Do Kegels Work

I am 3 & 1/2 months post robotic surgery.  I was very, very lucky in the ED department with my first erection 18 days after surgery which I attribute to my surgeon's skills.  However, I am very incontinent using 5 to 8 pads a  day.  I can retain my urine while sitting or lying down but once I am up it's a constant drip.  My question is, do kegels work?  I have done them on & off but am so discouraged that I have not been doing them religiously.  I have read that at 6 months post surgery, men who did kegels & those that didn't have about the same incontinence rates. 

So, you guys with leaking problems like me, are you doing your kegels religiously & for the guys who are continent, did any of you regain continence without kegels?  Alao, I am open to all suggestions to improve my incontinece.

Many people say they do. From a logic point of view, we all know exercise is good for muscles, so it makes sense.

From an individual point of view, it is hard to prove. There are some variables here. How much urtethra did the surgeon cut out ? How were we built as far as prostate proximity to the bladder ? What kind of a job did the surgeon do sewing our urethra back to the bladder ? etc. etc.

From a technique point of view, are we doing them correctly ? Are doing them too much, tiring out our sphincter ? Are we doing them too little, not building up the muscle ? etc. stc.

I think we are foolish not to do them. Because we don't get lung cancer right away, does that prove smoking is not bad for us ? Kegals don't work instantly, but strengthening the pelvic floor has to be a positive thing.

It is easy to get discouraged (this is an 8 monther talking). You may elect to see a therapist who can measure your efforts and give you some pointers. My advice ( for what it's worth), is to continue kegaling, and goive it at least 6 months. Then perhaps you can cinclude it isn't going to work for you.

Good luck . Keep your head up about this. I know it is a bummer.

I was not a doer of kegals. Tried them a few times, but was fully continent within a month of when my original catheter was removed. There are so many factors involved. My doctor feels they are over rated, and that many men go too nuts doing them, and in the end, its counterproductive, because they wear down the muscle tone throughout the day. Like very thing else with PC, there is no one way, or right or wrong way.

David in SC

Heavy Leaker, I don't recall the details, but I had similar issues as you. The pads had to be replaced very often at first. I found that on days that I did a lot of Kegels, I leaked a lot more than on a day that I rested. However, I saw better overall progress (a day or a few after doing lots of exercises), so I believe that they helped. I also believe that most of my progress just came with time, and my progress came with plateaus, where I would make significant progress over days and then none for weeks. Hang in there, I'm betting it will gradually get better with time like mine did - at first I couldn't hold anything when I stood up, no matter how many kegels I did or did not do, but I seem to recall at 5-6 months I was fully continent. Everybody's different... but a lot of guys have mentioned about the plateaus, so don't get too discouraged.
Jeff

Well, they certainly did not work for me. Unless I am lying down, I squirt whenever I do them. I can stand in from of the toilet and kegel till the cows come home but I still leak when I am vertical. Every day I try to hold an pucker but it just leaks out. Frustrating.
I'm telling you, "There's a hole in the bucket dear Liza, dear Liza. There's a hole in the bucket dear Liza a hole...."
Jeff

Initially I did them whenever I was either sitting watching TV or driving, so I did do them a lot

Walking also was a great help, in effect the mind does the kegels for you while walking and retrains itself to hold. When I did leak I NEVER leaked while I walked, it was usually when standing from a sitting position that caused the most likely leak

If you want to test out a Kegal to see if it works, squat down, do one and hold it, then stand back up, if you are dry it worked, try it again without doing the kegal, if you leaked the non-Kegal bend then you know the exercise is working in step one.

Doing this squat, kegal, stand routine was what I worked on most and was the last step in my being 100% continent

My guy recommends them but advises not to do them while peeing the way women do. He likes you to keep a good stream if you`ve got one going. As for me i`m doing them when i think about it but i`ve only lost a stress drop or two since they pulled the cath so i`m not sure i would know any big difference one way or the other. Tim

Casey59 said...

Heavy Leaker said...
My question is, do kegels work?  I have done them on & off but am so discouraged that I have not been doing them religiously. 

