radical incontinence

[mue1692]

I am 68 yrs old and lead an active lifestyle.  I had the nerve sparing da vinci prostatectomy on august 28, 2008 after exhibiting 10 of 18 positives from my prostate biopsy with a gleason score of 6 (3=3).  the surgery was done by the urology group in cincinnati, ohio.   the postoperative pathology showed positive margins and the adjacent lymph nodes, partially removed, were free of cancer.

here is my problem.

I get absolutely no signal/feel no urgency that I have to urinate, which means that I am leaking constantly.  I go through 6 to 8 pads a day.  I recognize recovery of continence as a long term process but I would expect to see some improvement at this point.  certainly one does not go from incontinent to continet over night!  If anything, I am getting worse.    

I am doing kagel exercises.  however, it is unclear to me how doing exercises on a voluntary muscle helps reguvinate an involutary one.  as I see it,  the kegel exercises help get me to the bathroom when I get the urge to urinate without leaking in transit.  since I have no urge, I leak before I can energize the voluntary sphinctor.

here are my questions.

1)  why am I not experiencing any improvement toward continence?
2)  what is it about the da vinci procedure that damages the involuntary bladder spinctor so dramatically?  after all, the spinctor was not operated upon and the procedure was nerve sparing!?  where does the incontinence problem come from?    
3)  what data says that exercising a voluntary muscle positively influence an involuntary one?  

thank you very much for your answers.

[Samsun]

I had operation in early June and still have problems when walking fast or running. But this seems to be a very slow process sometimes. I have accepted that I am one of those slow cases. I have tried to develop some own methods to control leaking. Instead of having a mere nice soft pad that ***** all leaking, I put hard toilet paper in my briefs between the pad and penis that makes me feel immediately that something came out. I change the toilet paper immediately when this happens. This has helped a lot to develop control (and I need only one pad per day because I change the paper many times per day!).

[BaldiR]

I'm contemplating surgery vs. radiation vs. active surveillance and
would be interested in answers to your questions.
Why were the lymph nodes removed?
Did you have any urinary problems previously, like inflated prostate,
or any surgery to reduce these problems?