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Kegel Exercises-- not so easy

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Posted 12/28/2009 4:19 PM (GMT 0)
OK, surgery next month so since they recommend doing Kegel stuff, I am. I know what muscles to tighten and relax. I know some folks don't think much of these, but I'm just following the suggestions I got from my surgeon!

On the handout I got, it says to build up to:  hold in (tighten) for 5 seconds and then loosen for 5 seconds. I am supposed to do this about 30 times and do it 3 times a day.

I find it is tough to do it intensely. That is, to tighten hard. I can tighten hard enough (by far) to say stop a stream, but not much harder. Also, I find it hard to take 5 seconds loosening. It seems to take 2 seconds.

Should I be trying to tighten hard?

Inout please?

Mel

Posted 12/28/2009 4:46 PM (GMT 0)
Doing Kegles properly is tough. After nearly one year post surgery, I went to a physical therapist that specializes in helping individuals strengthen their pelvic floor.

The trick to strengthening your pelvic floor is that you have to do it gradually... just like building up strength in any muscle in the body. 30 days before surgery is plenty of time to get a little stronger. However, you'll find that you'll weaken a little following surgery and need to rebuild again. You won't be using your pelvic floor much to hold back while the catheter is in place.

The physical therapist started me with three tighten and release exercises (10 sets each, 30 seconds between sets). I startred lying back in a chair for a week or so until I achieved a certain level of muscle stability. Then I did the same exercises with some additional exercises sitting up. After a week or so of that, I did a set of exercises standing up until the bio-feedback monitor showed the proper strength had been achieved.

Between visits to the clinic, I followed up with doing a set of these exercises three times per day at home. The whole strengthening process took about 4-6 weeks as I recall. The process helped a lot.

The clinical route to pelvic floor strengthening should only be necessary following surgery if you continue to have issues with urinary incontinence for several months. But I believe the gradual strengthening is the key whatever you do.

The hardest part about the pelvic floor strengthening is having patience. After all, this is a new way of retention for men!

My advice would be to take it easy on yourself.

I wish you all the best.

Barry
Posted 12/28/2009 4:48 PM (GMT 0)
Mel,
You want to be able to tighten them without tightening your abdominals. They work against each other. I was always able to stop my stream - until the surgery. Now, no matter how hard I tighten, I still leak.
At one point about 2 wweks after the catherter came out I was so frustrated with leaking I tightened and tightened some more and tightened and yanked and... I felt a "pop" down there. Five months later I am still leaking 400 ml per day.
I hope they work for you.
Jeff
Posted 12/28/2009 6:36 PM (GMT 0)
Start gradually, it takes a pretty long time to strengthen them. They ask to start pre-op so as to get a head start on strengthening muscles we never had to work on before

I recall doing the exercises as often as possible, pre-op even sitting in the car driving. Now 8 mo post op I cannot remember the last time I did them, stopped once I was leak free
Posted 12/28/2009 7:12 PM (GMT 0)
With any exercise program the most important thing is that you DO IT. Thus it is worse if you set a program that is so hard that you can't keep it up than if you set one that is more modest but easy to do regularly.

You are not training for the Olympics, just to have a bit more strength where you will need it. The nurse who taught me pre-op said that most guys do fine even if they don't do any, so, whatever I did, it was going to give me an edge.
Posted 12/28/2009 11:25 PM (GMT 0)
I have learned thru practice and asking that the best kegel workout is hold for 3 seconds then release for 3 seconds with 10 repetitions. Do that during a day as many times as you want. I still do it once or twice a day when I think about it and I am doing just fine.
Posted 12/28/2009 11:59 PM (GMT 0)
You are in better shape than I was. I went to some clinic and they stuck a rod up my rear-end (that would shock) to train me how to do kegels. However, they told me to do kegels for 5 minutes 2 times a day. They said to lay on my right side and hold for 5 minutes and then release for 10 seconds. It seemed to work. I did not do that many before surgery because I was so stressed about cancer I could not concentrate on anything. Also, as stated, I had a horrible experience with the rod up my rear.
Posted 12/29/2009 12:52 PM (GMT 0)
The best approach per my doctor is to stop and start when urinating. If you do this for every bathroom visit, I that should be enough to suppliment the other sets.
Posted 12/29/2009 8:32 PM (GMT 0)
Greetings, everyone.  I agree with Ike.  My surgeon advised from the first visit until surgery to stop my flow of urine 4 or 5 times each time I went.  He also advised me to do the same after my catheter came out.  This is what I did both prior to surgery and for about 6 weeks post surgery and was basically dry from the day my cath came out.  David

Posted 1/3/2010 9:51 PM (GMT 0)
I would suggest a visit to a physical therapist that works in this area. They have equipment that will let you know if you are actually working the pelvic floor muscles. It was my experience the it is very easy to work the abdominal muscles.
Good Luck
KW
Posted 1/4/2010 9:25 AM (GMT 0)
Kegels seem to be one of those exercises that is the same but different for each man
- my urologist/surgeon has me doing 20 kegels 5 times a day - basically set up as standing pelvic thrusts - with no basic -do it and hold it guideline - I equated it to the" time warp dance" from the Rocky Horror Picture Show.
Things are improving slowly. If I hold before standing I don't leak , but if I stand up I leak - and if I got up to go to the bathroom to pee - well, the flow starts and I can't stop it (yet).. I have not been able to stop / restart flow once it has started -
One of the best descriptions I found in order to isolate the right muscle ( do not clench the buttocks or abdomen) is to imagine and focus on stopping a fart.
Imagine being in a crowded elevator with the CEO of your company ( or the in-laws) and having to stop breaking wind.
That helped me isolate the right muscle. It is still weak, but I am working on it daily.
Hugs
BRONSON
.............
Posted 1/4/2010 9:48 AM (GMT 0)
Mel.
I was able to stop and restart my stream easily before the surgery- I practiced in the shower. Kegels were no problem. After the surgery, things are different.

I do kegels in bed before I get up and before I go to sleep. I will do them while reclining on the couch too. It is the only way I do not squirt into my pad.
I have been to the PT who used ultra sound twice to show me how, and electrical biofeedback another time. In all cases I was doing it correctly. However I still leak.
Jeff
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