@jrs619
This is known possible side effect of RT - worsening of incontinence or developing one.
I am so sorry that it happened to you and that it is effecting your sleep too : (.

@jeffmarc had that happen several years after RT and he resolved it with surgery, maybe you can consider dong that too.

Wishing you the best of luck 🍀

@jrs619
I had this same problem. 3 1/2 years after the prostatectomy my PSA started rising, so I had salvage radiation. 6 years later I started having incontinence problems. It got progressively worse over the following 6 years.

I started using a Wiesner penis clamp when I went out. That eliminated the need to wear a pad for up to two hours at a time.

I finally got tired of it and in June I had an AUS (artificial urinary sphincter) put in and I no longer have to use any pads at all. Test done. That device works.

@jrs619 My radiation cystitis hit a year later, with back to back UTIs and hematuria. I never had leakage, but I did have my detrusor muscle go into overdrive and leave me afraid to go far from the house, even with pads or absorbent briefs on.

Eventually, Myrbetriq helped the detrusor muscle relax (it took 2× the initial dose), and dietary tweaks calmed down the irritation. I titrated off Myrbetriq after a year.

3½ years later, things are almost back to normal now, except that I go to the bathroom a bit more frequently and get up 1–2× most nights. But I managed a redeye to Europe OK.

Counterintuitively, the biggest help is drinking lots of water. You'd think it would make incontinence worse, but it actually dilutes irritants and flushes them out of the bladder.