Newbie to the club, now post Ralp, but needing some advice

I had been worried about my prostate for a while due to blood in the ejaculate and Dr decided to do PSA test in addition to DRE which was coming out large but negative. The PSA result was 7.5 so was sent to a local surgeon who after doing another PSA and found it had come down and an ultrasound which only showed an enlarged prostate, pronounced no problem. Prostate size was 45ml
3 months later I had a further PSA test which was sitting pretty constant at 4.5. GP called me back and wanted to send me back to surgeon, but I refused to go to him as he was no a urologist and was referred to a Urology specialist in Christchurch who immediately did a Biopsy and found a small amount of what he called "pre Cancer" in 2 cores, the largest was 20% and recommended monitoring.
Next PSA at 3 months had dropped to 4.25 and the specialist said all was looking good.
Next monitoring was MRI and Biospy and the cancer had moved to more that 50% on 1 core and was present in a second. MRI showed a lesion in the other side (Left) and Biopsy tried to target but failed.
Advice was that I needed to take action and had appointments with both radiotherapy and surgical specialist. Brachy was ruled out as prostate was too big and external beam was not available in my town. Decided on Robotic radical prostatectomy which was performed just over 2 weeks ago. The histology results are in my profile below. The main Tumor was 16mm across and foci were found in the left side as well, but very small. The cancer has not spread anywhere except for it just says PNI present - no further comments. Prostate size was now shown at 78g. i.e. it had grown from 45ml to 78g in a year.
It seems from reading other results that this is a fairly good outcome, but can someone comment on my presumption.
Also, I know that it is very early days post catheter removal, but I am very incontinent when standing or walking. I am close to the continent when sitting and fully continent at night. How good or bad am I on this score?
Any help or comments would be much appreciated. It has been a pretty rough ride over the last 6 weeks, when I went from - you are doing really well after the 4.25 PSA test to Radical prostatectomy in just over 3 weeks.

Harry,

Some men are continent almost immediately after catheter removal, others take a few months, another unlucky few never are. If you're continent lying down but now when you stand up, then that is a good sign. It's important to walk, climb stairs, etc. to strengthen your pelvic muscles. Learn how to do Kegal exercises.

It takes time to heal....take that time.

Initially, I was fully continent when sitting and lying down, but pretty much incontinent when walking. I weighted my pads every day to have an objetive idea of my course. I observed very clear and progressive reduction in week average terms. After two months from cath removal my daily loss was 5 grs. or less and I forgot about pads. It is not a problem at all now, but stlll observe further improvement of rare minor dribling episodes in the long time range. I had a larger prostate, 100 grs. or bigger. In summary, your initial control in bed and sitting is promising, probably your issue will be solved soon.
Your surgically confirmed G6 is what everybody here would like to have. PNI is almost always present in the surgery reports if they look carefully (mine was negative but I guess it does not mean much in my case).

Thank you for all the replies and the very encouraging comments. It is a relief that other members have gone through pretty much identical experience with the continence. I was expecting there to be some problems with continence but not feeling like an upended watering can as soon as I stood up.
When I was suddenly faced with the surgery some 6 or 7 weeks ago I knew nothing about the continence problem at all until I was immediately booked in to see the continence nurse when it became immediately obvious. I also had not realised there would be a major ED problem until the consult with the URO on the day the surgery was suggested. It was all a major shock when he said that I probably only had a 30% chance of getting erections back.
I immediately went off and researched with google and have found very differing opinions, but there does seem to be "advertising" connected with some of the surgeon's results with reference to what constitutes an acceptable erection.
Since the DAY when I went from "your fine" to "you need surgery", it has really been a rollercoaster. My initial research showed that Pre-surgery kegel exercises were really important but my surgeon had said nothing. I made it my job to find out what to do and work hard at it for the 3 weeks pre-op and have started again now.
I also learnt that getting myself into a bit better shape (not that I was bad beforehand) would improve the results of surgery so started a fast walk each day of about 4km. I am slowly getting back to this now and all the encouragement from your message has spurred me on to try to do a bit more now. I have just found so far that I am totally incontinent during the walk and return from my walk with nothing in my bladder.
I am determined to beat these problems but it does get hard when you get depressed.

HarryN, our age and numbers are in the same neighborhood. I am 3 month post RALP and the incontinence is a drag. Laying down or sitting is not a problem but transitioning to upright entails a conscience effort at "tightening" thing up on the way to the bathroom. I do not always make it.

I am doing 3 sets of Kegels per day as well as knocking a few off anytime I am waiting for something: at a red light, waiting at the microwave, watching a progress bar on the computer, etc. Some days are better than others and it depends on how active I am.

I was a very active runner and missed two have marathons due to this, one in Bozeman while I was in Cleveland for surgery and one in Deadwood, SD because I pass blood when I run. Instead I do a 3 mile trail walk and on alternate days I swim laps, some days a 1000 yds and someday a mile.

I do get discouraged but have to think that it just takes time. I try to notice the little clues that I might be getting better. For example, prior to surgery when I would pee, there was always that action of getting the last drop, sort of "wringing it out." I was unable to do or experience that after surgery until the last week. That is encouraging.

As for ED, I am about 60% of what I was (which wasn't like when I was 16). I am less concerned about that than a bit disappointed that orgasms are, well, like going from a fine craft beer to a lite beer. Hardly worth the bother.

Your doctor is right about the 6-week, its pointless to start Cialis or Viagra before your nerves have done some healing. Erection is caused by muscle relaxation which is caused by secretion of nitric oxide (NO) from nerves. ED meds works by inhibiting break down of NO but during the first months after surgery there isn't any NO secreted so the ED meds won't work. As the nerves heal, they gradually start to secret NO and ED meds become effective. Full ED recovery can take up to 24 months. Good luck.

Harry- You are doing fine. As others say, everyone recovers continence differently, but based on what I've read, you're ahead of the curve. Improvement can occur suddenly, so do your kegels, walking and stay patient.

ED takes longer to resolve for most men. Believe it when they say the nerves take a long time to heal. I'm a bit over 18 months since surgery and in the past few months I have had signs of life. Starting a penile rehab program will be beneficial in the long run. Talk to your uro about that.

Good luck.

Hi VinceInMT, thanks for the advice on the difference in price, between the brand stuff and the unbranded stuff. Will make sure I ask for the unbranded.
How long was it before you noticed that the sildenafil made some difference?
Have you read "Intimacy With Impotence: The Couple's Guide To Better Sex After Prostate Disease". Written by a couple that have been through what we are now. I am currently reading it and think it is really worth a go. Should help to get a bit more excitement out of you relationship.

HarryN, thanks for the book recommendation.

As for the effect of the prescription, at that low dose there is nothing magical but anecdotally I think that it is a bit more responsive to attention an hour or so after I take it, not much different but a little. After all, I am taking 20mg when a full dose as the Blue Pill is 100mg.

Also, I think the way they prescribe it is called "off label," so you might have to mention that. I read something about it being prescribed for high blood pressure in the lungs at that dosage.