Can't do Kegel exercises. They seem too weak for full incontinence

One more thing: I have occassionally used an incontinence clamp for an hour or two while doing Yoga or other exercises, but I want to make sure it does not interfere with my long term recovery process (however long that may take). Anyone with experience using the clamp, or with opinion of the utility or potential harm of the occasional use of the clamp for short periods
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I too had prostatectomy in early September and worked on pelvic floor and kegel exercises under the direction of a PT for many weeks. Instead of getting better, my incontinence is getting worse whcih concerned me, I do have pre-existing OAB issues which complicate matters. I have started taking Vibegron to help with my OAB , but so far no improvement. Also, I did notice I tend to strain when I do no.2 even when I am no constipated, so I believe that does not help either. I am at a loss but I have found a lot of valuable infomation in this thread which I will try to learn from. Knowing that it may take some people a very long time before improving is somewhat reassuring and gives me some hope.

It is possible I over-did my exercises and fatigued my still-healing pelvic floor, so I took a break from theses exercises for about a week. I will do the same for another week or two. In the meantime, I am only doing diaphragmatic breathing for 5 minutes twice a day. I do plan to visiit with my surgeon in mid January, and will see what he suggests, I plan to ask him to renew his referal to a PTherapist which I will use to work with a different PT from the previous one.

Any input or advice from those on this discussion thread would be very welcome.

Happy holidays!

good morning Soli

I am not a PT or super-experienced in all of this. I am just a case of one. (NS RP) January 2025)
In terms of doing too much and resting, I really think this can be important
most of the research supports a regimen of daily Kegels ( slow and quick ones anywhere from five to 15 of the slow ones anywhere from once to three times a day ( I believe I saw one reference to someone doing ten sets a day in all the NIH articles I looked at none were even close to that. For me, at the beginning< I would do anything to speed up the return of continence. I definitely did too many, too hard, too much straining etc. It was hard for me to back off as I kept thinking I did not want the slow route ( no pain, no gain) However when I finally got a to a trained PT she convinced me correctly to work on form and slow down.
She also recommended that I lie on back for about 20 minutes three times a day.
Now that I am 11 months out, I can definitely see a correlation to my doing too much and regression, For examp0le, I lift up my grand kids and have fun with them, then I leak more,. When I do my daily exercise (stationary bike and walking mainly) and feel good and try to double it, I leak. When I move furniture around or work on projects, I leak. When I take it easy I leak little at this point. This makes me believe in the correlation between core muscles and continence and taking it slow and easy and careful
I have also noticed that when I get poor sleep, I leak more.
Besides getting to a good PT if your current PT is not experienced with males and RP,.- and please do not take this as a professional recommendation:
I would try really paying attention to your daily activity and any changes you notice
I would continue to do a daily Kegel routine ( slow and fast ones) as well as core and other exercises in which you purposely engage PFMs for example, every time you get up from a chair.
I would lie on my back three times a day ( less gravity on the bladder) (How can this hurt?)

Why wait for the next time you will see your urologist? I would try to get the next available and make sure s/he has something specific to offer?
I hope this helps
Incontinence sucks

@soli straining while doing number 2 definitely weakens the pelvic floor muscles (per my PT). Try drawing your abs up and in towards the diaphragm. This put pressure higher up and puts less pressure on the pelvic floor. The same technique also helps to empty the bladder completely.

I was 61 when I had surgery. I was in good shape as I have consistently lifted weights and exercised my entire life. Despite that, after surgery I was completely incontinent. No matter how many Keegles I did, it did not work. I ended up trying everything, clamps, condom catheter, different exercises, etc. I was producing an overwhelming amount of urine, filling my condom catheter bag many times over the course of a day. I also had a lot of pain. Part of my problem was that I had an infection that nobody thought was there as they all said it was just part of healing. After I demanded to have tests for infection (which proved that I was indeed dealing with a serious infection) I was out on antibiotics (like 6 weeks after surgery) my ability to control urine returned quickly.
If you have an issue with not being able to contract your muscles for Keegles, do different exercises. I have read research articles that show that there are several exercises that far exceed the effectiveness of Keegles for strengthening the pelvic floor.
I would make sure my bladder was empty. Put on a fresh Depends. Put a towel on the floor and do bridges, side leg raises, cat-cows, unweighted squats, sit ups, crunches, all fours hovering, leg lifts, pelvic thrusts, things like that. Do them every day. I stopped with Keegles because when you do larger muscle group movements, you are exercising those muscles as part of the larger group.
If none of those are possible, try to work on the exercise you can almost do the best and practice that and add as you increase strength.
Talk to your doctor and seek help from a physical therapist if possible.
My incontinence resolved. I returned to pre-surgery control after about 6 months. However, I worked on it every day.
Good luck!