A new member in diapers w/questions

Hello everyone. New to this forum. I underwent RALP on Jan 3rd. I just had my catheter removed a few hours ago. I was given instructions for kegel exercises which I read on my way home, and I just did my first set of them. My question is am I suppose to consciously tighten the kegels to stop urine flow or does simply performing the exercises and letting the kegels relax to work subconsciously the thing to do.

Also, I received a temporary copy of the pathology report and I have two questions about it. Under Perineural Invasion it says Focally observed. Under Pathologic Staging it says pT2s, NX, MX Stage group II. Under Additional Pathologic Findings it says Background areas of high grade PIN. Do any of you know what these areas of the report mean?

The important things that I do have a layman’s understanding of are Gleason 3+4, Margins: Negative, Tumor Quantitation: Approx 7% of gland volumne involved(all on left side).

Golf's post covers the basics.

My post-surgery PT nurse also explained "learning" Kegels this way: THE FIRST TIME, while urinating, stop the flow without tensing any other muscles to be sure you have it right. Once you understand the muscle, NEVER AGAIN stop the flow unless you need to. Stopping the flow should have nothing to do with doing your Kegels on a daily basis. I have also seen writeups which suggest that stopping your stream (unless needed) actually may send conflicting signals to the muscles, and make regaining continence even more difficult.

And last, do not wear out the muscles. Start with 2 sets or so each day, then add another set as you can. If you get to the end of the day and find yourself leaking more, you are likely doing too many Kegels.

And yes, if you read ten articles on Kegels, you will get ten variations on how and when to do them.

All that said, Welcome to HW. We hate to see new members, but for some reason they just don't seem to be finding a cure for PCa, so I guess we'll just have to keep the lights on -

By the way, it took me three months to get any real control over my incontinence.

Yeah, I think everyone has on opinion on what worked for them... and I'm sure you'll workout what works for you.
I too started kegeling (if that is a word) way before surgery. A week on my own while I was waiting for dates to see the Uro and then he set me up with a biofeed back nurse that showed me with out a doubt how to do them correctly for about a month. Her big point I can pass along is to not do too many.

Quality is more important than quantity.

Get that right muscle group down and then do them at meal times in increasing sets.
After the catheter came out I didn't even try to do any for the first few days... I just went with the flow. (I found the catheter bothersome and just enjoyed the relief) Then back to the kegels and light walking.

As my wife always says "only worry about the things you have to... the rest of it will sort itself out". Time will sort out a lot of this one for you. Enjoy being free from the 'ball and chain / hose and bag" so to speak. And in a day or two get to work.
All the best with recovery.

Wow. I'm surprised by the many responses that I have received in just a few hours. I wish to thank all of you for your responses. I think I should just give the whole thing a rest for a couple of days and start my exercises in a few days. I'm sure the urethra is stretched out having that tube stuck up there for a week.

Tooyoung4this: Yes, you are way too young for this old man disease. I'm 59 and feel I'm too young. I wish my doctor had started me on these exercises beforehand like yours did. Doctors do have varied opinions. I talked to three uro-surgeons before RALP all within the same practice but not all were at the same location. One had claimed close to a 1,000 davinci surgeries, but didn't believe in Cialis or a VED for ED rehab. I went with another surgeon with less but adequate robotic surgeries but prescribed low dose Cialis and a VED. While considering the surgeon I went with, I was scheduling a lithtripsy in the scheduler's office and mentioned the direction I was considering. The scheduler told me "Oh he is good. He has low ED rates". I asked her how she knew because she doesn't see the medical records. She reminded me that she is the one that schedules the corrective operations afterwards. That little bone thrown to me clinched my decision.

Clocknut thanks for the info on Perineural invasion and the high grade pins.

Update. Well the first day after the cath was removed, I had zero control. I've since found that I have no leakage at night which is the exact opposite of what I thought would happen. Leakage occurs more when I'm standing up than sitting. Every time I physically stress my body, attempt to pass gas, etc, I leak a little. Yesterday morning while sitting at the computer, I was able to retain a significant amount of urine and then pee it out of me instead of simply leaking it out. It looks like it will be a gradual process of re-potty training myself (PT II as in Potty Training II). I sometimes wonder if I can go back to physical work leaking urine every time I have to physically stress my body, but I will know in time I'm sure. I'm lucky in that I could retire right now if I had too. I would prefer to in a better position but I could make it work.

If your work is civilized (ie, there are doors on the stalls, or you have one-hole washrooms with a door that locks) pads should not be an issue, especially if you are leaking at a relatively low rate - stress incontinence only or mostly, which appears to be what you are presently describing. You may also find that you leak more later in the day or evening - all part of the usual pattern.

Pads are considerably less hassle than peeing your pants without pads.

Desertrat
I was exactly the same. Each day seemed like a long long day trying to gauge improvement but it will get better. The land mark for me was when I went for my daily walk early in the morning, and was 99% dry. I normally went in the afternoon and leaked after about 100 ft from the house. That's when I put together all that I read about the muscles getting tired by days end. Makes sense now but I had to see it to believe it. I then rearranged my schedule around a little.
Hold in there... it gets better.