportunity that might present itself. Try it. You'll like it. Let us know how it goes.

doctuth

Thanks doctuth. That's really interesting, I'll definitely try those protocols. I'm only a few weeks into cycling and still have significant discomfort at 100% inflation after about 45 minutes. So I'll leave the overnight strategy until I've broken in the implant to a more comfortable level. Do you have a recommended sleeping position? I'm usually a side sleeper, which I guess would be less likely to put pressure on a fully inflated implant. In the meantime I'll play around with the ~30% inflation when out and about. I've noticed that after a cycling session I rarely have any continence issues, even when completely flaccid. Maybe residual pressure in the cylinders helps, as I usually still feel somewhat firm for quite a while.

Pre IPP I used a penile clamp at times, but also found it uncomfortable after extended wearing. But it was often a lifesaver for me when I was reluctant to go out and didn't want to wear a pad. The one I have recommends that it is released every two hours. I haven't used it since long before the IPP surgery and I think it would be way too difficult/uncomfortable at present. In any case I haven't really needed it for some time.

Yes, involuntary morning wood is a thing that only exists in my memory. But at least we can create our own now .

[doctuth]

Thanks for your reply. I think that the inflation protocol will definitely help you since your leaking problem is minimal. I have a Titan with the largest girth available. My girth is 7.5 inches so there is a lot to work with. Having a full shaft may add to my success. I usually press the deflate button and let the fluid equalize. If I try to deflate to the max, I get a significant back fill after a few minutes which leaves me at about the same results. Plus, I add one pump to reset the valve and make the next inflation easier. All of this leaves me with a constant chubby which I would estimate is about 15% inflated. This might also aid my control during the day. I am now a definite show-er but it is all good. I didn't get the implant to have a flaccid penis. I had that for far too long.

Regarding sleeping position, I have always been a side sleeper. Tenting has not been a problem. But even when standing, I hang at about 4-5 o'clock. My natural erections used to be at about 2 o'clock. My guess is that the implant is straight and when fully inflated is relatively heavy. My bone pressed length is 7.5 inches so that is a bit of a lever-arm. So even lying on my back it tends to fall between my legs. Maybe that is too much information.

Regarding the clamp, I had a humorous experience. I needed a CAT Scan to check an abdominal Aortic
aneurysm. While preparing me for it, the nurse removed my pen and my clamp from my shirt pocket. I knew it would show up on the image, so I had tucked it in that pocket to void any embarrassment. She said, "What is that?" I said, "You don't want to know." She said, "Yes, I do!" So, I explained in detail and warned her that she may also see some significant hardware in the lower region of the image. She smiled and proceeded. You are only a few weeks into this journey, but you will eventually have a collection of your own adventures. Embrace it!

doctuth

[doctuth]

For the Uncircumcised Only

For those of you who suffer incontinence due to prostate cancer treatment, surgery, radiation, etc. you may want to read about my journey. What does that have to do with circumcision? Well, be patient and listen to what I have to say. First, I will refer you to my post in the Members Only section titled Controlling Incontinence with an IPP. That had to do with a Korean study where several men who had undergone prostatectomy and were suffering ED and urine leakage were implanted with IPPs. They were able to control their leakage by inflation of the implants from 30% to 90% depending on the severity. 72.2% were successful. It inspired me to try that protocol with great success. 30% worked for me. I then hit upon the idea of 100% at night while sleeping. That also worked and allowed me to be semi-flaccid during the day. I got reports from 3 other FT brothers that it also worked for them.

But there was a problem. During sneezing, coughing, and strenuous exercise or lifting, I would occasionally lose a drop or two, enough to leave an embarrassing wet spot on my pants. This was more apt to happen when I had not urinated for 2 to 3 hours. This led to the need for careful planning for extended activities. Pads were not an option. I hated them. Thank you for your patience. The main act follows.

I found a clear plastic cap from a hair product can that was 2 inches in diameter and 1 ½
inches long. It fit just right over my penis glans and a small amount of foreskin which provided for a hermetic seal when I burped out the trapped air. The remaining foreskin folded itself over the edge of the cap to ensure a seal so strong that no amount of pulling could dislodge it. It was totally comfortable, and I could wear it at all times and remove it quickly by retracting the foreskin to break the seal when I needed to urinate.

So now you know why your anatomy is so crucial. Unfortunately, if your foreskin has been surgically removed, you will not be a candidate for this solution. I have not been circumcised, but my foreskin has always been short covering only about one half of my glans when flaccid. Fortunately, that is enough to accomplish the deed. Those of you with a “loose” circ. may be able to get a seal if you can pull enough skin forward to engage the rim of the cup. I have tried to fully retract my foreskin and then place the cap, but the seal in inadequate and the cap falls off. With the above technique, I have never had a failure and am secure in never having wet spots on my pants.


OK, now for the drawbacks. As mentioned, the cap was only 1 ½ inches long, so in order to cover the glans and engage the foreskin I had to push it on so that it flattened the tip of the glans. I did not like the appearance of the blunt tip although it was not uncomfortable. In addition, since the cap had a flat end, it would show a corner on my bulge that was not natural. I decided I need a cap with a dome-shaped tip. I searched the stores and found some hair-spray products with rounded caps, but the diameter wasn’t right. Then I came upon the idea of a small display dome such as is used to display, watches, trinkets and dried flowers. I searched Amazon and found hundreds in all sizes. I found a clear plastic one 2.1 inches in diameter and 2.4 inches long. PERFECT! I ordered a package of 4 for about $9.00. The fit was perfect. No more crushed glans tip and there was plenty of length to seal the foreskin. In fact, I could leave a little air space at the tip as a reservoir if needed.

You can imagine my joy at being relieved of the worry while being totally comfortable. And there is one more serendipity! Since my implantation, I, like many others have lamented the lack if engorgement of the glans. I have discovered that the gentle suction provided to retain the cap has resulted in engorgement of the glans to the full diameter of the cap i.e. 2.1 inches. In addition, it has added ¼ inch to my length. And it remains so for hours after removing the cap. Long enough for some fun.

P.S. Obviously, this cap trick can be used by non-bionic men as well. Those with a ” conservative” circ. may be successful with a longer cap provided the remnant of foreskin can be mobilized enough. Another observation is that since the cap is round and the penis may not be, due to the corporal implants, more skin is needed to take up the slack. It is worth the try. Your size may not be the same as mine. I suggest you try caps from various products to get a functional diameter for your penis and then check out Amazon for a “Cadillac”.

P.P.S. My cap is so comfortable that I forgot to remove it on two occasions when urinating. I quickly noted my error and corrected it, but I did not lose a drop. This thing is secure! I’m happy to discuss this in person if you wish. PM me. We can talk on the phone or do a show and tell in the Denver area.

doctuth