Kegel Exercises - Best Method For Better Results?

[Archives1]

I had a prostatectomy four weeks ago and am struggling with incontinence though it is slowly improving from six pads/day to two/day. I have been following Michelle Kenway videos on YouTube. The biggest question I have is how often should they be done. Her tips for maximum results include:

- 9 Kegel exercises/set (i.e. 3 exercises lying down, 3 exercises sitting and 3 exercises standing) I have the most difficulty getting the proper technique when standing.
- 2 sets/day (i.e. total 18 Kegel exercises). I've been doing 6 sets/day and this may be too much.
- Hold each exercise up to 10 seconds
- Perform exercises with maximum effort
- Exercise at least 2-3 days of the week; I've been doing them 6 days/week. What do you think is the best frequency?
- Rest completely between each exercise
- Combine the above with 10 one second fast exercises for stress training.
- Relieve your bladder every 2 hours so that you stretch the bladder and train it to hold more. This is what I am struggling with now as I have been going every 30 minutes during the day.


Additionally I've been doing mini-crunches/partial setups as recommended by The Prostate Clinic:

I'm interested in hearing what worked best for others and how long did it take to achieve significant improvement. Thank you.

 

[Archives1]

JC,

I have been in this forum for over a year and periodically this topic comes up for discussion.

After going to my own physical therapist and then reading the routines suggested to others on this forum I can make a few observations.

If you get 10 responses you will get 10 different opinions on what works best. Ultimately, what works best is a routine that you will follow every day.

Don’t just reply on Kegel exercises for recovery. Walking is an excellent way to exercise the same pelvic floor muscles that isometric Kegel exercises tone. Increase time and pace on your walks.

Each of us recover differently and our age, degree of physical activity before surgery and pre-existing medical conditions all come into play for our recovery. All that before the trauma of the surgery is factored in on your body.

I can tell you the exercise routine you described is comprehensive and will give you positive results. Be measured in your expectations, your body is going to adjust to life after RP surgery at its own pace regardless of how many Kegel exercises you do.

Can you help your body adjust? Absolutely and you are doing just that with you exercises. In my mind recovery is 50% following a good post surgery routine and 50% things out of your control giving your body time to heal.

Good luck.

Greensleeves

 

[Archives1]

That sounds like a lot to me, JC. As with any muscle, your pelvic floor muscles targeted in kegel exercises can be overworked. I hear that when these muscles are overworked, it can be very painful. I'm 4 and a half months out from my prostatectomy, and the incontinence has improved considerably for me. I no longer leak when I stand from a sitting position, and I can go the whole day with only one change of underwear. I still need supports during the day and at night in bed, but accidents in bed only occur when I have had some wine in the evening, which rarely happens these days, but harder to pass up during the holiday season. I do light kegel exercises about 5 mornings/week, and I combine them with walking 3.5 miles 5x/week and light weight training 3x/week. I am gradually gaining better control of my bladder, but I still have a ways to go before I can feel normal again. Let's see what others in the forum have to say.

 

[Archives1]

As was said previously, you will get help in different ways. In my case I searched a lot before going with something that seemed to make the most sense as it was varied. It has worked extremely well for me. My surgery was last December (Dec 2020). I follow the 7 different exercise sets on this page. I have been completely dry since April. Maybe I've just been lucky, but it is another path to try. The link: https://www.google.com/search?q=doi...i=b7k5YMPnDM7ozgLA6rroCw#imgrc=wf93VqkadDtqiM

 

[Archives1]

Hi JC, as @Greensleeves351 says, this is a regular topic. I agree with him from my own experience.

I am currently 4 months post surgery and my incontinence has been improving steadily for around the last 5 weeks now and I expect this improvement to be ongoing. I rarely leak at night now, usually only if I try to pass wind in bed, and get through the day with one or two pads depending on how physically strenuous my day is. Like you, immediately after catheter removal I scoured the internet for information and videos, and attacked the kegels, determined to beat the incontinence as quickly as possible.

When I had my one month post surgery followup with my urologist, he suggested I see a physiotherapist specialising in the pelvis and recommended a local one. When I saw her initially I regarded myself as being well researched, and she acknowledged that I was indeed more knowledgeable than most people she saw at 4 weeks post surgery. At our initial consultation, we went through what exactly had happened to my pelvic muscles during surgery, she explained which pelvic muscles we were going to work with, why, and what we wanted to achieve with these muscles. She then used an ultrasound to check and show me that I was doing the exercises correctly and on the correct muscles and agreed a tailored individual exercise program for me to follow.

I saw her every 3 weeks thereafter and we reviewed my progress with the exercises and with my incontinence, and she adjusted my program, gradually increasing the repetitions, duration and complexity of my exercises. She was worth every cent she cost me. If you are able to locate a specialist pelvic physiotherapist local to you, I highly recommend you see them.

