I had the single-incision DaVinci robotic radical prostatectomy in mid-April 2025. Catheter came out April 29th. My incontinence has been exasperating and frustrating. I sleep well at night, except I do get up once to urinate which I do not understand. Without a prostate to exacerbate urinary problems, I am very disappointed that I have to get up at night. Right now my incontinence really accelerates after breakfast. By 10:00 - 11:00 a.m., I have gone through a second pad inside my diaper. The presence of the pad increases discomfort in the genital and perineum area (crowded inside that diaper). I also need Tylenol at 09:00 a.m. because I start to feel a strong, rather heavy level of increasing perineum pain by 9:00 a.m. I switch to Mortrin at ~1:00 - 2:00 p.m. because the Tylenol doesn't help very long. Then by 6:00 - 7:00 p.m., I need the Tylenol again. I have done my Kegel exercises, but having no prior experience, I don't know if I am doing enough, too many, or not enough. All I know is that they do not work, and that I am in pain. I have resorted to hourly visits to the bathroom that sees me urinate a very good volume. It is exasperating that within 5-10 minutes after using the bathroom, and replacing a wet diaper and/or pad, I leak again. The biggest source of leaking is when I have been sitting down (chair, couch, car seat, etc.), and then I stand up. There is apparently a release of pressure down there, and like a flood gate opening, it just starts flowing out of me. I try to use a Kegel move on it to halt it, but as soon as I release the Kegel move, it resumes. I carry 2-3 pads in my car if I am out on errands because when I park my car, and stand to exit the car, I flood my pad. I just stand there, let it happen, then get back in the car, pull the wet pad out, and insert a new, clean, dry pad. I can't stand walking around in a store with a completely soaked pad or diaper. I find myself parking in distant places to make sure I have the privacy for the quick change of pads without being seen. I have been having thoughts of my dad who, like a lot of men, had prostate cancer and never did a thing about it. My dad lived with it for more than 20 years and died at age 99 years. My maternal grandfather had prostate cancer in the 1970's - 1980's. He had injections straight into the prostate (ouch!), and lived to age 96 without having had the surgery. I am now regretting that I ever had the surgery. I have no genetic predisposition (genetic testing), and my Gleeson Score was 3+4 = 7 and a PSA of 6.2. Pathology report did say that there were surgical margins and slight invasion into my left seminal vesicle, so I am classified a pT3b which means that I have a likelihood of the cancer returning. My doctor says we need to talk about radiation. That will happen in my 3-month, post-catheter removal follow-up in July. Anyone have any ideas on resolving the perineum and deep penis paid? And how many Kegel exercises do you do...how many is "enough"?
I can certainly empathize with your situation. I am 50 years old with a pT3b but with Gleason 9. I will also be having follow up radiation sometime soon. My RALP was 2 weeks ago 5/22. I have similar incontinence issues and I hope they get better over the coming months. The perineum pain when I sit down is also bothersome but I’m hoping that too will resolve over the next few months. I am also doing Kagels but I may ask doctor if I should be referred to a physical therapist. I have heard it helps.
I hope things get better for you.