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@tico14

New here. RALP in 2018, age 72. Gleason 7 (4+3); EPE & PSM unifocal rt posterior; pT3a, pN0. Were I starting again, I would have waited but here I am. Surgeon said surgery was nerve sparing. My nerves disagree. Nothing works down there except to leak - a lot! Minimum six Depends a day since. No other problems until over the past year and a half, when my PSA started to rise in August 2023 from < 0.01, to January 2024 < 0.04, June 2024 < 0.04, December 2024 < 0.07, February 2025 < 0.09 (different lab), April 2025 < 0.07 and May 2025 < 0.06. Concerned, but not worried - yet.

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Replies to "New here. RALP in 2018, age 72. Gleason 7 (4+3); EPE & PSM unifocal rt posterior;..."

After surgery, they don’t usually want to do anything until your PSA hits .2. Then it is important to do something soon because waiting has longer term implications. Bouncing around like you’re saying is not unusual.

Fixed for incontinence
The sling is an option If you’ve had radiation the sling may not work..

Bulkamid is another option not as widely used on men

Another choice is ProACT. It has been discussed in this forum recently. They insert a couple of balloons in your body where your prostate was And they can inflate and deflate them to match what you need.

The AUS (artificial urinary sphincter) is the last option to consider. It is not 100% blockage, there can be leakage.

Not sure I could say 100% leakage proof about any of the products mentioned they just improve it a lot, close to that

ProACT is something I would be interested in, A few other people in this forum have had it and really like it. A urologist I work with, who specializes in incontinence, said that they were working on getting certified for it, and she would look around for another urologist that was already using it at Kaiser.

Contact a urologist to specializes in incontinence. They are the ones to talk to about this.