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About these Kegels...

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Posted 10/8/2009 10:30 PM (GMT 0)
OK, I am now 11 days post-catheter removal, and frustrated by lack of any significant improvement in continence.  I was not advised to do any pre-op Kegel training, so this is all on-the-job training for me now, and I'm not sure I am doing this right.

1.  I can feel the muscle clench during Kegel exercise by pressing in with a couple of fingers between the scrotum and anus, so I am pretty sure I have isolated the right muscle.  I can stop my first AM urine flow or squeeze a few drops out with a voluntary clench.

2.  I am doing 3 sets of 10 reps per day, holding the clench for 5-10 seconds.  In addition, I am kegeling whenever I get up from sitting, bend over, or feel some flow coming, typically whenever I am walking around.  I am feeling sore muscles in my lower abdomen now, actually more abdominal pain than I felt from the robotic surgery.  If I am feeling sore muscles, am I overdoing it?  My "kegel muscle" does not feel sore, just the lower abdomen and into the groin area.

3.  For you lucky guys who are dry:  Do you subconsciously continuously kegel while walking around?  It seems like I would have to hold a continuous kegel to mitigate the flow while just walking around, and I am not sure if this is something that I should be doing.  I thought that kegeling was to train and strengthen a voluntary muscle, like your biceps, to assist with the added load your bladder may put on the diaphragmatic sphincter during "stress" activities.  So how do you establish involuntary control?

I feel like someone thas old me that we all have vestigial wing muscles in our shoulderblade area, and if I could only exercise them properly then I could fly - just before pushing me off the roof!

Doc

Posted 10/8/2009 11:06 PM (GMT 0)
Hey Doc,
I kegeled a little before surgery. I peed in the shower and could stop my flow so I figured I was ok.
The doc told me not to kegel until the cath came out. Post surgery I started jogging within one week figuring I would beat this within two weeks. about three days after the cath came out, I did a kegel and did it harder, and did it harder, and did it harder and... rip! I actually felt a pop! Man that hurt. I'm still leaking at 11 weeks. Still have not discussed this with the Uro. Next meeting is 10/27.
So if you want advice on pads or incontinence clamps, I'm available. But as far as stopping the leak I'm open to all suggestions.
Jeff
Posted 10/8/2009 11:11 PM (GMT 0)
Hello Doc. My uro/surgeon wasn't keen on kegels before or after surgery, feels a lot of men over do them during critical healing periods in the weeks after surgery. I tried them at the most for 2 days, not real relgious about them, and never again. Can only speak for myself, was 100% dry in slightly less than a month. Like most things, I am sure the correct answer has to do with moderation.

David in SC
Posted 10/8/2009 11:49 PM (GMT 0)
My surgeon also wasn't really hot on kegels after surgery. I did the pee-stop-pee-stop routine daily prior to my RRP but I really didn't do it much afterward since I was fully continent after cath removal. Again, it seems as Purgatory said, moderation may be the key.
Posted 10/9/2009 2:45 AM (GMT 0)

Doc said...

3. For you lucky guys who are dry: Do you subconsciously continuously kegel while walking around?

For me, no, the feeling I have down there is just the same as before surgery -- no feeling of tension. I still Kegel when I think of it though, as I think it helps with erections.
Posted 10/9/2009 2:49 AM (GMT 0)
Hi Doc, I promised my doctor I'd do my kegels and everytime my wife asked, you could set your watch on the hour, every hour, I assured he I was kegeling up a storm.

I lied. I was convinced I'd get dry some day in the future, and kegel or no kegel, the date would be about the same.

I'm not quite 90 days since the catheter came out and I'm at one pad for 24 hours and every week is better than the last.

I'd suggest you take a nice diazapam, or three or four, and put contenance on the 'don't worry about it' shelf for a few months. If you really, really work hard at it you'll notice things getting better in three weeks. But, if you just let it be, and not worry, you'll notice things getting better in 21 days.

Sheldon AKA Sleepless
Posted 10/9/2009 5:15 AM (GMT 0)
Hi Doc I was 95% dry from day 1 (I am 2 months fron open surgery) but I do have to be careful some times when I move quickly when sitting if I am concentrating to much on something else I sometimes to late to stop a small leak I never Kegel until I start to feel a leak coming I also have to be careful when passing wind and I have never done any Kegel exercises
Posted 10/9/2009 10:22 AM (GMT 0)
Hi Doc.  Like a couple of others have said, my doc didn't really push the kegels but rather said to stop the flow 4 or 5 times each time you pee.  I did this for the 5 to 6 weeks between diagnosis and surgery and was basically dry from catheter removal.  Not perfect by any means - still have to concentrate when lifting something heavy or at intimate times but all things considered doing very well.  David

Posted 10/9/2009 10:25 AM (GMT 0)
I was told by all the medics I have seen in England not to do Kegals whilst urinating apart the odd time just to check that the right muscles are being exercised. I started 3 months prior to surgery with repetitions of 10 secs per hold 10 times and did this twice daily. I started again about 2-3 days after catheter removal and I still do the exercises but not every day. I have been 99.9% dry for approx a month, and I am reasonably pleased with that. I cannot say that they helped because I cannot compare with not doing them, but I feel happy that I did the kegals pre and post op.

