After prostratectomy: What underwear and protection do you recommend?

As you can tell from the responses, every person is different, from the amount of incontinence, whether or when it stopped, to which products they feel comfortable using. I'm 18 months post surgery, and still have quite a bit of leakage when I am active, so to play it safe, I have settled on wearing a Depend or Tena brief on days when I am mostly sitting down (work days, desk job), and then adding a pad during active days. It works; not what I would have hoped for, but it is the "new me." Good luck with your surgery and your journey.

@djkurr, in addition to the link that @jeffmarc posted for you, here are a few more:
@retireddoc, @spino and others talk about worrying about incontinence and things you can do to help prevent or improve it.
- Improving Incontinence Post Therapy https://connect.mayoclinic.org/discussion/improving-incontinence-post-therapy/
- Washable incontinence underwear https://connect.mayoclinic.org/discussion/washable-incontinence-underwear/
- Incontinence Improvement with Pelvic PT https://connect.mayoclinic.org/discussion/disappoints-incontinence-improvement-with-pelvic-pt/

There are many discussions about Kegel and pelvic floor exercises. Use the group search and keywords to find more answers:
Kegel discussions: https://connect.mayoclinic.org/group/prostate-cancer/

Surgery and recovery https://connect.mayoclinic.org/group/prostate-cancer/

Keep asking questions. 🙂

@djkurr Stage two and moderate aggressive guy here too. I had surgery just about two months ago. I can't tell you what to do decision wise...but my calculation was that doing nothing would lead to major regrets and major progression.

Catching cancer at this stage means much better chance of avoiding having to do lots of followup treatments later, all with side effects that are difficult.

I use to sleep nude at night. I haven't got back to that stage post surgery yet, but there are really more important things in life....like life.

The catheter phase is annoying...but I got used to it in a week and then it was gone. The incontinence phase is challenging early, but it gets much better for most over the course of three months. I'm much better. But, no doubt, it's challenging.

There are lots of treatment options, so if surgery isn't your choice, you've got options. I decided not on which treatment had the least disagreeable side effects...but which treatment would offer the best chance if there was recurrence. Meaning, if it came back, what first treatment option gave me the best chance.

Lots of people choose radiation, which may be an option for you. In my case, I would have had to do radiation plus hormone therapy at the start, and I definitely didn't want that.

As others have said, start with loose sweat pants at the hospital and for the first couple of weeks. Once the catheter is out, start with pullup briefs and then insert a heavy pad into the pullup so that you don't go through so many pullups. Once you're done with pullups and just using pads (I started with Tena Maxium Pads), you'll need somewhat tight underwear to hold the pad in place or you'll risk leaks. I went so far as to wear a jock strap for ultimate confidence that the pad won't gap or slide. But, very few people do that.

Hang in there and you'll get through this. Not easy and we sure didn't ask for this...but the hand has been dealt. Keep posting and we'll offer support and advice best we can. It's a great community here.

@djkurr A good plan for the early phase of incontinence is to use a quality pullup brief and then insert pads in the front and just change those as needed. You can keep one pad in your back pocket while at work and then switch it out and not change the brief. The brief is there for insurance if there are leaks.

Nobody will know that you're wearing them. It makes no sound and they are compact enough that if you wear standard pants, it's complete unnoticeable.

For me, I got away from pullups within a couple of weeks post catheter and just went with pads. Once again, just keep a pad in your back pocket and switch when needed.

For pullup briefs, I used: "Tena Men Maximum Incontinence Underwear, Grey"
Those worked great.
https://www.amazon.com/dp/B0DPR5BZPZ
For pads, I used: TENA Men Maximum Guards. Also have worked great.
https://www.amazon.com/dp/B072JC8RQT
For post surgery, I used these protectors on my recliner and bed and car seat....but candidly, they were only necessary for me twice when my pad had slipped while sleeping.
https://www.amazon.com/dp/B0037VRWE6
So, to keep pads from slipping around, I wore a jock strap. I used these because they are cheap. They run small, so definitely, order a size up from your normal underwear size.
https://www.amazon.com/dp/B07WN3SQHJ
Everyone is different, but these all worked great for me.

I'm close to moving to lighter pads....but the Tena maximums are great for some confidence during longer stretches.

I was leaking a lot for first couple of weeks, and was paranoid about it. Depends briefs are the best, but if you're going through a lot, any cheaper brand will work. At night, I added a pad that I could take out without changing the Depends.
After the leaking slowed down, I used a pad during the day in my underwear, and that gradually went to shields (Tena) and nothing now unless I am going to be very active. I prefer boxer-briefs. They are tighter to your body and legs than regular boxers, and I found the pads less likely to slip. My favorite brand is the Duluth Trading Post "Bullpen" boxer briefs. They have a pocket in front (for your junk) that holds apart pad or shield right in place.

