My comment is directed toward those who are worried about incontinence, not those who are dealing with it. My own concern about incontinence only exceeded my concern about erectile dysfunction. I was geared up and focused on incontinence when I had my surgery. RALP and a catheter are a cautionary tale for anyone, I think.
I survived my (first) catheter, even though the pain in my penis after surgery had to be the pinnacle of pain I've experienced, and that probably has contributed to my difficulty with concern number two.
However, weighing male diapers (of which I have an apparently lifetime supply,) then pads (the ubiquitous ones for women work just fine,) I quickly discovered my volume of leakage was very low--and diminishing.
Yes, I even now still have very occasional climacturia, but the volume is incredibly low, urine is sterile not poisonous, and as an avid hiker and biker who has lived in the tropics, my existing clothes (and bedwear) have seen far worse. For me, this turned out to be a fear more than a problem and I am grateful.
My concern about doing "kegels"--which my pt refuses to call pelvic floor exercises since it's a largely female problem named for an old white man ;-)-- rapidly turned into amazement that my body could retrain itself after such a damaging abdominal surgery.
I may keep hanging onto the supplies or buy more when my condition changes--after all, as some of you know far better than I, this is a progressive disease, but I am grateful that this particular concern has remained minor, not compelling.
So, as I said, to those of you worrying that incontinence will ruin your life, it may, but not necessarily. Each day will have enough problems of its own. Don't pick your medical path by overfocusing on one or more of the quality of life issues. For today, my recently torn ankle ligament is far more preoccupying than incontinence, erectile dysfunction, or cancer, and for the last week until yesterday it was the sinusitis which I was reasonably certain was a very short term agony.
So here's to the journey, and embracing it one day at a time, so long as it is today. For my brothers who are fiercely doing pelvic floor exercises wondering why they haven't brought the hoped for relief, you have my respect and my empathy. May you find the grace and courage to live well however you find today. For those who only wish incontinence was your primary concern, you have my respect and my admiration, as you go where I have yet to go and have no interest in going, but may well go in the days yet to come. (But my guess is you might not have bothered to read this thread anyway :-(.)
Like you I have suffered the consequences of radiation, in my case for ovarian cancer. I have found that the care for these consequences seems minimal compared to what is provided in the UK. I found an amazing support group, Pelvic Radiation Disease Association that I wish was available here. They provide a comprehensive booklet entitled "managing the bladder late effects of pelvic radiotherapy" that is available online for free from their website, click on their Resources tab. Mayo won't let my share the link in this comment.
Perhaps that can guide your efforts.
I agree that life is too rich to focus on one issue. Every day we breath is a gift.