Posted 10/9/2009 11:30 AM (GMT 0)
There are 2 parts to making the journey back to dryness

1) Strengthen the muscles
2) The mind needs to relearn when to clamp down those muscles and stay dry subconsciously


Part 1 does not take that long, do not over do it
Part 2 takes time for the mind to relearn when it is supposed to tighten those muscles around the uretha

patience, it is a 2-3 month or more process, but you WILL bet there
Posted 10/9/2009 4:15 PM (GMT 0)
funny thing the nurse told me to avoid foods that make you fart, 3 months out and that is the only time I leak. I still say the best thing is to go commando, get rid of those pads. You need to develop a natural response that comes from the subconsious.
Posted 10/9/2009 4:21 PM (GMT 0)
Unless you can squeeze the wind out slowly and gently it is a problem. If you really want to let rip you are in big trouble unless sitting on the loo. Obviously the same muscles are involved in holding both in. I wonder if this gets better with time.
Posted 10/9/2009 7:02 PM (GMT 0)
Doc,

11 days is not that long of a time. I'm 3 and 1/2 months (and 2 catheters) post op, and still have continence problems. I do know that I'm making progress, measured in the slowly decreasing number of dead fish I pull out of my underwear on a daily basis.

I sometimes do the Kegels, but more often than not, I forget. Right now, my doc doesn't seem to be concerned about them. There are other techniques down the road if it doesn't correct itself.

Everybody's different. Give yourself time.

-Charlie
Posted 10/9/2009 8:42 PM (GMT 0)
dogbot, for me it did get better over time, i can generally rip a good one with no fear of a squirt from the other end.
Posted 10/10/2009 2:44 AM (GMT 0)
Sounds like this is just going to take time, and I should not be too discouraged at this point. It can be a double-edged sword to read posts by guys who have spectacular success in staying dry early - it is very encouraging, but also creates a challenge to "work harder doing whatever he did" with the hope of sharing some of that success.

Never considered the etiquete of flatulence training before, and I am too damp to worry about that now. This disease really makes you appreciate the intricacies of normal physiology.

Doc
Posted 10/10/2009 3:14 AM (GMT 0)
yep ,doc, lol, this disease sometimes gets us down to the basest of thinking, and we take big thrills in the simplist body function. Ah, what a world.
Posted 10/10/2009 3:32 AM (GMT 0)

Doc,

Eleven days is nothing in this journey. Measure your progress by the week, not the day and you will see that you have made progress. I found that I would do kegels any time I thought about it...sitting in traffic, on a walk trying to hold it from point a to point b, watching TV. Don't be shy about it but don't go wacky. It took me 3 months total to taper off. Hang it there.

Ted

Posted 10/10/2009 4:44 PM (GMT 0)
I did kegels once a day 2 weeks before surgery. I started up as soon as the catheter was out using a program I found that suggested holding 10 seconds then releasing 10 seconds for 15 reps. Then wait 60 seconds and hold for a second then release for a second for 10 reps. Once in the morning and once at night. This wasn't doing anything. I told my urologist and he said that was nuts. He recommended holding 3 seconds, then waiting 5 seconds for 10 reps and to do that as often during the day as I liked. I usually fit in 2 to 3 times a day and at 6 weeks I wear 1 pad a day out of security more then need. I just played 54 holes of golf the last two days and I might have leaked once but that was from drinking beer. Passing gas is sometimes a problem if I force it. I do think the kegels help. Walking in my opinion is even better.
Posted 10/14/2009 2:12 AM (GMT 0)
I have to agree with the kegels. I started mine hold for ten, release for ten and have now built up to hold for 60 release for 10. I do this during my walk to the bus stop (8 minutes) and bus drop to office (12 minutes). May seem like overkill, but threw the pads out after less than 90 days and no leaks since
Posted 10/14/2009 6:29 PM (GMT 0)
I kegeled for 8 months my uro told me I was probably not going to get any better but I kegeled for another 6 months and I did do it faithfully Finally they scoped me Dec (08) and did some test and it was determined that I had 80% control and told me that was as good as it would get, but they also found that I had some scar tissue that was restricting flow also so I had to get the scar tissue fixed March 08 then I had the AUS implant done this Aug 28 Monday Oct 12 they activated in the past 2 days since I have not felt this relieved in a long time.

as you will hear we are all different and that makes the difference in how you heal but on the other side there is nothing quick about any of this after surgery or radiation etc.... give it time learn all the options out there stay as positive as possible it does help
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