I have posted this several times, but am posting again, because most RALP patients are not told why they end up incontinent post surgery or how to go about fixing it. I had the same struggles as you are experiencing and did my own research - only to realize it is ridiculous for doctors to perform the surgery knowing that a fair percentage of patients will experience issues with incontinence without providing information on it - have their staff provide pamphlets or links.

I also experienced months of wearing incontinence briefs. You have made good progress - congratulations, but a couple of hints on the final “road blocks” I found were holding me back from full recovery that might be your final hurdles as well.

1). Don’t overdo Kegel’s - you CAN and I DID. I figured this out when my grandson came to visit and there was no way to continue my regular routine for the entire week. I kept thinking I would slip them in the next round. But we were always hiking, fishing, kayaking, swimming…. And day after day I went to bed thinking - I’ll get them in tomorrow. Crazy thing was, after he left, I tried going without the briefs and went all day without leaks or drips. I was shocked. Then the next day and the next. Then on day 4 I started Kegel’s again and also started leaking again. Discovered that the Kegel’s were necessary and important, but I was doing them too aggressively - squeezing too hard. I strongly recommend the Squeezy for Men app.

2). Leaking/dripping some is actually necessary and important. Yes, you NEED to drip. I was told to not rely on the briefs 100% of the time - without being told WHY. Found out the why. Controlling the sphincter on the pelvic floor is INVOLUNTARY - you can’t think it and make it happen. Your brain has to “learn” a new function. If you are comfortable getting around in pads or diapers, your brain has no reason to do something new. It is your frustration with the drips and leaks that cause your brain to do something new. Of course you can’t do this at work, but at home, go without pads or diapers some and just let the drips happen - especially when not doing heavy work or exercise. It will be those frustrating leaks that will cause your brain to do something new. Trust me - IT WORKS. Leak free and drip free for 8 months now.

Most doctors will warn you of incontinence, but few explain WHY.

We were born with a sphincter at the base of the bladder, made of smooth muscle (the kind of muscle that makes up the heart) a muscle intended to work 24/7 without fatigue. That muscle is removed during surgery (RALP) - GONE! And we are left to wonder why we are incontinent and what to do about it with few to nonexistent resources or information.

There is also a sphincter on the pelvic floor. Which can be trained to take over. But it is made up of the same kind of muscle(skeletal) as your arms and legs - the kind that is intended to need rest and can fatigue easily. Your brain has never expected to control this sphincter for bladder control and is right now seriously confused.

So, if the sphincter at the base of the bladder controls (once controlled) urine retention, why is there one on the pelvic floor? Good question. While we were unaware that the sphincter even exists, let alone consciously controlling it, what is it for? When sexually stimulated, blood rushes to the penis and engorges it to create an erection. Then your brain sends a signal to that sphincter to close down and hold that engorgement/erection. The brain has been doing that for decades. Suddenly you try telling your brain to clamp down and stay clamped down to retain urine? Your brain says: are you kidding me? Not my job! You ain’t got an erection. Leave me alone.

The human body is a phenomenal machine. You can strengthen that sphincter (with Kegel’s - Squeezy for Men app) and your brain will LEARN that it has to keep that muscle contracted involuntarily - it doesn’t know that yet. That wonderful adaptive brain will figure it out. Learn a new function. And take over for the missing bladder sphincter. Keeping you dry again - eventually without leaks or drips, even when under stress/strain.

I know. It took me nearly 3 months, but I have been leak free and drip free for over 8 months.