@psychometric, first, I'm a PCa patient, like you, sorting through treatment decisions, so my opinion doesn't mean as much as the people who have walked ahead of us on the PCa treatment trail. However, your diagnostic situation and mine seem very similar. In your shoes, I would go (and have gone) for multiple opinions about different treatments from various providers. Each time I did so I learned something helpful.

Based on your comment that both RO's now disfavor SBRT and the fact that your surgeon did a cystoscopy, I'm wondering if we are not in a similar position: trying to select between treatments with a pre-treatment risk of a grade 3 late stage GU toxicity reaction to radiation therapy because of pre-existing lower urinary tract symptoms (LUTS). Have they talked to you about that? My understanding is there are several possible reasons: obstructive, neurological, and functional/medication, each with a different solution. Sounds like your surgeon ruled out the internal obstructive causes. The Rx for 'over-active bladder' is attempting to address one functional possibility. Heavyphil is right, in most cases the cause of LUTS can be addressed before the RT, making you a better candidate for RT, if that were your preference.

In my particular case, I think early on in my diagnosis and treatment discussions I was too overwhelmed with the larger picture to pick up on the nuances of the discussion. For me, one of the greatest values of talking to several providers about several different treatment approaches was that I was a better listener and I asked better questions at the later diagnosis and treatment discussions. One question I didn't ask is: Is there a difference in how much each type of RT affects the GU system?

Please follow up and let us know the outcomes of your discussions and decisions. It will certainly help me and others!

Best wishes!
Guy