I started Kegel’s immediately. And did you all know: there is a sub-specialty in Physical Therapy, called “Pelvic Floor Physical Therapy” (PFPT)? I worked in health care 40 years and had never heard of it. It is for guys like us, and post-pregnancy new mothers, and a lot of women who just “leak” all the time.
Frustrated with the utter lack of progress with my Kegel’s the first ~6 weeks post-catheter removal, I asked for PFPT once I had read about it.
The first thing my PFPT therapist said, is that most urologist’s Kegel instructions are only 50% correct. She said “don’t ever start your urine flow, then stop it, then resume, then start, etc. She said: “your BRAIN has told you it is time to urinate…LET IT HAPPEN UNABATED…don’t play the start/stop/start/stop game. You are “messing with your brain’s necessity and ability to control urination, and that game will train your brain NOT to send messages that it is time to urinate.” She said to practice Kegel’s when awakening in the morning before you get out of bed (do them laying down), and once at night when going to bed, again, laying down. If you can work-in a mid-afternoon set of Kegel’s then that would be good. There are specific breathing exercises that go with Kegel’s to ensure you are contracting and relaxing the pelvic floor muscles properly.
She also has me logging how much liquid (any form) that I consume in a 24 period, and relate that to the times and volumes that my brain signals me to urinate, and…if/when I have leakage (estimated volume S/M/L) and the time so she can track patterns of leakage after liquid consumption. She then set me up with exercises and frequency and goals/limitations/“how”/“when” to consume liquids. My worst pattern was morning when I drank 8oz of OJ and 6 oz water to take my vitamins, plus the 3-4 oz of Silk almond milk on my cereal. She said you should only consume a “max” of 8 oz of liquid at a time, no matter how the single or multiple sources add up. I also had to stop my somewhat habitual desire to pop a can of soda 2-3 times per day. So, I was consuming twice the morning volume that I should have, and it showed on my urination chart: heavy urination at 10:00 a.m., followed by exasperating “leakage” from 11:00 a.m. - 3:00 p.m., made worse by consuming 12-24 oz of soda at lunch. I have since trained myself to try not to consume even one 12 oz soda at lunch…and no “refills”. I spread out my morning as well: 2-3 oz of Silk milk on my cereal, and 8-10 oz of OJ and water for vitamins two hours at 10:00. Again, my PFPT therapist basically said “no more than 8 oz (1 cup) of liquid in any form at any time.” She said to try to spread it out, so no more than 8 oz is consumed in any 2-hour period, better if you can stretch that out to 3-4 hours. And here is a big one:
Eliminate caffeine from your liquids, whether coffee or sodas. Caffeine is a bladder irritant, especially now “post-op,” My PFPT therapist said “your bladder is pissed off right now (no pun intended). Your bladder is angry and irritated, and caffeine makes it worse. Your bladder wants to get rid of it “asap”, so it will do what is necessary: more frequent calls to pee, or more perpetual leakage. I am fortunately mostly a decaf guy (sodas included). My therapist said that “once you regain your continence, your bladder will better-tolerate the reintroduction of caffeine over time.
Hope this helps.