My New Normal – I Dribble
Yes, my new normal following my life extending, nerve sparing radical prostatectomy, is that I dribble!
So, why am I writing about the subject of dribbling 2 ½ years after I had a prostatectomy for my prostate cancer? I hope, that by sharing my story I am filling a hole in the information process required by other men to make an informed decision about their cancer treatment, and to empathise with all the men who have had a prostatectomy and continue to dribble or leak. And, once made your decision and you are recovering, there will be no surprises.
When I was doing my research on prostate cancer treatments following my diagnosis and prior to my forthcoming surgery, everyone I talked to in the related medical fields, the brochures that I read, and the YouTube clips that I watched, talked mainly about the amazing results of nerve sparing surgery to regain an erection. As if this was the only thing that mattered.
Yes, I admit regaining erectile function is important, in fact it is very important, but you don’t have sex multiple times during the day and night, whereas peeing post surgery has become a much more regular daily and nocturnal event. But no one talks about it.
As I write this article, it has been 2 ½ years since my surgery and I have had many occasions to reflect upon what I was told or read prior to my prostatectomy and comparing it to my current status.
Let’s say that the Urologist, or the GP, or the pelvic floor physiotherapist, or the prostate nurse, or the multitude of documents that I read from well-regarded prostate cancer support services, did not lie. But they did not tell me the full story.
I did read all the brochures. I followed my physiotherapist instructions to toughen up my pelvic floor muscles to the point of being able to crack a walnut. And, once I had achieved that, I was told that my urinary problems would be under control.
Clearly these specialists have never had a prostatectomy.
In short, the result of my life extending, nerve sparing radical prostatectomy and years of pelvic floor exercise, is that my “New Normal” is that I dribble.
For 59 years of using my penis for urinary purposes, I had a basic idea of how my system was laid out and its basic operation. You know the routine, lift the seat, unzip, point Pedro, relax, feel the euphoria of bladder release, shake, shake, shake, zip up, lower the seat, flush. Job done.
So, before my diagnosis of prostate cancer, everything related to my plumbing was going pretty good. I was very happy with my holding power and looking forward to a long life avoiding incontinence issues.
But, all good things must come to an end (sounds like a Grimms’ Fairy Tale), and once I got over the shock of the cancer diagnosis, I did my research on the cancer and the various treatments.
I visited all the prostate cancer websites, downloaded and read the recommended articles and made a decision that a radical prostatectomy was the best way to go.
It was less invasive, higher success rate, nerve sparing and quicker recovery.
So, all I can say is that the “glossy” brochure in the Urologist waiting room describing the robotic procedure was, informative.
But by describing it as being “glossy”, I mean, it glossed over the entire scope of work of this anatomical renovation job that I was about to embark on and its permanent impact on my urinary system.
Yes, I did agree to the surgery, knowing what I knew then.
Yes, I did agree for the removal of my prostate gland and disconnection and disposal of a few unwanted reproduction components of my body.
Yes, I knew that the operation will impact on my bladder, but the exercises will sort that out.
But, no where did I get informed or give consent to having my perfectly functioning bladder shut off valve removed and not replaced!! Where was that in the brochure?
So here I am 2 ½ years post surgery and I dribble. This is my New Normal.
The amount that I dribble, varies on the situation. In the early days I used a pad, but with my exercise regime, and regular use of a bathroom, my dribbles are minor. A 1ml here, 2ml there. It depends on what I am doing and for how long. It’s called Stress Incontinence, and you can feel it being released and slowly making its way down, until it reaches the absorbent fabric of my undies. Now as I have mentioned this in the past, every man will have a different journey, with different stories and varying incontinence quantities.
To help others gauge their own post-op bladder function status and to avoid future wet surprises, I have provided some “real life” post surgery dribble stories that you won't read in the glossy brochures.
At the time, I found these events totally disheartening, but in hindsight, I now find them humorous. So, I hope by sharing them, that you will also see the funny side of wetting yourself 😊.
Camel Riding.
Yes, I went camel riding 8 months after my op. I was in Morocco and camel riding is something you do.
I never thought of the consequences of the rhythmic up and down movement of the hump pushing into my perineum with every camel hoof step.
And with every upward compression of my urethra, a tiny bit of wee squeezed past my not-so-watertight pelvic floor sphincter. Now a tiny bit of wee is not embarrassing, but after an hour of camel ups and downs, you guessed it, the camel saddle was wet, and I had very embarrassing wet trousers. I swear the camel could smell me pissing on its back and it was not happy!
Kissing
How could a simple kiss break the seal on my super clenched pelvic floor sphincter?
It can, regardless of my years of yoga and pelvic floor exercises.
The original design (V1.0) of my pelvic floor sphincter, is to unconsciously fully open on the first signs of intimacy. This in a past life would permit the discharge of my self-made lubricant and the mighty rush of semen to gush uninhibited.
