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Kegel Frequency post RP

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Posted 8/28/2017 7:12 PM (GMT -5)
I had RRP surgery on 8/16/17 and had my catheter removed today, 12 days later.

The good news is that I had a good pathology report -- clear margins, negative EPE, LN and SV. Final Gleason is 3+4=7. Bad news is I'm leaking like a faucet. I know its early, it will get it better and I will eventually be fine but had a question on kegels.

Going into surgery, I was doing over 200 kegels a day for a good 6-7 weeks. I was in good shape, running and weight lifting frequently. Post surgery, I walked a lot right away -- in hospital and up to,4 miles a day since being home with catheter in. This walking has helped with what has been a quick and pain free recovery. I feel great and intend to keep walking a lot.

That said, my Uro wants me to go real slow on re-starting kegels -- 5 per day for 1st week, 10 per day 2nd week, 15 per day 3rd week, etc. My guess is this slow build will lead to slow recovery of continence.

I'd be curious to know if others have followed this slow re-build of kegels and what results were like. Or has a more aggressive use of kegels helped more with continence?

Thanks in advance.
Posted 8/28/2017 8:07 PM (GMT -5)
I recently heard a presentation from a local Physical Therapist who specializes in incontinence related to prostate procedures. He said that doing hundreds of kegels a day was WAY too much, and especially so right after surgery.

(In men who have not even had a prostate procedure, on-line info from UCLA urologists talk more along the lines of doing no more than 3 sets of 10 kegels per day, for a total of 30. Similar info from the Mayo Clinic talk about working up to anywhere from 3 to 4 sets of 10 or 20 per day, for a total of from 30 to 80, maximum.)
Posted 8/28/2017 11:15 PM (GMT -5)
Most of my Kegels was before surgery. After Cath removal, I didn't do any for the first week after cath removal as I was trying to walk as much as I could. I started kegels week 3 and did for three Weeks about 2-3 times a day , 5 -10 min for each time. I did switch between repeats of 10 and holding for 10 sec and also quick twitches of 25. I stopped once I got full control around 6 weeks after RP.
Posted 8/29/2017 5:14 AM (GMT -5)
Rick it's pretty early yet and since you had the cath in for 12 days you gotta retrain your bladder. I would practice kegels when walking but didn't worry about doing sets or reps.

Larry
Posted 8/29/2017 5:21 AM (GMT -5)
I did 20 reps about 5 times a day. Make sure you're doing them correctly!

Bobby Mac
Posted 8/29/2017 10:35 AM (GMT -5)
Go slow and easy after surgery. Too much of a good thing isn't a good thing right now!

Amazing.....your physician is right ;-)
Posted 8/29/2017 12:12 PM (GMT -5)
I don't know what answer to give you regarding the frequency of exercise, but I do have a suggestion that will help you regain continence. When you start to try to control your flow, do it in the shower. Try to keep from flowing for a little bit and then relax your muscles to see if you could still keep from flowing. At first, you probably will have no control, but in the shower, you can see what's working and it makes no mess.

After my operation, I was a sopping mess and replaced pad after pad and was often so wet, I could not tell if I was controlling anything at anytime. Kind of frustrating. Slowly it got better. The 'shower technique' seemed to really help me regain control, but be patient, it did not happen overnight and if you strain too hard, you might injure yourself. Just relax in the shower and see if you can start controlling the flow using your muscles.

Good luck.

Bob
Posted 8/29/2017 1:09 PM (GMT -5)
I appreciate everyone's advice. It sounds like not pushing the kegels too much too soon after surgery is the right thing to do. I'm ok delaying continence some if that avoids an injury/setback.

I was completely dry at night but I gather that's pretty common. At this point, the only thing slowing down the leaking is just increasing the amount I pro actively urinate and even that is not something I can get to happen on command. Feels like I'm re-learning everything right now!
Posted 8/29/2017 9:06 PM (GMT -5)
I am 6 weeks post surgery, my surgeon said to do 10 sets of 10 keels each, hold for 10 seconds, relax for 10 seconds. I am still 100% incontinent but have coping techniques that allow me to function at work. We buy a lot of Depends and Guards, I developed a trick of folding a paper towel into quarters that I put between me and the Guard. I keep a roll of Bounty in the car also.

This is a long term thing, from 4-10 months I hear. You can do a search in the box above re: incontinence. PITA

So, I whined so much my dr gave me a script for Pelvic Floor PT to help with my incontinence. They will put a probe up my butt and I do my kegel with biofeedback training to make sure I am doing them right, which I believe I presently am doing. I will report back what I find but the far I know that I'm suppose to put my had on my stomach while doing them and it should float up an down, i.e.: belly breathing.

Nick
Posted 9/1/2017 6:46 PM (GMT -5)
I've already had improvement with incontinence since cath came out four days ago on Monday. Ive been following a daily pattern of being totally dry in bed at night (though up 3-4 times during the night to go....with a really strong stream!) and only an occasional a leak or two going from sitting to standing during day. Then, late afternoon, I just start squirting on and off for like an hour or so 4-6pm. It's gets better after that with not much leaking during the evening

Has anyone else experienced this pattern? If so, where did all this end up for you?
Posted 9/2/2017 4:36 AM (GMT -5)
Sounds like your doing great Rick! Pretty soon you won't even think about it.

Larry
Posted 9/2/2017 9:05 AM (GMT -5)
@Rick, your on track, the fact that you are dry at night isa Good sign. I did tons of kegels before surgery, then after surgery I did 3 sets of 10, 5 x a day. After a few months I got down to 3 A day. Doing too many can tire the muscles and delay progress.

@Nick, I experienced exactly what you describe. Afternoons you get tired and so you leak a bit more. 20 months post op, I am as continent as I think one can be after this barbaric surgery. No pads, an occasional squirt, often an imaginary one, when I hold in my pee too long but otherwise totally dry. The occasional squirt isn't even enough to bother me.

Remember, progress won't be linear. You will have good days and bad days progress will come over weeks, and later, over months. I used to weigh my pads, and kept a journal to track how much I leaked each week. That helped me see progress.
Posted 9/2/2017 9:21 AM (GMT -5)
Thanks Pratoman.

This is probably a dumb question but is the point of kegels to strengthen the pelvic floor muscles so that you will be voluntarily squeezing them to stop the leaking or does the strengthening ultimately cause those muscles to just work involuntarily to stop the leaks?
Posted 9/2/2017 9:28 AM (GMT -5)
I think both, but from my experience, and based on where I think this question is coming from, eventually you won't have to consciously kegels to hold it in, it will be automatic, unless you really hold it in and wait till the bladder is so full it's almost overflowing, or if you are lifting something heavy
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