Agreeing that those protective absorbent mats to have on your bed is a good idea. Mattresses are expensive.

@marlon
I tried the store brand pads once and found them much inferior to depends. People can try them, but be aware they might not work as well.

This will be a phased process for you. You'll have the catheter, and it will need drainage (whether large bag or small straped to your leg), fairly frequently during the day while it is in for 10-12 days before removal. You will be best starting with full Depends-type underwear shorts after the catheter is removed. I personally stayed home while I had the catheter in. I did not leave the house, but I had the luxury of being retired. You may need to work, BUT...you likely will not want to or be able to work for about 2-3 weeks minimum. Everyone heals differently, but after I had the DaVinci, single-incision prostatectomy, I felt deep pain. It felt like I had been pummeled and beat down... "assaulted."
You will have lost the most important of your two urinary sphincters due to the surgery. The one that is left is the weaker of the two, and it will take time to strengthen it to regain your continence. ***MAKE SURE that you ask your urologist for a prescription for Pelvic Floor Physical Therapy (PFPT). Your insurance will initially approve two sessions (most likely) but your PFPT Therapist will write a simple justification for a total of eight sessions that your insurance company will approve. This therapy goes well beyond basic Kegel exercises. Try to start your basic Kegel exercises before your surgery as well, to get a head start.
"Luckier guys" see full restoration of urinary continence within about three months, but they are kind of rare. I progressed from the full Depends pull up undershorts underwear to wearing Depends "pads" at about 3-4 months. The challenge was that I was a "boxers" guy. I had to switch to jockey style underwear so the pads would fit properly in and stick to the fabric of the jockey style crotch. A "pad" would fall out of boxer shorts. You will wear the "pads" for 3-6 months before you can switch down to thin Depends "Shields" for just occasional leaks and unexpected squirts. You'll also use about 5-8 "pads" per day due to the volume of urine you produce. Same with the Depends diaper-style underwear. Once you get to Shields you will have learned a lot of control and retention of your urine, so you will get to the point that you'll eventually wear just one to two, maybe three "max" Shields per day. I wear two, sometimes a third just to feel cleaner.
It took me about 9 months before I became 98% continent, but to this day, now 14 months post-op, I still wear Shields because I still have rare little leaks and squirts like when I sit down in my car, or squat in the backyard. I look forward to being 100% continent, but even at 14 months, I am not. It is my fault too...I stopped doing my Kegel and PFPT style exercises months ago. I ws over-doing them to the point of having pain in those small, thin muscles. I just stop and never resumed after I felt better "down there." Also...
You will learn in PFPT that you must limit your liquid intake. No alcohol, no caffeine containing drinks (coffee, tea, sodas), and no acidic beverages like OJ. You'll basically be drinking water 95% of the time, and only 8 ounces at a time. If you drink more, you'll be rushing to the bathroom or changing yet another diaper or pad. I adapted easily and well to my new liquid consumption. You also learn to urinate every two hours "max" so you get urine out of you more frequently. You'll drink 8 ounces of water right after you urinate. There is a fine line between drinking enough liquid to keep your bladder from shrinking, and drinking too much and flooding diapers and pads to much frustration. Good luck to you. You will be fine.

I tried multiple types of briefs after surgery.
The ones that helped the most and I still use after 22 years are microfiber with a pouch. The pads fit perfectly in the pouch. Also went to one size smaller to ensure no slipping.

I bought briefs to wear after the catheter was removed, thinking my boxer briefs would not be snug enough to hold a pad tightly. The briefs were too small for me, so wish I would have gone up a size. For sure boxers are not snug enough and for sure cotton boxer briefs would also not hold a pad tightly. But eventually found that most of my synthetic (polyester or whatever material) boxer briefs were snug enough.

@rlpostrp
Four days after surgery, I went to three clients offices, and worked on their computer problems with the catheter in and a bag strap to my leg. Seven days after surgery, I went back to work full-time. I was following a weekend. Some people recover a lot quicker than other so all I needed was Tylenol. I had no leakage with the catheter in, so I didn’t need a pad.

At that time 16 years ago, they kept the catheter in for two weeks. When they removed it, I had no leakage at all. When I was at clients office with a catheter, I just went into their bathroom and emptied the bag occasionally.

None of my clients had any idea I just had prostate cancer surgery. I did not tell any of them.

Recovery can be very different from one person to another. I was 62 when I had the surgery.