@jeffmarc
I had prostate surgery on September 3rd of last year. My PSA is undetectable, which I’m grateful for, but I continue to struggle with incontinence that has not improved at all despite more than five months of diligent pelvic floor exercises.

Biofeedback testing with my new physical therapist confirmed that I am performing the pelvic floor exercises correctly. However, I still need to build the habit of contracting the muscles proactively — for example, just before sneezing, standing up, or making other position changes. In addition, I need to do the exercises not mostly lying down as in the past, but while standing up and doing normal things like walking or anything else functional.

Currently, I use one pad at night and typically two to three pads during the day. About a month ago, I began using the Weisner clamp you mentioned during the day. To reduce the risk of UTI, I empty my bladder every hour or two and reposition the clamp periodically to minimize discomfort. If the discomfort becomes noticeable or persistent, I stop using it for an hour or two. So far, it has been helpful, but I’m unsure whether this is a sustainable long-term solution.

My surgeon referred me to a specialist who was ready to schedule an AUS implant right away. I told him, “Not so fast.” While I understand that the American Urological Association suggests considering further intervention if continence has not improved within six months — and I am now at about the six-month mark — I am not ready to move to another invasive procedure just yet. I would like to continue working intensively with my new PT for a couple more months and then reassess.

I would really appreciate hearing from others who have faced a similar situation. Did continued therapy beyond six months make a difference for you? How did you decide when it was time to move forward with AUS?

Thank you in advance for sharing your experiences.