One month post daVince robotic prostatectomy. 70 years old. Active (could exercise more) Catheter removed day 8. Persistent incontinence. Doing Kegel exercises. Awaiting contacts with local Physical Therapists for Pelvic floor, core and post surgical rehab program.
Open to ideas from others post surgery. How long will this take to regain control?
At what point to consider medications or other options?
Depends on the type of body "signaling". If urine starts flowing without any prior sense of a need to urinate, than this isn't a good omen. I did get very intense signals that only allowed me some seconds to run for the toilet. Also, the signaling repetition rate was of the order of 20-30 min and the evacuated volume was less than 100 ml. That lasted for approx the first 1-2 months. At 6 months it wasn't any more a concern of mine, frequency declined and reassuring volumes of up to 300 ml were attained. They say that whatever improvement can occur this is within the 1st year or a year and a half. In my case the best, almost 100% continence was observed at the 2.5 to 3 years mark. Now, 5 years post RP, I started doing Kegels again, that I had stopped for some years, as have noticed some slight deterioration.
Mahalo (thank you) all for the Replies.
As was said...it's all different. I only "leaked" a bit after surgery. Might have filled a couple of pads the first week or two? I know after a couple of months I stopped wearing any pads at all and have not leaked since. I was 60 at the time. I'd say at 1 month you're a bit early and remember this, it does not subside proportionately. It seems to improve all at once. So don't get discouraged. I never did Kegels but a lot of guys say they really help. Good luck to ya!
After nearly two years following my robotic RP, I’m still experiencing minor incontinence issues. Mostly drips and dribbles. I did all the exercises (daily Kegels) and prescribed PT. But still have SUI — while playing golf or chasing my grandkids.
I have looked into surgical options, but really don’t want to go that route. Since your surgery was fairly recent, I would continue with your exercises and I hope your incontinence abates.
Up to 2 years buddy!
You will get lots of nice advice about kegels and information regarding the different types of incontinence. If yours is not too bad, do whatever you can-kegels, reduced fluid intake, no caffeine etc etc.
But, if it is heavy and constant, or becomes that way, the sling and the AUS (artificial urinary sphincter) are the ‘last stop’ solutions. The AUS is ideal for the worst cases, such as mine was.
Yes it is another surgery, and yes it is a device implanted in you, and yes it has to be replaced approximately every 7-15 years.
However, only those who have lived with heavy and/or relentless incontinence for any length of time can appreciate how little those things matter.z. Easy to use, not perfect but nearly so.
Try everything else first of course, but know that it’s there if you need it. I couldn’t be happier.
Mahalo (thank you) all for the Replies.
maybe connect with the Penis Project. I think it’s based in Australia but it’s also web based.
That remaining sphincter is lazy. And it is a voluntary muscle. This means your brain has to figure out when to activate it. Brains don’t like to be wet down there, so will figure it out. Unusual situations will trigger leakage for the first year or two, as the brain has not encountered them. Exercise after surgery is an extreme version of this. For months, after a sweaty hike, I’d be wet in my pad, hoping it was sweat. Nope. (Coming down was the issue, fwiw). 2-3 months in, the brain had it figured out.
Isolating right Kegel muscles asap helps immensely. Hang in there.
All of the comments posted thus far are very informative for you...give it time. I am coming up on 5 years, 66 when I had my RP, and still have stress incontinence. I wore the thicker pads for quite some time, but for the last couple of years, only some very thin, made for men, smaller pads, by TENA, found on Amazon. Some days are certainly better than others! Lifting, squatting, laughing, passing gas, all contribute to this annoyance, but I've just accepted that's the way it is. This string is a good reminder to me to continue the kegels, with regularity. I also did kegels, had PT, and seemed to help. At PT, I was taught to tighten the pelvic floor when about to lift, step up, etc., but don't always remember. Admittedly not as consistent now with the kegels as I should be. I've also considered surgical options, but don't want to at this time. It's a journey as we all know. Good luck!
My incontinence story. 60 Days after RP I was still using a thin pad a day(mostly stress type incontinence). I asked my uro one visit if it was too early to think about penile rehabilitation and he said probably not. He gave me a sample package of Viagra (don't remember the dose) and in the next few days I tried one with decent results. The after effects were that I completely "dried up" and didn't need pads anymore. I don't know if it was a coincidence or there was a medical reason/connection but I know it happened. I've read a lot about PDE5 inhibitors and their effects on urinary tracts since then and in NO way am I an authority on the subject but you may want ask your Doc about it.
First of all, I wish you good luck and patience. Having said that, my story is sort like London441's, with whom I agree. After my RALP I found myself incontinent. I did everything i could for 2 years, constant Kegels, went to a pelvic muscle counselor for weekly visits for about a year, even tried biofeedback. Nothing of this worked. After 2 years, my urologist recommended an AUS. I had this done close to 2 years a go. The first one failed, so I had to have a second surgery to replace the first one. After 1 1/2 years of the second AUS, I am sure that my AUS was well worth the 2 surgeries. As London441 said, it is not a perfect solution, but it is definitely way preferable than living with constantly be soaking pads or diapers. I now use one light pad per day for some drips and dribbles, which, as London said, is the imperfect part. Be patient and continue with the Kegels. I hope you recover your continence!
12-year post surgery PSA 
Psa still showing post surgery. 
Update: 3 weeks Post Davinci Surgery
Kegels and other exercises for incontinence
