What are the kegel excersices for?

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I haven't posted since January, so I thought I woukd jump back in. It's now been just over three months since my prostatectomy, and I don't see much, if any, change. I do mutiple sets of kegels and walk two miles everyday, yet I still fill multiple pads. I can't stand without filling a pad, even when I think my bladder is empty. What eventually takes over for the urinary sphincter once it is removed? Maybe if I understood the healing process I wouldn't be so frustrated by the length of time it's taking. Also, after three months I was finally able to make an appointment with a pelvic floor expert, with training dealing with post prostatectomys. I hope it helps.

 

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I am 6+ weeks removed and it is very frustrating. Have seen improvement and just saw pelvic floor expert for first time. It has been frustrating to say the least. that will continue to see improvement

 

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@TiredofBeingWet From what I’ve heard men here say, you won’t be healed for at least two years and even then, you’ll likely still need pads. I don’t know why doctors aren’t honest with patients about this procedure before they have it done. They should tell you what to expect. There’s a constant flow of new male post-prostatectomy patients coming to this website, knowing nothing about what’s happening to them and it’s absurd that doctors withhold the actual recovery information like that.

 

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Thank you all for responding. I'm just frustrated that it still seems to be full scale leakage. I was hoping to be at least a little closer to the finish line by now. I think I can handle drips when I caugh, but this total lack of control is really depressing. Each time I talk with my Urologist he says taking into account my 30 pounds extra weight and being 66, everything is normal. I asked him about the AUS down the road, just to give me some hope, but he said he wouldn't address it yet.
I would just like to know how, or if, the pelvic floor muscles will be eventually taking over as a new form of sphincter, and how it controls the urine flow.
Sorry for ranting.

 

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Kegel exercises are supposed to help bladder control muscles.

 

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Been over a year post RP for me and still leaking 300-500ml/day even after seeing a pelvic floor specialist. Frustrating and sometimes embarrassing.

 

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I’m 2 years out from my op. I too initially couldn’t see any improvement from the kegels, then it started and gradually improved. I now don’t wear any protection but I do have a routine that works on just in case. I may wear a pad if I’m going to do heavy work, or I may take a pad and even a spare pair of underwear just in case. I keep up the kegels to a rigid routine that I worked out with my physio. I find if I don’t stick to the process I regret it soon after.

There are many places online that can discuss how kegels work, some with graphics. Basically, pelvic floor muscles when stretched the right way put a kink in the urinary tract similar to a garden hose being kinked to stop the water flow. The trick. Is in training the muscle to push/pull the right way. My physio used an ultrasound device to show me muscles and urethra doing what they do.

I feel your frustration and hopefully you will start to see brnnefits soon.

 

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TIRED, as SNOW said don’t rely upon urologists. I’m sure there’s truthful ones there, but after 4 docs in 8 years, they have to be few and far between. They don’t prepare men for the aftermath. Most of us have one prostate, and have minimal ideas of what to expect. They hopefully rid us of the cancer, which after 8 years at 78 and <0.01 PSA, I think they’ve done it for me. But you need to be your own advocate, search the helpful advice on this forum, and don’t give up.

 

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I had surgery in July 2021. It took several months to see any difference. However in March the next year things were a lot better. Kegels really help.
This too shall pass.

 

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When I stand from a sitting position I try to stop my urine flow by doing a kegel, but unless it's a very minimal flow, I can't do it. Anyone else experienced this?

 

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@TiredofBeingWet This happens to me every time I get up to pee in the middle of the night, which is every 5-60 minutes, even with Botox. I’m really good at doing kegels, in fact I’m kind of too good at doing them because my pelvic floor muscle is almost always clenched at this point. But when I try to do them in the middle of the night, it just doesn’t work when I go from laying down to standing up. I ruin so many diapers this way and it makes me mad because it’s not like I fully use them; I just waste them a little bit. Pads are not an option because sometimes I have a total void in the middle of the night, so I definitely have to wear diapers.

Before Botox injections, when I would go from sitting to standing, I would lose urine. But Botox injections have stopped almost all of my daytime issues, thankfully!

Part of why I leak so much at night is because I am a horrible insomniac and have to take sleeping meds, which relax my muscles so that’s part of why I can’t hold in my pee when I wake up to pee from sleeping and stand up. But my primary problem is that I severed the nerve between my brain and my kidneys that tells my kidneys to go to to sleep at night and to only be active during the day. I pee about 10 times as much during the night as I do during the day.

I have a totally different diagnosis than you do, however. I have Neurogenic Bladder.

I’m surprised none of the men here have taken the initiative to create their own website for post–prostatectomy recovery. It should be called the National Association for Prostatectomy Recovery. This website is at least 98% about prostatectomies so they should probably change the name.