If not, executive summary of my learnings for you ~ Some of the muscles that involuntarily control your bladder have been removed with your prostate, the purpose of doing the pelvic exercises is to train your pelvic floor muscles up to replace the function of these missing muscles. The remaining bladder control muscle (internal bladder sphincter) has been traumatised during surgery and will need time to recover, generally 2-3 months depending on how your surgery went and the skill of your surgeon, before it begins to gradually come back on line. The goal is to gradually build up your pelvic floor muscles so that when the internal sphincter muscle starts to come back on line around 2-3 months post surgery, they are strong enough to work with it on bladder control. No matter how hard you work at your exercises, you will not see any significant improvement until the internal sphincter starts to recover from surgery. Like any physical therapy, the goal is to start slow and gradually increase the load placed on the muscles and gradually build up the muscle strength. Particularly at the initial stage, quality is far more important than quantity. Start at doing less repetitions at 30% intensity 3 times daily and gradually build up from there. And start walking daily, you need to train up your pelvic floor muscles in all situations, lying/sitting/standing/walking ~ doing kegels while standing/walking is much harder (and messier) initially, but is extra satisfying when you achieve progress. Hint ~ I started off doing less repetitions while standing/walking than while lying/sitting initially.

Craig Allingham is an Australian physiotherapist who specialises in helping men recover from prostate conditions and surgery. He wrote a very easy to read book that is now in its 3rd printing which I found helpful and motivating, it sells online for around A$15. He also has a youtube channel containing some videos he made to support the book.

Buy The Book – Prostate Recovery MAP

prostaterecoverymap.com

 

[Archives1]

Thank you all for the helpful responses! I'm taking it all in as I enter this next phase of life. Prior to surgery, I was walking 6 miles/day 5 days/week. Post surgery, I have only been walking around the block daily. I don't think my bladder will hold out for six miles yet but I'll start increasing the distances and speed. I will moderate the Kegel exercises a bit. I'll look into a physiotherapist as well since so many have recommended it.

I really appreciate your input!

 

[Archives1]

I started walking my 6 miles/day routine last week and the incontinence has improved significantly. I was able to walk that distance without needing to relieve myself and with no noticeable leakage. Thanks again for that bit of advice!

 

[Archives1]

Congratulations.

Your next challenge is to continue to monitor this forum and pass on your lessons learned to others experiencing the aftermath of RP surgery.

Greensleeves.

 

[Archives1]

I walked 5 miles 4 or 5 days per week prior to surgery. Fast 15 minute miles. I am 7 1/2 weeks post surgery and 5 weeks post catheter removal.Still experiencing major leakage.Just started with a physiotherapist who has me doing stretches and no kegels. I gave walking a go starting a week ago. One mile the first day with minimal leakage. 3 miles the next day with major gushing throughout. Skipped a couple of days and today one mile with major gushing.
Should I keep it up ? Back off for awhile ? Any similar experience to share ?
Thanks.

 

[Archives1]

Oneflpdwn: Walking is great but I cannot imagine walking without doing Kegel exercises too. I would first ask the physiotherapist why Kegel exercises are not part of your rehab. Kegels alone got me 90% continent within 6 weeks. At that point I started walking 6 miles every other day and I improved from 90 to 95% continent. I still need to do the Kegel exercises every day or else I'll start to leak again.

As I've stated before: YouTube video 6x/day: Kegels for Men - REAL TIME Daily Kegels WORKOUT.

This routine is very effective for me. Everyone is different and you need time for your body to heal from the surgery.

Best of luck!

 

[Archives1]

As I've stated before: YouTube video 6x/day: Kegels for Men - REAL TIME Daily Kegels WORKOUT.

This routine is very effective for me. Everyone is different and you need time for your body to heal from the surgery.

Best of luck![/quote]

I’ve been doing these and I think they are helping. Thanks!

 

[Archives1]

I’ve disliked Kegels ever since I was taught them. They just seem more trouble than they’re worth. Therefore, I haven’t done them as much as recommended.
Do your Kegels. Do your Kegels.
“Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.”

https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/kegel-exercises-for-men/art-20045074

Do your Kegels. Do your Kegels.
Curing incontinence after radical prostatectomy with minimal kegels

Kegel Exercises? There's a Better Way

https://www.smh.com/news/kegel-exercises-theres-a-better-way

Do your Kegels. Do your Kegels.
Why? Maybe I already have enough pelvic floor strength and I just have to learn to use it. Am I supposed to do Kegels all the time to hold my urine? If holding my urine all the time is supposed to come automatically, how does doing Kegels help that? They strengthen me? They make me more apt to engage my muscles?
Do your Kegels. Do your Kegels.
Approved alternative exercises to Kegels
Bridges and squats.

The Best Pelvic Floor Exercises for Men | Ivy Rehab

Looking for the best Kegel exercises to strengthen your pelvic floor? Read our comprehensive guide to learn more.

www.ivyrehab.com

https://www.michiganurology.com/exercises-to-strengthen-your-pelvic-floor/

Benefits Of Kegel Exercises For Men

Kegel exercises strengthen the muscles around the pelvis, which can improve erections and orgasms for men. Learn more about the benefits of kegels for men

onlinedoctor.superdrug.com

I should do squats anyway and I can do bridges on my bed.

 

[Archives1]

It's been four months and I'm maybe halfway back to normal and I've done minimal Kegels. Maybe Kegels would get me normal faster but I can get normal eventually without them.

And who's to say masturbation isn't a substitute for Kegels? More fun to do and if you're not wasting sperm God won't be so irate.