After a radical prostatectomy if you ain’t holden urine (total incontinence) then it’s goin right thru

time may be money but money don’t buy time…..james taylor



I am 4 weeks past robotic radical prostatectomy and 2.5 weeks after catheter removal. I do not have any urge to urinate. The only urine stream I get is after lying down and then the stream is only 1-2 seconds in duration. However, I have constant leakage throughout the day/night and must change pads every 30-45 minutes. Thoughts?

Wives, diapers, Walsh, and Incontinence revisited.


15 Replies to “After a radical prostatectomy if you ain’t holden urine (total incontinence) then it’s goin right thru”

  1. I am the one you responded to in the above audio clip. Would like to update you and ask additional advice. Email address being sent.


      1. Dr. McHugh:Thanks for keeping your blog so diverse; especially all of the humor. That has helped during some challenging times.And thanks for replying to my request. I did not want to present anything that might sound discouraging to other readers who are pondering what action to take. At 6.5 months post-op, I am still totally incontinent. I presume it is largely due to the fact that there were complications during the surgery. Although the surgeon says that he was pleased with the bladder connection, he gave thought during the surgery to removing the bladder. He had to take the gland out in pieces. All of the nerves on the left side were removed, as were 60% on the right side. The kegels have not helped at all. I wear Depends with guards. The Depends I change 3x per day and the guards – depending on fluid intake -a minimum of every two hours. My surgeon told me last week that being six months out with no improvement, means that I most likely will not see any improvement. He reluctantly wrote an order for pelvic floor therapy which I start next week. Based on what I’ve read, the sling is recommended only when the pad count is a max of 3-5 per day. The artificial sphincter seems to be the recommendation of choice. At age 58 I am hesitant to go there so soon post-op for two reasons: possible complications and likelihood of having to repeat the surgery several years later. What are your thoughts?Dennis Date: Sat, 9 Mar 2013 14:49:32 +0000 To:




  3. As recommended, I practiced the Kegel exercises before my surgery and thought I had it perfected – I found out after surgery that I had not perfected the technique and my exercises had been for naught.

    Immediately after surgery I was leaking badly. I could not climb a set of stairs to the washroom or bedroom without leaking. Walking around the block, or getting in or out of the car caused leakage. I found it very stressful. I kept at the Kegel exercises, working constantly with them and quickly learned to do it right – stress is a great motivator. Two months after surgery I was able to give up the pads at night; one month later I was able to give them up during the day as well.

    I am now 2 1/2 years post-op and don’t need pads. My high blood pressure pills do increase the pressure to urinate, so I have to be careful – there have been a few accidents, and minor leakage is not uncommon (not enough to even cause stains). The Kegel exercises have fallen out of my routine, but I am satisfied that if I can discipline myself to get back to them my situation will improve to nearly 100%. I have become a firm believer in the benefits of Kegel exercises.

    Some things also help. Just after my surgery I had a visit from friends – we had a couple of glasses of wine. I was up that night until the small hours of the morning because I couldn’t stop peeing. I was not previously a heavy drinker, but I learned from that one experience that I had to modify some practices. I have gone from 2 to 4 cups of coffer per day to 1 (coffee is a diuretic), I rarely drink colas and I have reduced my water consumption (I always used to drink a lot of it). I still have alcohol on occasion, but in moderation – if I go out with the boys, I’ll have a glass of wine while they are drinking beer. I’m working at losing weight in order to get off the blood pressure pills – that will reduce my need to urinate.

    These changes may not work for everyone, but I think the lesson is to examine what you can change in order to improve the situation.


  4. Hey guys,Had my op done 4 years ago,i did kegals Pardon my spelling,car wrek,mgr head injury,,right after surg doc says he severed my pee tube..went straight to pads 5 a day,zero erection hit me i could not have mixed drinks.sodas as well.
    after time i paced myself on 4 yrs at peace with maby 1 pad a week..
    the sex part,had to do alone trial an error,
    have zero fluids 7 hrs least before sex.
    doc put me on triple mix.
    wow you really can have a great life.
    you must adjust your life and be thankful you are cancer free..

    Nobody talks about the sex part.?????????????
    the operation effect on my sex life.caused i think a divorce..
    Im at an age & settled in my life i faced the fact of sex with a stranger an accident might happen so to save face? im also again at peace just being a single guy..
    bought a farm have quite a few and dates life is good.
    here is what guys wont say..i am not ashamed!
    THE Only question i coulden find was the orgasm Part…
    Heck weve had our friend for life…what gives?
    my whole family seems to die from cancer both sides.
    at age 47 seemed a no brainer. i was divorced and still am..
    im afraid sex with a new partner might end in a bad way
    Here is the only question i looked for before surgery..
    the Orgasm..
    I found when i have an orgasm it can continue as long as you can stand it.
    Its the exact same orgasm as before..but more intence and
    just the lenght of time it can go..
    maby this is a taboo topic.
    i feel its a normal thing to talk about among men.
    facing the operation..
    so there
    I wish you peace an love..
    hang in there is does get better!


  5. 2 years post-op; 6-8 pads per day minimum; urodynamic study result: gravitational incontinence due to intrinsic sphincter deficiency. recommendation: artificial urinary sphincter. Any thoughts?


  6. Dr. McHugh: Can you describe the recovery stage in an anticipated timeline? After 2 weeks, should…4 weeks…6 weeks. Include restrictions you normally prescribe and comfort levels with sitting, walking, etc. Thanks!


  7. Thanks, but my questions were regarding your patients post-op recovery timeline experience with the AMS 800 implant. There’s scrotal and abdominal pain. How long does each typically last? What do you advise about physical activity post-op (sitting, walking, lifting, sex, etc.)?


  8. 10 days post AMS 800 activation and now wear only one pad per day; down from 8 pad a day minimum during past 26 months. Problems associated with intrinsic urinary sphincter/gravitational incontinence: vanished. HAVE MY LIFE BAAAAACCCKKKKKKK!!! The one pad is necessary for coughs, sneezes, physical exertion, etc. and so far has only been 30-40% full after 14-16 hours. Can I get an AAAAA-MEN!!!? I will say the post-op 6 week wait for activation was challenging at times. Felt like I had lost in a bad brawl. Still tender in the private places. But got no complaints. As Brooks-n-Dunn said, “I’m a brand new mannnnnnnn!”


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