For me, it's that the really effective muscle is gone, & I have to rely on the other two that haven't been trained since birth (unlike the other half of our species). Before surgery 5 years ago, I could last all day. Now I carry one of those specially shaped plastic bottles in the car, but so far have not had to use it. If I'm out, I no longer automatically think "I can make it home".
I plan ahead. If the urge is there, I deal with it soon. I usually can make it through the night.
I do drink more fluids these days, so combined with the weaker muscles, I end up with frequent trips to the commode.
However, THE MOST ANNOYING THING about all of this, is NOT the frequent trips. It's that my penis has shrunk (see related threads) to the point where getting it out of my pants needs more than a little help. Even sitting naked on the commode, I have to check that the scrotal sac is not blocking the penis. If I don't, I urinate all over myself.
@readandlearn Shrinkage is definitely a real thing. I was very much worried about that for sure. I think I read a bunch of your postings and feel really bad you're dealing with this issue for so long.
I'm not saying do this, but the Restorex unit appears to be effective for me for that issue. Mind you, I had no intention of going this route, but my sexual function doctor got me signed up for a trial and got the unit for free (it's $550 otherwise). I agreed because I figured it would push me to actually do it daily.
I've been using it for two months and can definitely tell a difference in size. It takes at least a month before you really notice changes. It's a FDA approved device developed by the docs at Mayo.
Don't know if you've explored this, but perhaps you could reach out to a specialist and see if it makes sense for your situation. Hang in there and thanks for sharing.