No continence after prostatesetamy

Hi, timbom. Sorry you're having such a tough road to recovery.
Given your history of urination difficulties and the length of time you had an indwelling catheter, it's not surprising you're still incontinent after 3 months. Probably your urologist is thinking the same thing. Your bladder capacity must have shrunk substantially over that period. Prescribing oxybutynin for bladder spasms and seeing if that helps makes sense.
I assume by "doing exercises" you mean Kegels. Keep that up. If your urologist said five times a day, do it. I think most guys are advised to do them three or four times a day. As with any muscle group, avoid overexercise -- a temptation when you'e in a hurry to see results.
Also, take a lot of vigorous walks. Many guys report the walks helped them as much as or more than the Kegels.
Have you done PT? A physical therapist trained in male pelvic floor dysfunction can give you additional exercises targeting weak muscle groups and teach you techniques for helping curb leakage under stress, as when getting up or coughing.
It must be frustrating not to see the kind of progress you'd hoped for by now, but it's probably wise to give recovery through exercise more time to kick in before doing urodynamic testing and considering other solutions.

Your case is more complicated than mine, but my continence proceeded on schedule until around three months... dry nights, okay when sitting but would dribble when standing or walking. Uro put me into PT as described above (Kegel coach with TENS device and anal probe). RO said if sufficient continence had not returned by 9-10 months that it never would, and ultimately I had an artificial sphincter implanted at around month 8 so it would heal in time to start adjuvant radiation at the one year mark.

I can tell that my natural sphincter now works somewhat as does the AUS and I am still learning how to coordinate my natural muscles and the actuator pump more effectively, but still leak when I sit down and wear one light pad per day. Sitting on hard surfaces seems to be a common problem for guys with the AUS.

The long and short of it is, if you haven't seen improvement at six months you should probably start to investigate your options.

Tombom,
We feel your pain. Literally, as many of us have been there. I had a real hard time also for 6-12 months, but maybe not as severe as you. Unlike what many say, I am convinced that I continued to improve- at a glacial rate- over maybe 18 months. Very slow but steady until I got to my present state, where I only wear the smallest shields on occasion when I feel the need for more security. And even then, when I wear one all day, I almost never can detect any dampness when I remove it at bed time. This is tolerable, but for the 1st 6 months I was longing for enough time to elapse so that I could get a sling or AUS.

You might want to consider the anti spasm meds your doc is offering. Whether I wear a shield or not, once a day on the best days, 2 to 6 times a day on the worst days, I feel a contraction that may or may not be a bladder spasm. It is a spasm of some muscle. It can even happen a few minutes after I have emptied my bladder. I have to clamp it off with an emergency Kegal immediately, instantly, or I would definitely end up wet. Sometimes despite my best effort, I still end up with a drop or 2 escaping, maybe a dime or quarter size spot, but never enough to show since the 6 month period. This is 4 years later and this has continued. But in retrospect, I am convinced that a lot of my trouble in the 1st 6+ months was this same spasm, but I was just sort of in that condition of spasm any time I was up and walking. about a year ago, my doc gave me a sample pack of Vesicare. I still have a few of those left, I never actually got a prescription or took them regularly due to a slight dry mouth. But they definitely cut down on the frequency and severity of the spasms. You might want to give them a try, at least until you heal some more.

I had a very large prostate. My URO(researcher and department chairman at Vanderbilt, very widely published over past 30 years) told me that men(like me) with large prostates sometimes take a lot longer to become continent, but in the end, they became continent at the same % as the guys with smaller prostates. just takes longer on average. Your prostate was even larger than mine. So there is still hope, even though it is taking you a while.

I also had the electro-stim/bio-feedback treatments a couple of months in. I think it was helpful. However, I think it also showed that my pelvic/sphincter muscle strength was not all that bad to start with, an in retrospect I suspect my main problem was those spasms happening all day every day. I think my sphincter was having to do battle against a bladder that was in frequent, almost continuous if standing, spasm/contraction, and the little sphincter can only generate enough contraction strength to over come that pressure for so long.

I also felt that walking for long periods was, for whatever reason, more helpful than anything else.

Hang in there bro, it should get a lot better, and if it doesn't you will just have to have another surgical procedure. Most report that those either fix it 100% or at least result in a major improvement. Look into both the bio-feedback/electro stim training and the anti spasm meds.