7 weeks after Prostatectomy and still waking up a lot to pee.

At seven weeks post-op, your bladder is still rather "pissed off" (pun intended - haha). The bladder sat on top of your prostate that supplied some physical support to the bladder, which is no longer there. The consequence of the surgery is that you also lost the most important sphincter that controls urine retention and voluntary action to void when you need to. Also, the older you get, the smaller your bladder becomes (whether or not you had prostate CA). So, your bladder holds less urine now and without the support of the prostate that it used to have.

If you have not received an order for it, I highly recommend asking you urologist for a prescription for eight sessions of Pelvic Floor Physical Therapy (PFPT). There are NUMEROUS exercises beyond the standard Kegel's that will help you retrain, and "newly" train your bladder and remaining weaker sphincter, to regain continence. I was pretty good by my sixth session of PFPT, went for the seventh session, and skipped the last one. I am 99% continent after 6 months. I would recommend readjusting your expectations for when you will regain full urinary continence...don't allow yourself to expect too much too soon - you'll just get frustrated. One caveat: the pelvic floor muscles are rather small. I was over-doing-it with the PFPT exercises...I was aching down there. The therapist educated me that the muscles are small and can be easily over-worked with Kegel's. Start slowly and don't over-do-it...you're not at the gym pressing 250 pounds.
Depending on whether you wear boxer shorts (me) or jockey style undershorts, you would benefit from wearing a diaper (boxers) or a pad (jockey shorts), if you are prone to spontaneous leaks and accidents during waking hours. My accidents were mostly standing up from a seated position, or sitting down. Pressure release or new pressure applied to the perineum when you are seated or stand back up, causes a proportionate change in pressure on your bladder. At night, it will get better. The fact that you are laying down prone on your back prevents gravity from working on your bladder. See below for advice on liquid consumption. And...
I thought I'd be brilliant ("not") to save myself grief while out on errands or shopping, so I put a "pad" inside my "diaper", so I could use a restroom to quickly pull out the wet pad and replace with a fresh dry pad. It took me a while, but I realized that the extra thickness/volume of the pad had to be accommodated in terms of "space occupied", and it was...by pushing up on my perineum, thus causing my bladder to leak more than it should have, and would have had I not had the pad inserted in the diaper. When I finally caught on, and removed the pad from my routine, I improved my perceived "incontinence" by 75% instantly. Instead of carrying an extra "pad" in my pants pocket, now I carry an extra, folded up Depends diaper (no bigger than a traditional wallet). I wear a lot of Vuori shorts and long pants that have a zippered pocket on the side of the left thigh. The folded diaper fits perfectly in the zippered pocket, and I never have to worry about it falling out and embarrassing myself in public (no guy wants to drop a diaper on the floor of the grocery store or at the mall right?). All of these months later, I now just use a thin Depends "Shield" in my new boxer-style briefs (like jockey shorts with short legs). I barely stain/dribble now at six months post-op. I got to this point after 4.5 - 5 months.
Be patient...readjust your expectations...get the right protection (diaper or pad), and lastly...adjust the volume of liquid you drink. Part of PFPT is that the therapist will tell you not to consume any more than 8 oz of any liquid at any given time, and that the best time to drink is right after you urinate "on schedule" every two (2) hours whether you need to or not. Having a two-hour schedule ensures that your bladder doesn't ever have too much urine in it. And for now...avoid all caffeine (coffee, tea, sodas), and acidic liquids (OJ, etc.).
Good luck.

Ten week after surgery, I still experience limited "stress incontinence" like when I suddently cough or get up from a chair. I started pelvic floor exercises with a PT 4 weeks ago, and expect to continue for the next 6 weeks. I do have pre-existing OAB issues whereby my bladder feels it is full when it is only 1/3 full. I have gotten up about 3 times at night for decades and still do. Over these years, I tried all kinds of OAB medications which either did not work or raised my blood pressure (e.g. myrbetriq). I tried electrical stimation therapy (PTNS), I even tried Botox injection...none worked. There are some drugs like vibegron and tolterodine which I have not yet tried which I plan to discuss with my uroligst during my next appointment (not with high hopes given my past experiences but out of curiosity). As for the limited stress incontience which I am easily managing with Depend day and night briefs, I am hoping it will gradually improve as I continue my pelvic floor exercise.

