Ask your urologist immediately for 8 session of Pelvic Floor Physical Therapy (PFPT). There is actually a subspecialty of physical therapy called PFPT. It is a normal and frequently used therapy for postpartum women who have been stretched out and are in recovery, but it is also for post-prostatectomy men and elderly men who have started incontinence.
On my own first day of PFPT, my therapist said that I was approved for just two session through my Medicare Advantage Plan HMO, but she said not to worry...all it takes is for her as the therapist to write a simple justification for a total of 8 sessions. My Medicare HMO approved it.
The PFPT exercises go well beyond standard Kegel exercises, to include learning how to breathe and use your diaphragm. My PFPT explained that your entire abdomen below your diaphragm to your anus is one giant compartment that works in unison based on pressure and airflow controlled by your diaphragm. You will learn specific exercises and feelings to know that you are using your diaphragm while properly breathing during your exercises. It was actually frustrating for me: I am a natural athlete and never had a problem mastering anything of a physical nature, but my therapist was frustrated. In the earliest of sessions she'd gently say "no...breathe this way, and don't hold your breath." By the end of my eighth session she was exasperated and nearly screaming at me: "NO, NO, you're STILL doing it backwards/wrong...I thought you said you're an athlete!" Let me tell you, learning to breathe the opposite of what nature wants, or to breathe at all was a challenge. Her other admonishment was "YOU'RE HOLDING YOUR BREATH...B R E A T H E!!!" I say this in lighthearted, retrospective jest. You'll likely have no issues with it, but the main thing to know, is that there is a whole world beyond Kegel exercises that a PFPT therapist needs to train you with. Ask your urologist for an order for PFPT.
Urologists are likely reluctant to write orders for it, because it costs them their group practice physician bonus pool money. If you don't know, for the last 30 years or more, physicians have been rewarded with bonus money for NOT referring patients for additional treatments, especially expensive ones. Whether quarterly, semi-annually, or annually, the physicians are rewarded by dividing a pool of money amongst their colleagues in the medical group for under-utilizing what insurance companies are known not to want to pay for. The pool of money is known ahead of time, and it is slowly chipped away at...dwindles...the more physicians write orders for what insurance companies don't want to pay for. There is often one or more people in a group practice, and every hospital has a small staff of former nurses and physicians who do patient chart reviews and assessments to rate the level of care and services given to patients, vs what is expected. Renegade, non-compliant physicians figuratively "get their hands slapped" for over-ordering/over-utilizing treatments and other patient services. This is of course, because hospitals know what they are going to be paid for a patient at the moment the patient is admitted to the hospital. If they know they are getting, say, $10,000 to care for a patient with a certain diagnosis who is normally in the hospital for "x" numbers of days, the hospital loses money if that patient isn/t discharged on time and overstays their "financial welcome." Hospitals like really sick patients (to a degree) because they get more money form them. A patient may be admitted for some type of surgery that will pay, say $20,000. But, if they are a Type II Diabetic with COPD because they smoked all of their life, and they have high blood pressure requiring medicine, and happen to have Crohn's disease of the bowel, then each of those additional conditions, offers added reimbursement on top of the $20,000 for the surgery. It is always a roll of the dice though: sometimes those patients take a real turn for the worse, and DO overstay their financial welcome because all of those other conditions delayed their normal recovery for the surgery. It's a crap shoot for sure. Sorry for the detour, but I think a lot of people do not know that about the finances of hospitals and medical groups contracted with certain insurance payers.
I offer this because you my friend, will be in a progression of diapers, to thicker pads, to thinner "Shields" style pads for the next year, but hopefully less. I am now at 11 months post-op, and I still can't claim 100% continence. I am 95% - 98% continent, but I still have mini-leaks and squirts with certain activities/motions. If you are over 65 years of age, Medicare will pay for most/all of the expense of the diapers (Medicare Plan dependent). Good luck, and hang in there.
@rlpostrp
Thanks for taking time to respond in detail.