So, after the robot had completed its RRP renovations on my plumbing system and with the tightest yoga lower bandha muscles engaged, with one simple passionate kiss, the muscles relax and oooops, that’s wee in my pants!!
Alcohol
Again, another true story from my journey to find new ways to wet myself.
This time I was 10 months post op and I decided one evening to get into numerous rounds of drinking shots. What could possibly go wrong?
When I drink large volumes of beer, my bladder is usually full well before I feel the euphoria of intoxication, and as a result nature and water pressure directs me to empty the bladder. (i.e to Break the Seal). It is simple physics of liquids, and it is manageable.
But spirits, oh no, that is a whole new urinary hazard.
See, when you drink shots, you don't fill up your bladder and therefore you are content with your fully engaged pelvic floor muscles to hold back the small amount of hydraulic pressure.
But, (there is always a “but” in my stories), alcohol is a muscle relaxant, so guess which muscle relaxes with lots of shots and without you being conscious of its actions?
You guessed it. Dribble !
And to make it worse, the alcohol euphoria did not make me aware of the events unfolding downstairs, so I did not even know I had wet myself until my drinking buddies started laughing and pointing at the large wet spot in my jeans!!
Dear Urologist, put that story in the RRP glossy brochures !!!
Lawn Bowls
Step forward, drop my back leg, bowl, lift my body up..... dribble.
Bicycle riding
The bicycle seat is designed to fit snuggly into my perineum and it puts pressure to the urethra. So every time I lift off and return to the saddle, yes I ……dribble.
Oral Sex
Climacturia, such an amazing Scrabble word, I would love to win the game on that triple word score. Sadly, climacturia appears more in my sexual follies than in Scrabble, and constant dribbling during oral sex is still a thing for me, including being told by my partner, that it tastes a lot like vinegar!! And remember that bit in the glossy brochure stating that I would have a “dry orgasm”? No, I squirt!
Stinky Pedro
If, for whatever reason I dribble during the day, by the end of that day my best friend Pedro who is tucked away in my jocks, develops a fragrance. Actually, it’s more of an odour, not too dissimilar to the smell of an old public urinal. In fact, it is gross and I am very conscious of bringing Pedro out to play with a lover if he smells that way.
So many dribble stories, and I am sure you all have your own humorous, embarrassing and even depressing tales of wee.
So, what can we, as prostate cancer survivors do with this dribbly issue?
Drink less? No, that is not the answer. If we drink less, we dehydrate, our bladder loses its flexibility and our wee ends up stinking of stale piss. Drink more is the recommendation.
Pelvic floor exercises? I've done that and yoga and pelvic exercises do work. I can only imagine the size of the wet spot I would have if I didn’t do my clenching and relaxing routine. But when I have a bike saddle or a camel pressing up into my groin, not even Superman could hold back the dribbles. So now I avoid camel and horse riding and I accept that I will dribble when I cycle. And I am still doing my exercises.
Use the bathroom regularly? Now this does work. Get into the habit of going to the bathroom before doing an activity that will create a dribble, and definitely empty your bladder before engaging in sex.
Wear a pad? Pads do work, and when I need to wear one, I have the confidence of no public displays of leakage.
Stop doing shots? That was easy, I now stick to beer and wine.
Stop having Sex? Now that is a stupid suggestion, but I do have to warn my partner to be wary of dribbles and urine ejaculation. I could issue out safety goggles but instead I use a firm cock ring that does a remarkable job in keeping Pedro firm for penetration and locks in any urine leakage.
Odours? I did some self-research and experimentation, and found that drinking coffee generates a pungent stale urine smell. I went off coffee and I drank tea and water for a while and the result was a significant reduction in Pedro’s fragrance.
I even researched that if I drank fruity herbal teas, would I get a fruit salad taste and smell? No sadly, but the idea has potential. If I am on a promise of intimacy, I will give Pedro a little duche, but I am still conscious of my partner being exposed to the smell and taste of my dribbles, so I use a scented lubricant.
And if you didn’t already know, do not let a partner to go down there if you have just eaten Asparagus !!!!
Engineering Solution
If you are having excessive urinary leakage, and pelvic floor exercises are not making any difference, there is a solution. It is an engineering solution. Put a new valve back in to replace the one that was removed. Google Artificial Urinary Sphincter and you will see a number of articles describing this device, and the testimonials that I have read, give the device a 100% leak free feeling.
If the device sounds suitable for your situation, talk to your urologist and I highly recommend using prostate cancer support groups to chat with men who have had one inserted.
Dribble On
Now, don’t get me wrong, I was angry about my situation, but that resentment has now passed. In recent times, I have listened to many men regarding their post-op journey, and everyone’s journey is different. What I have discussed here in a humorous manner, is meant to be informative for other men, and to give assurance that we are not alone on this journey.
I have come to the realisation that I will never regain my water tight bladder again. I have accepted that I will be up 3 times (or more) a night to the toilet, and that my new normal is that I dribble. But I am alive and healthy. What more can I ask for?
C’est la vie 😊