 

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@snow - Hey snow - I don't have nearly the IC issues that you and so many others have on this forum. I kid you not. - I think I have done A MILLION kegels. Truly - for me they have done nothing! Happy if they work for others. - Pam

 

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@TiredofBeingWet i say find another urologist. if you want to know about the AUS and he refuses to discuss it, he doesn't care about you. my opinion. i hate urologists and haven't dealt with any i trust.

 

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the way i understand it is that men have 3 sphincters to control our urine flow. we use 2 and the 3rd one kind of lies dormant. when we have a RP, the 2 sphincters we use are removed and we now have to strengthen the remaining one. I did not have any doctor tell me this prior to, or even after, the surgery. I had to find out on my own. It took several months before I got down to 1 pad. I'm at a pad now a year later. not much improvement, but if i stop doing kegels, i tend to need more pads. i went to PT and found out i was doing the kegels correctly. Pt was a waste of time otherwise. and money. for me. build the core muscles and kegels. Eventually, it will likely be sling surgery for me. Don't expect to find an honest urologist. they don't seem to exist. not where I live. I won't even see a urologist anymore. Unless I don't regain full continence; then i have to go to one for the sling surgery. Otherwise, I've crossed urologists off my list. and I don't need them anyway. VA doctor has done for me and explained more to me than any urologist.

 

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There is a Mayo Clinic site for prostate which covers all aspects of the prostate and has many knowledgeable people. The site talks about PSA, prostatectomy and radiation, cancer reoccurrence, incontinence, erectile dysfunction, medicines, etc. connect.mayoclinic.org. They also have many other groups like chronic pain, bladder and kidney, and many others. I wish I had seen this site before my prostatectomy, I have learned a lot.
I had some incontinence problems prior to my prostatectomy due to pudendal neuralgia but the surgery in the pelvic area antagonized this nerve which is hyper sensitive and gave me tremendous pain. The pain is getting better but the incontinence is very bad but I can manage it with protection. I am happy I can do things with my grandchildren. My PSA has changed from <.01 to .04 and probably headed towards cancer reoccurrence since there were positive margins of cancer when they took the prostate out. Wishing everyone the best

 

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In the same boat. My PSA was undetectable after RP a year ago but it was stage T3a with epe and positive margins. Last PSA was .04 Next PSA in 2 months. Still major incontinence.

 

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@Dustmaker Just how long did it take for you to see any results?

 

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I think it was at the 6 month mark I noticed quality improvements. I was measuring everything to track. I was weighing my pads before and after so I knew my leakage rate, how many pads per day/night. My physio challenged me to go pad free after I told him I could no longer measure any leakage, I think the mental challenge had an affect and I never back and remain dry at night.

I also injured my back at first by trying too hard too often. I had great pain from my sciatic nerve that took a while to fix, but I also believe it helped my leakage. Even now I have occasional days where for no reason I feel like I’ve gone backwards. It’s just a feeling as there is no evidence, I just have what I'll describe as the perception of dampness.

I set myself goals and targets, so the first was to be able to walk my dog and still be able to successfully urinate, so not all my bladder leaked into the pad during the walk. A big day as I recall.


My physio, who specialises in men’s incontinance kept my expectations realistic if I got depressed about my progress.

 

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Can you explain more about sciatic? I sometimes get back pain when sleeping and get very stiff

 

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I’m just another lone voice crying in the incontinent wilderness. I had my RP in December 2020 at a military hospital. My focus was on getting rid of the cancer, so I was prepared for the incontinence theoretically. The first month was terrible, as I learned kegels and did lots of them every morning, even as I had lots of flow. By about three months, though, I was much more manageable, generally wearing only one pull-up during the day. However, my PSA came back positive, so I had 40 sessions of “salvage radiation.” At six months post-RP, I was down to only .1-.2 ounces per day of leaking, but the radiologist-oncologist warmed me that the treatments MIGHT make that worse. Boy howdy was he right. At three months post-radiation, my flow began a steady increase until I was at 40+ ounces of leakage per day at ten months post-radiation. By then, I had retired and transitioned to the VA, where I NEVER saw a VA urologist, only PAs. Fortunately, I found a great urologist outside with 30+ years of experience dealing with these issues, and the VA let me go to him. First he tried Botox, which reduced my flow to 15-20 ounces per day, but he stood ready to implant an AUS at my call. I waited eleven months after the Botox, as it was wearing off, to have the AUS surgery, which was 2.5 years after the RP and thousands of pads and pull-ups This urologist had written a chapter on the device and its surgery for one of the medical textbooks. I was in and out, and six weeks after surgery, it was like a miracle. I wish I had not waited as long as I did for the AUS. Hope this helps in your own decision-making.