Hi Chris
I can’t offer you any advice or even positive outcome but just to share our experience, as we are in similar position (except luckily psa remains undetectable).
My husband Steve had RARP in January 2024, PFE’s were done religiously as recommended in the hope of regaining continence over time. It did improve slightly after six months so we expected that to continue but he just stayed in the same situation, wearing 2-3 pads a day and has no control at all when standing. (When sitting or laying down the bladder can fill up so he gets the normal urge to go but other than that it’s a constant drip). Urologist said he was to give it 12 months before he would see him again. In that time we paid privately to have Emsella chair sessions just to say he had tried all he could, again no improvement.
Steve saw the urologist again in February and like you, he was told it won’t improve now, thought to be damage to the remaining urinary sphincter during RARP.
He has now been referred to another surgeon/urologist to discuss having an AUS (artificial urinary sphincter) fitted, we will also ask him about the male sling but we are told that the AUS is the gold standard in the UK.
Still awaiting that appointment, we were told it would take some time. It’s given us the chance to read up on it all and prepare questions.
Like you, Steve is managing to live a relatively ‘normal’ life, there are some things he prefers not to do now and he is fed up of it!!
So sadly, you’re not alone in this situation and we will let you know how things go, if there’s anything further to report that may help.
Take care
Debbie