Q. What are the possible causes for urinary incontinence?

Hello doctor,

I am 76 years old. I had an open radical prostatectomy about four months back. Today, I am completely incontinent. I do not smoke or drink. I do hiking and exercise daily. I also do the Kegel exercises faithfully. I have read several ways to do them and I can locate the sphincter muscle. After the surgery, besides the catheter, I had a drain tube from my chest. For the two days in the hospital, it drained at least a cup a day. On the second day, as I was leaving, the nurse took out the drain. I traveled six hours to my home. Upon arriving, I noticed that the scrotum had swollen and my penis had shrunk. By the end of the next day, it had swollen so much that I could hardly walk and if I scratched, it would bleed. I called the surgeon, and he was not concerned. The next day, I was in very much pain and could not reach the surgeon. That evening, I called my regular doctor who told me to go to ER. The next day, they did a CAT scan and found a lake at the bottom of my abdomen, but told not to worry as my scrotum would not explode. Four days later I saw the surgeon, who told me to increase the diuretic that I was using to reduce blood pressure (Hydrochlorothiazide). I increased the dose from 50 mg once a day to 150 mg. After a week, I suffered from severe cramps. My surgeon told me to eat bananas. I did and there was no change. So, he lowered the dose to 100 mg. After three weeks, the scrotum returned to normal, but my penis was shrunken from about 4 to 5 inches to less than an inch. Today, I can stop the urination with mental concentration, but the sphincter does not seem to get the signal from the bladder. My penis is now about one inch. I am socially isolated because of the smell. I cannot continue my professional speaking to promote books. My surgeon says sorry. In a year, I can be put in with an artificial sphincter. Do you think the lake in my abdomen caused the problem? Do you have any suggestions? Currently, I am taking Atenolol 50 mg, Amlodipine or Olmesartan 5 to 40 mg and Simvastatin 20 mg. The blood examination revealed all parameters within the normal limits.