The best answer for you is probably this:  If you don’t do them, then they don’t work.

Here’s some other relevant questions and answers pertaining to your posting:

• Will Kegels guarantee you instant continence.  No.

• After RP, do you need to use muscles in your pelvic floor that have been used less than before RP?  Yes.  Those muscles will be weak from lack of use.  Kegel exercises target strengthening those muscles.

• If you don’t do Kegels, will you regain continence?  Yes (except for the small percentage of men that don’t regain complete continence irrespective of whether they do Kegel exercises or not, but have other issues.)

• Do some doctors say Kegels don’t help?  Yes, because of the question/answer above.

• Do some doctors say that doing Kegels correctly will hurt you?  No.  (Note, if anyone reading this has a doctor who has answered this question with a "Yes", then please do your PC brothers a favor by posting his name here on this site so that others can avoid making the same mistake you made by going to a stupid doctor.)

• If you do Kegels, will you regain continence faster?  Yes; also see the next question.

• Any peer-reviewed, medical journal published evidence that doing Kegels will result in me regaining continence faster?  Yes; here’s a good example:  http://www.ncbi.nlm.nih.gov/pubmed/16002204?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1

• At 3 & ½ months after RP, aren’t most men continent?  No; there have been many studies done and can be easily found on via internet search, and the typical is that about half of men are continent at that point.

• Is there a “right way” and a “wrong way” to do Kegels?  Yes.  Lots of good descriptions of the right & wrong ways are available.  If you didn’t get one from your doctor, here’s one:  http://www.healthboards.com/boards/showpost.php?p=4135151&postcount=3

• Can doing Kegels a "wrong way" be harmful?  Yes, of course.  Doing just about any exercise wrong can be harmful.

• Can I get a guarantee on when Kegels will work for me?  No

• Will just reading about other people regaining continence faster by doing Kegels, while I continue to not religiously do Kegels myself, help me regain continence faster?  No.

• Guaranteed?  No

 

Casey,

Thanks for the answers & links.  However, I don't understand your next to last comment.  "Will just reading about other people regaining continence faster by doing Kegels, while I continue to not religiously do Kegels myself, help me regain continence faster?  No."  What do you mean by this?  It seems rather sarcastic.  I am willing to do whatever is necessary to regain continence.  My Dr. never told me how many Kegels to do or how to do them.   After 3 weeks of trying to do them properly, I went to Biofeedback sessions once or twice a week for 6 weeks.  At the first session I could only Kegel for about 2 seconds.  By the end I could do much better but I have seen no progress in regaining my continence.  For this reason, I have asked about Kegels effectiveness.  What number of kegels do you recommend & how mant sets of kegels per day should I do?  How will I know if the kegels are working or if time alone is helping?  My Dr. said "kegels might help".  I don't see that as positive direction.  I apologize to you if you were not trying to be sarcastic & I will definitely take your comments to heart in seeking a solution to my incontinence problems.  I certainly don't like using 5 to 8 pads a day.

Casey59 said...
It's all simply a matter of time. 

Unless you are among the very small percentage who won't recover within a year, then it just takes time.  Doing Kegels regularly & correctly does reduce the time to continence recovery, but even if you don't do them you will (most probably) eventually regain continence.  While wearing pads is frustrating, I encourage that you channel your frustration energy into motivation to do the Kegels religiously rather than allow it to overwhelm you into lower levels of commitment...which is what you described is happening.

If your doctor hasn't provided you with materials & instructions for Kegels, there are other doctors who post very good instructions online.  Here's one which addresses all the questions you asked in your last posting:  http://www.urologyteam.com/female-urology/kegel-exercises    (don't be thrown off by the portion of the URL that says "female-urology"; it also addresses men's post-RP needs)

I've heard of one doctor who holds a 4-hour training session for all his RP patients on combined topics of pelvic floor rehabilitation treatment (Kegel exercises) and sexual function rehabilitation.  In my view, this is a best-in-class medical care.

Casey 59,

Again I thank you for your help.  I'm going to read that link right now.  Due to the comments from all of you guys, I am recommitting to the kegels& will keep you posted.