Urinary Frequency

[snydez99]

I'm scheduled to get the implant soon. I have BPH & pee a lot ( large quantities) anyway has anyone had worse urinary frequency or incontenence after the procedure? Cathiter maybe for a day or so? But anyone have long term issues with worse urinary frequency or incontenence after the procedure?

My Doc told me main problem infection right?

Thanks in Advance
Hopeful

[niall4473]

Yes, I have had to urinate more frequently, and it takes longer, since my implant, also the need becomes acute a lot quicker.
I attribute this to the reservoir pressing on my bladder.

[happycamper59]

Same here as niall....I find standing now, rather than sitting, empties the bladder much better.

[strongagain]

.I find standing now, rather than sitting, empties the bladder much better.

Precisely same with me.

[Afallach]

Wow, after the prostate removal surgery, it took about 15 months before most of the incontinence had stopped. Was only wearing a pad mostly for confidence if I was going to be very active. After the implant, it’s like I’m back at step one. The sense of urgency is pretty much immediate. I get up four times at night. Now instead of zero to one pad per day, I’m up to four or five that are sometimes pretty soaked. It’s like a constant drip.
The doc said it’s due to swelling or I’m failing to empty the bladder completely. I don’t find that comforting since I stand at the toilet five minutes each time I go. I can just hope he’s right and that it will improve again.

[LGXDownunder]

Wow, after the prostate removal surgery, it took about 15 months before most of the incontinence had stopped. Was only wearing a pad mostly for confidence if I was going to be very active. After the implant, it’s like I’m back at step one. The sense of urgency is pretty much immediate. I get up four times at night. Now instead of zero to one pad per day, I’m up to four or five that are sometimes pretty soaked. It’s like a constant drip.
The doc said it’s due to swelling or I’m failing to empty the bladder completely. I don’t find that comforting since I stand at the toilet five minutes each time I go. I can just hope he’s right and that it will improve again.

I'm really sorry to hear you are going through that (again) and hope that you see improvement soon. Post prostatectomy I had much the same experience with incontinence for nearly 2 years and it was soul destroying. I went through up to 7 or 8 heavy duty pads a day at times and I literally didn't want to leave the house. Finally it settled down to be a less dramatic but still persistent problem. Note that I have a very low tolerance for any leakage whatsoever and was 100% dry before the prostate surgery. Eventually I was referred to a urologist specializing in persistent male urinary incontinence post RRP. After various tests including urodynamics, and trying different medications for overactive bladder (which made no difference), about 10 months ago I had Botox injected into the wall of my bladder. That improved things further and got me to about 99.9% cured. I have rarely worn a pad since then; only if I think there is some risk of leakage, such as sustained really strenuous activity with a lot of bending and lifting, or where even the most trivial accident would be embarrassing.

On getting my implant 12 weeks ago I did have some post op leakage after the catheter came out, but nothing like the flood I endured post RRP. I recall some discomfort urinating in the first week or two and some urgency, but I was able to control it. I was also 30% erect for the first 6 weeks which didn't help with comfort but was manageable. Once activated and I started cycling the implant I've noticed further improvement and I'm now pretty much 100% dry again. The only recent episode I've had was a few weeks ago when I know I drank way too much while out with friends, and even that was a fairly minor issue. I think cycling the implant regularly and aggressively may be having a positive effect in tightening everything up. Currently I mostly sleep through the night and there is usually no urgency in the morning.

Another FT brother, doctuth, shared his experience with me about using his implant to help resolve incontinence issues. He has a thread about it here:
https://www.franktalk.org/phpBB3/viewtopic.php?f=16&t=24326&hilit=Controlling+Incontinence+With+An+IPP#p229381
I was already aware of the study referred to in that topic, but I haven't yet seriously experimented with the technique discussed because I seem to be getting results without it. Anyway it may be worth reading. Drawing on my own past battles I'm assuming you have already tried things like tried pelvic floor exercises (Kegels) and double voiding?

[Afallach]

Thanks LGXdownunder for the info. The incontinence is every bit as humiliating as the ED has been. I hadn’t heard of injecting Botox into the bladder and if the technique of 30 to 60% inflation doesn’t solve the issue then I’ll be searching for a doctor to perform the Botox injections. Only nine weeks out now and the cycling is still uncomfortable at 100%. But I could easily leave it at 30% throughout my day. I just started riding my horse this last weekend, starting with dry pads and had to change after an easy 40 minute ride. Needless to say it was a challenge all around but I don’t give up easily. Thanks again.

