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Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 20397
Experience:  Specializing in general urology and reconstructive urology.
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4 months ago, I underwent a radical prostatectomy. The 3 month

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4 months ago, I underwent a radical prostatectomy. The 3 month post-op check showed that the results were the best they could be and my consultant said I did not need to see him for another year.
By that stage, I also had the problem of incontinence effectively under control apart from the occasional dribble. I had several sessions with a physiotherapist who was satisfied that I was performing pelvic floor exercises correctly and I have continued to carry these out.
However, during the last week or so, the incontinence has returned with a vengeance. I am now wetting the bed during the night whereas even when I first had the catheter removed, I always woke up and was able to get to the toilet. I am also freely leaking when sitting in the car - a problem which I have not had for a long time. I have had some discomfort and soreness and, on one occasion, a slight pink colour on toilet tissue - but otherwise urine is clear.
I have seen my GP who has confirmed there is no infection. I need to understand why my condition has deteriorated.
Hello and thanks for trusting me to help you today. I look forward to working with you.
Have they checked your bladder by ultrasound to see that your are completely leaking all the urine out?
How is your urine flow when you do urinate?
Customer: replied 3 years ago.

I had an ultrasound check when catheter removed and this showed that bladder was emptying, I have not had one since but the bladder feels empty.

The flow has been weak ever since catheter was removed but I had nevertheless achieved control.

The current problem started a few days ago.

If you were relatively dry before, this nuance of leakage may be related to bladder spasms which is forcing your hand out of the bladder in the presence of a week sphincter after your prostatectomy. This typically would be caused by an infection if it is sudden in onset but it sounds like they have ruled this out. Regardless, your doctor may want to consider putting you on medication such as oxybutynin which is designed to stop to see if this helps to improve your leakage.
Your sphincter would not be working well and then suddenly stopped working. This is not likely a problem with the sphincter.
Hope this helps.
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Customer: replied 3 years ago.

Thank you. I note that the sphincter is not likely to cease working once the problem has been brought under control.

I was prescribed oxybutynin last week and I used it for 2 days but it did not appear to be effective. I ceased to use it because I developed constipation followed by diarrhoea which seemed to increase the pressure on my bladder and make the matter worse.

Today I was prescribed Vesicare which is I understand similar and I will now try this.

In view of the sudden onset combined with discomfort and soreness, I thought that this was most likely caused by an infection leading to inflammation. Can a urine test sometimes fail to detect an infection?

Yes, a urine test is not 100% accurate. It is possible they may have missed the infection. They may want to consider repeating the test to see if they missed the infection. I would recommend switching to the Vesicare to see if you can tolerate this. The medication is going to take more than a few days to work. I would give it at least a week to see if you any changes. Hope this helps.
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