Are Kegels Worthwhile?
At our RARP consult, I asked the well-respected surgeon if my husband should start doing Kegels. He said it couldn't hurt, but that most improvement attributed to Kegels happens naturally over time.
What say you?
Mary
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I think of Kegels similarly to any muscle exercise: Continue, as desired or needed.
My understanding is that we lose 2 sphincters during RP, and the remaining sphincter muscle is the weakest.
My continence was very good postop and I continued Kegel PT exercises probably for 2 - 3 mos.
Then I had persistent PSA and Salvage Radiation treatment including 4 mos ADT. My stress urgency and minor leaks increased a bit and after restarting kegels and completing salvage treatment my control improved back to "negligible" events.
So I continue "as needed".
Also finished 9 wks of PT for an IT Band syndrome and many of the exercises were similar to those for kegel PT, and further improved my continence.
Best wishes.
@phl6953 -- Since you asked, here's what I'm doing: I did kegals about 1 month before the operation. I tried to do them about 5 times a day, each time 1 set of 10 reps, with each rep holding for about 10 seconds. Frankly, when I started I couldn't hold them that long, nor did I do a great job remembering. I didn't go to a physical therapist, but rather I simply watched videos on youtube on how to do them, along with reading web site material at places like Mayo Clinic. I particularly liked some youtube videos by Michelle Kenway. Frankly, initially I started looking at videos just to see what kegals were. I had no idea. I had planned to go to a physical therapist. But watching the video's and trying them, I felt like I was probably doing them right. However, if I'd had trouble figuring out how to do them or if I'd had any incontinence, I would have gone to a physical therapist. Who knows, I still might go to a PT at some point. The only reason I didn't go to a PT was frankly laziness on my part. Anyway, after the catheter came out I resumed kegals. Again I watched the videos and tried to make sure I was doing them right. They do mention how to "test" if you're doing them right, which I do occasionally. I now just do them twice a day; 1 set of 10 reps holding for 10 seconds with a 10 second break between. Then I immediately do a set of about 6 fast twitch reps holding only for a couple seconds, with a short break of about 5 seconds between reps. It seems to be working for me. Again, I'm neither a PT nor a medical professional of any kind. I'm not even recommending my routine for you. Rather I'm just responding to your question of how I'm doing them.
Best wishes for you and yours.
@phl6953 -- Reading through my long response, I'm not sure if I directly answered your question. Short answer -- i use an analog stopwatch display on my smartphone to time my kegals. 1 set, 10 reps holding for 10 seconds each rep with 10 seconds rest between each rep, takes me 3 minutes and 20 seconds. Then I immediately start doing the fast twitch, about 6 - 8 sets, holding only about 2 seconds each rep with about 5 seconds rest between reps. Total time, less than 5 minutes. Hope this answers your question. Best wishes.
Before surgery: 10 quick holds periodically throughout the day. I did them obsessively.
After surgery: 10 quick holds followed by 10-5 second holds every hour I was awake. I still do them today when I feel like it.
Very good, thank you very much!
Thank you so much. Your answer is very correct. I just need such an answer.
Because I don't live in the United States and can't see these videos, do you have any way to help me?
@phl6953 -- If you don't have access to youtube, maybe there's another similar site that'll have videos on how to do kegals for men after protate surgery. If so, look forr Michelle Kenway. Here's a link to Mayo's website for kegals for men: https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/kegel-exercises-for-men/art-20045074 Best wishes.
Most of this thread has been how to do pelvic floor exercises [PFE], not about the original question--do they make a difference? The answer to this question is more complicated, based on what I've learned, than we might think.
The word on the street, as reflected in this thread so far, is that PFE helps.
However, it's very hard to prove this is the case. In fact, clearly many people do PFE faithfully, whether "correctly" or not, and still have some (or unremitted) incontinence. This is also reflected in this thread.
And it is also the case that scientifically there is at least some question as to whether too much PFE or PFE done wrong might actually negatively contribute to continence.
So is the surgeon (as originally quoted) right? Perhaps so. Although like many such technical experts, he might not have been politically sensitive to his audience. In the meantime, we as a community should probably take these thoughts in and wonder whether they are right or not, rather than being confident that what we think is true or experience as true is definitely true.
My own experience was that I was remarkably continent, so either the PFE was amazingly effective or, alternatively, the PFE was not in fact the most significant factor for me. Now if only that had worked for erectile function!
Kegels speed up the process. I could see a difference after
several weeks
I prefer to think of it as the surgeon is partially right and partially wrong -- fuzzy logic. There are not only two answers to the question. Also an individual doesn't know where on the spectrum of 'PFE benefits' that they lie until, or if, they give PFE a try.
I think that variations in both amount and location of tissue removed during RARP combined with slight anatomical variations in each of us also play a role. An attitude of "let's try it to see if it works for me" may develop if incontinence persists, but like many of us are acutely aware, there's no guarantee of results -- be hopeful yet keep expectations reasonable.
OT: after five years of trying many methods of dealing with ED, I finally chose surgery and am pleased with the results.