[LGXDownunder]

Thanks LGXdownunder for the info. The incontinence is every bit as humiliating as the ED has been. I hadn’t heard of injecting Botox into the bladder and if the technique of 30 to 60% inflation doesn’t solve the issue then I’ll be searching for a doctor to perform the Botox injections. Only nine weeks out now and the cycling is still uncomfortable at 100%. But I could easily leave it at 30% throughout my day. I just started riding my horse this last weekend, starting with dry pads and had to change after an easy 40 minute ride. Needless to say it was a challenge all around but I don’t give up easily. Thanks again.

Yes I also found the incontinence extremely humiliating, and difficult to explain or talk about with others. In fact I probably found the ED easier to discuss. I was also surprised to learn of the Botox procedure. When the uro surgeon first told me about it my thoughts immediately turned to mainly female beauty treatments and so on. Mine was a simple day surgery but done under general anaesthetic. They have to go in through the urethra with a camera aided device, then inject at different points around the bladder wall. I didn't really have any discomfort afterwards but did have significant leakage for a few days post op due to irritation from the surgical instruments. My surgeon told me that the Botox works progressively and can take six months or more to fully take effect, and that has been my own experience with it. Keep experimenting with the inflation technique - yes 100% inflation is still uncomfortable, but I just grin and bear it hoping that it's making a difference. I'm now becoming very confident going for long walks and bike riding, and staying 100% dry, fingers crossed. I really haven't done much other than cycling the implant two to three times day, and using it for sex. Based on my very limited horse riding experience I'm thinking it will exert more pressure on the bladder sphincter and urethra than most other activities, so is a good test. Hopefully things will improve for you but at least there may be other options if needed. I know that you said that you already have a urethral sling, but a further option is an Artificial Urinary Sphincter (AUS), which you may have already considered. We also discussed that for me but dismissed it due to the relatively small amount of leakage I had. It would also be a lot of extra scrotal gear alongside the implant.

[Guvna98]

Like LGXdownunder, I had leakage issues after my RRP in 2012. For a few months after that surgery I wouldn’t pass a public restroom with stopping in regardless of how full my bladder was. After a year or so post surgery I was down to confidence pads that were there to absorb drips and dribbles- some days worse than others. Interestingly, in talking to my surgeon about my coming (October) IPP surgery, he said that my occasional minor leakage may improve post surgery.

Also, in prep for the surgery I’m using a VED to stem my atrophy issues and get my penile tissues healthier for the implant. I’m also getting more religious about my kegel exercises and since then my leakage has stopped altogether. This thread is the first that I’ve seen about a sustained leakage problem coming out of IPP surgery.


All the best in getting this under control- keep us posted.

[LGXDownunder]

Interestingly, in talking to my surgeon about my coming (October) IPP surgery, he said that my occasional minor leakage may improve post surgery.

Pre op I also discussed the possibility of the IPP resolving or improving minor residual incontinence with my uro surgeon. Initially he wasn't sure, but after thinking about it said that it might be possible due to additional urethral pressure, although no guarantee. I note that problematic incontinence cases are not his specialty, and he had earlier referred me to a colleague who does focus on those (and who ultimately performed my Botox procedure). I'm really happy that my implant now appears to be yielding pretty much 100% dryness as a side benefit. Anecdotally, I think aggressive cycling may be helping a lot, but there's no way I can prove that scientifically. Best of luck with your surgery, I really hope you have a great outcome for both ED and leakage.

Also, in prep for the surgery I’m using a VED to stem my atrophy issues and get my penile tissues healthier for the implant. I’m also getting more religious about my kegel exercises and since then my leakage has stopped altogether.

Interesting that the Kegels have made such a difference after such a long period. I've recently started doing them again when laying in bed at night, just before going to sleep. My thinking is that it may augment the improvement I'm already getting from the implant. My ultimate goal is to never have to even consider wearing any type of pad ever again, for any activity whatsoever, no matter how strenuous, flexion demanding and/or lengthy.

I definitely recommend daily VED use pre IPP surgery. I didn't have as long to prepare after I decided to go ahead, about 6 weeks, but had already been using the VED regularly for both sex and penile rehab for at least 18 months. Then I stepped it up to at least twice daily for 20-30 minutes each time, and probably more aggressively than I should have. But I believe that regime helped allow the largest cylinders possible for my anatomy to be implanted. Surgeon basically agreed afterwards that it probably made a difference. With continuous daily cycling I am now almost back at my original length, and girth looks normal but I haven't yet measured it properly.