@bert88 A couple of things I noticed about your original post. You said you are wearing an external catheter. I highly recommend you read How to Survive Prostate Cancer by Dr. Patrick Walsh. Dr. Walsh pioneered the nerve sparing techniques to preserve urinary and sexual control.
In the section on regaining continence, he specifically states that you should not under any circumstances use anything other than a diaper when recovering from a radical prostatectomy. Using an external catheter or clamp etc, will only delay your recovery as you will never develop the muscle control you need.
I had my surgery six weeks ago, I am down to one pad a day. After my catheter was removed, I was leaking like a sieve. It was extremely concerning. I walked every day even before my catheter was removed. I am up to three miles a day now. It's very uncomfortable walking when your leaking but I forced myself to do it. It appears to have paid off for me. I did wear a external catheter early on for a day and a half before I referenced Dr. Walsh's chapter on regaining urinary control. I immediately removed it.
An excerpt from Dr. Walsh's book:
The Return of Urinary Control
Some men are lucky. They are dry from the moment the catheter is removed. They can stop their stream on a dime and start it whenever they want to. The great physician Sir William Osler once made a perceptive comment that applies here: “The man who is well wears a crown that only the sick can see.” Men who are continent immediately after radical prostatectomy are blessed. Most men, however, have variable amounts of urinary leakage. You may be one of the lucky ones; then again, you may not. Most likely, it will take some time for your control of urine to come back completely. For most men, this process happens in three distinct stages: Phase one is when a man can remain dry when he’s lying down. In phase two, you’re dry when you’re walking around. If you can walk to the bathroom and not urinate until you get there, that’s a great sign—it means that the sphincter is intact. And in phase three, you are dry when you stand up (using muscles that put pressure on the sphincter) after sitting. In young, healthy men operated on by an experienced surgeon, about 80 percent should be wearing no pads—or at most, a security pad to catch the occasional drop—by three months after surgery, and at twelve months, 95 to 98 percent should be continent. Note: We consider any man continent if he wears no pad or if he wears a pad that is dry. Many men continue to wear a small pad just to be safe. Your doctor may have a different definition of continence, which you should find out before surgery. However, most men (even at three months) are not very wet, and when asked in a confidential questionnaire, 96 percent stated that leakage caused little to no bother. It’s hard to believe, but urinary control does continue to improve over two years and, in an occasional patient, for even longer than that. Can you do anything to speed things along and improve your urinary control? First, whatever you do, do not wear an incontinence device with an attached bag, a condom catheter, or clamp! If you use any artificial device, you will hurt yourself in the long run. You won’t be able to recover your urinary control, because you won’t develop the muscle control you need. Until your urinary control returns completely, wear a pad such as a Serenity pad or disposable diaper such as Depends. You can get these at a pharmacy or grocery store. Some men prefer using a special kind of padded underwear called Sir Dignity briefs; your doctor should have good suggestions and perhaps even some samples for you to try. Also, until your urinary control has returned to an acceptable level, don’t force fluids. When the catheter is in, you’re asked to drink a lot of fluids to flush out the system. However, once the catheter is out, you’ve got to slow the pace considerably. Avoid drinking excessive amounts of fluids, and stay away from caffeine in all forms—coffee, tea, and even soft drinks. Caffeine is a powerful pharmacologic agent that increases the frequency and urgency with which you need to urinate. If you are being treated for high blood pressure with an alpha-adrenergic antagonist such as doxazosin (Cardura) ask your doctor to put you on a different kind of drug. Also, if you were taking tamsulosin (Flomax) for BPH, you should discontinue it. Doxazosin and tamsulosin make the sphincter relax and can make incontinence worse.
Walsh, Patrick C.; Worthington, Janet Farrar. Dr. Patrick Walsh's Guide to Surviving Prostate Cancer (p. 251). Grand Central Publishing. Kindle Edition.
