@ljbboston -- I know you asked @perrychristopher, but thought I'd weigh with as well to your question. I'm no expert, but from what I read and heard from my doctor, Pelvic Physical Therapy is essentially just exercises (ie. Kegals) to strengthen the muscles that play a role in controlling urination. If you do choose RALP, then Kegals are very important as they will strengthen the muscles that remain after RALP. As with pretty much any muscle, starting early is better, so I was advised to start them before surgery since I had time. Then continue after the catheter came out. There's some excellent videos on the web. I particularly liked some by Michelle Kenway; she has several on youtube. They're easy to find. I'm not suggesting you shouldn't see a therapist, but rather the videos will give you a chance to see what they're like. Frankly, I ended up just using the videos as it seemed pretty straightforward to me and I felt like I was doing them right. But if I'd had any questions or concerns or incontinence, then I'd have definitely seen a therapist. As I said, I'm not a medical expert, but just wanted to share my experience with you.

I retired in February 2022. It had nothing to do with the PCa though. Forty years was enough for me, lol. I started the PT about 7 weeks after the surgery. They won't let you start before that as you need time to heal. I have seen others on this site say they had PT before surgery which seems like a good idea. My surgeon wanted me to talk to an Oncologist before I made my decision between surgery or radiation. I decided on surgery as I was 60 at time of diagnosis and also wanted to have the option of radiation if the PCa ever comes back. As far as other questions to ask other than his number of surgeries he's performed...... I'd ask based on size and location of tumor what are chances of incontinence after surgery. Also, what is he removing. Will it be nerve sparing surgery in his opinion. Also, my surgeon never ran a Decipher test on my biopsy sample or removed tumor. The Decipher test tells you how aggressive the cancer may be. You could ask him about the benefits of performing this if he hasn't ran it yet on the biopsy you had. It's a lot to handle but you'll get through it. Good luck with whatever decision you make. We are lucky in the sense there are so many treatments for PCa.

Hi. Just checking in to see how you’re doing. If you haven’t already seen the surgeon, you may want to add this question to your list

“What is Plan B if plan a fails and cancer returns?”

The only non-medical advice that I’ll share is if you decide to go the surgery route and perhaps even the radiation route I would learn how to do and start doing Keagles before whatever procedure you go through. That advice was given to me by someone on this forum. I did Keagles for three weeks before my surgery. I was mostly continant a week after the catheter was removed. I continue to do keagkes each day and seldom am in a panic to find a bathroom.

Good luck on your journey. We’re here for you!