We are all in the same boat. I wish you luck.

I am 4 weeks post RARP. Haven't attempted sex yet, but erections don't seem to be a problem. Have decent continence (I think) for this stage. Two things I like the most (coffee and alcohol) sure seem to exacerbate matters. Alcohol in the evenings result in frequent urges, but I piss like a racehorse. Sleep seems to be fine/dry, but when I wake up around 5 am or so, I do have an urge and will urinate three times in the first 30 - 45 minutes. I'm trying to be disciplined with no strenuous activity till the 6 week mark, but have been walking a good a bit with very mild/light floor exercises (to include kegels every other day as prescribed). I do squirt a little when on the floor, but not enough to embarrass or require pads. Currently, I'm testing to see how long I can go without the need of a pad. Getting better everyday, but by late afternoon or if going out in public, enough dribble/leakage to warrant. The Tena pads seem to work great. Mayo Jax did a great job helping me with expectations, so I'm not freaked out. One day at a time with the knowledge that results/progress vary from one pecker to the next. A good pathology report and positive attitude are my personal keys to victory.

@soli
You might look into Gemtesa. It can Reduce stress incontinence, which you’re having at night. It does not significantly affect blood pressure.

It’s interesting that you found Myrbetriq affected your blood pressure. I’ve had high blood pressure ever since taking Zytiga, but Myrbetriq Has never caused me a problem. I do take three medications twice a day to get my blood pressure below normal.

Thanks Jeff. I will definitely look into Gemetesa. I may also revist Myrbetriq since it could have been a case of correlation instead of causation.

@folmajt -- Sounds like you're doing really well and have a great attitude. I was 70 when I had NS RARP 16+ months ago. Even though I believe I was never incontinent, I certainly had many minor accidental releases while I was figuring out the new normal. For example, when I was allowed to resume working out in the gym at 6 weeks I started really easy. After a few more weeks I finally got to the point where I was lifting something that took a little effort. The first time I did, a little squirt. Those accidental releases would happen occasionally, typically when I did something new physically. It took a while to get past it, but now at 16 months, I feel fully back to normal. Switching to ED, it sounds like you're way ahead of me. At one month I was maybe 65% firm if I could get an erection at all. Also, the first few times I tried having sex I had some urine release as well. Progress was very slow for me and I used both Cialis and Viagra as part of my rehab. Also the dry climax's took a little getting used to. But by about 15 months I considered myself fully back to normal and I find the climax as satisfying as before. All along, I did my Kegels and worked on penile rehab. I just wanted to share my story with you because along the way there were many times I wondered if I'd ever get back to normal. Best wishes.

Hi @jeffmarc : it turns out the generic drug Vibegron which I said I will discuss with my urologist in my earlier response happens to have the brand name Gemtesa. So, we are on the same page!

@hmishkind
I see your post was in February, how are you doing now, 9 months later?

I am currently 7 weeks post RARP operation and I’m basically at the point that you describe in your post. I’m feeling depressed as I’m not seeing the progress I expected.

When does the situation get better?

@paulbwatertownct
What progress were you expecting that is not occurring. I had a prostatectomy 16 years ago and for 3 1/2 years I didn’t have issues then my PSA started rising.

Are you on ADT drugs? Those can cause depression for some people.

There are two things you can do about depression and anxiety with prostate cancer. A lot of people say that doing a lot of exercise changes their mood significantly. Getting out and running, Or at least walking a few miles. Going to A park to do it can lift your mood more. I do it twice a day just got back from the park across the street. Petted a Couple of dogs. I go and run 1 mile twice a day every day and go to the gym three times a week.

Another option is to have medication. Usually need to see a psychiatrist to get it prescribed. The below lists drugs that people on this forum and other places have mentioned, made them have a complete turnaround in how they felt about life.

Common drugs for depression and anxiety
Wellbutrin, Zoloft, Effexor, Buspirone, Cymbalta, Lexipro,

One thing you could do is attend an ancan.org Speaking freely meeting. People come on and talk about their emotions and their feelings about what’s going on with their cancers. If you go to that website, you could sign up and they’ll send you a newsletter. The next meeting is Thursday at 5 o’clock Pacific 8 PM Eastern. You could see that there are many other people that have similar feelings, but learn how to moderate them.

Been a year and 3 months, i still pee alot!