Just Started Pelvic Floor rehab therapy and have questions

[MountainLake622]

My urologist referred me to Pelvic Floor rehab therapy, since I am still having significant urinary incontinence that medications are not helping. Daily tadalafil helps with urgency but I haven't had much success w Myrbetriq for my OAB symptoms, although I am still taking it.

Last week was my first session, it was basically an evaluation and education session.

She did assess that I have limited range of motion and some weakness in my hips and core that is probably contributing to the tightness of my pelvic floor muscles. I have incomplete bladder emptying from BPH urethra obstruction, so I guess I am holding everything too tight in that area.

She gave me some very basic Kegel exercises to work on, and is having me focus on abdominal breathing.

Anyway, I am having a lot of difficulty isolating and moving my pelvic floor muscles. I feel like I am basically just constricting my glutes.

The instructions were to draw these muscles up and in, like I am attempting to suppress gas and to thrust my penis up and out from the base, but I find I'm not really able to do either.

Anyway this week's session will be more hands on so I am sure she will be able to help me, but just wondering it others have had a hard time activating and identifying these muscles?

 

[MichaelDahlke]

Hello Mountain Lake,

BPH can also be a reason for the OAB symptoms. If the treatment with the drugs does not show the desired effect, one can also think about a prostate resection, which often solves the problems much more sustainably.

The fact that many have problems at the beginning to control the right muscles is not unusual. You have to wait and see to what extent the training is actually helpful to your problem. If the problems due to the enlarged prostate are so considerable, it is usually better to drive with a TUR-P.

Best regards
Michael

 

[MountainLake622]

Hello Mountain Lake,

BPH can also be a reason for the OAB symptoms. If the treatment with the drugs does not show the desired effect, one can also think about a prostate resection, which often solves the problems much more sustainably.

The fact that many have problems at the beginning to control the right muscles is not unusual. You have to wait and see to what extent the training is actually helpful to your problem. If the problems due to the enlarged prostate are so considerable, it is usually better to drive with a TUR-P.

Best regards
Michael

Thanks Michael

She was able to help me isolate those muscles more. And gave me some additional exercises.

I'm not sure how much of an impact this will have on my continence overall, but if nothing else having more awareness of those muscles might give me more control and confidence.

My urologist is suggesting a TUR-P, but his NP suggested I try the pelvic floor therapy first.

I'd like to avoid the sexual side effects of the TUR-P If possible.

But, I am guessing even if I can get some better bladder control thru the pelvic floor therapy, eventually I'll need to consider surgical options.

I'm also wondering if given the extent of my IC already, if after the TUR-P I'd still need protective products? Yes it would be nice to wear less bulky products but seems like a lot to go thru.

Thanks a lot, I really appreciate the feedback.