Pre-surgical kegels: Six sets vs. three sets

Posted by fritzo @fritzo, Mar 14 8:11pm

Two Kegel questions for pre-surgical preparation about five weeks ahead of the big day.

Question One; I find the fast twitch, short kegels easy to do. But, doing the longer, 10 second kegels are much harder to do on the front side. How long can you actually pull your penis in for? I can't do it for very long right now.

Question Two: What has everyone has found to be the best protocol for pre-surgical kegel routines. The standard sounds like three sets...but I found a well structured study that shows six sets leads to much better results later.

There's lots of info out there about how to do kegels. Also, lots of info on starting gentle and gradually building so as not to over-exert. My doc recommended three sets of 10 slow and 10 fast per day. But, then I saw this 2018 study that showed the men who did six sets a day standing up had much better continence results at 12 weeks post surgery.

The study seems really well structured showing a huge improvement of doing six sets of slow/fast twich sets vs. the group that just did three sets of slow kegels per day.

Here's the study: Pelvic floor muscle training in radical prostatectomy: a randomized controlled trial of the impacts on pelvic floor muscle function and urinary incontinence.
https://pubmed.ncbi.nlm.nih.gov/31729959/
My takeaways:
• Do all your kegels standing because leakage later is usually related to standing.
• The increased number of sets at six showed much better continence QOL at 12 weeks post surgery than the three sets group.

Does this sound about right?

More about the study:
• Protocol for the intervention group was: Six sets of kegel exercises per day. Each set comprising 10 fast (1 s duration) and 10 slow (10 seconds duration) contractions with an equal rest time of 10 second providing a total of 120 contractions per day.
vs. the standard protocol of three sets of PFM exercises per day, with 10 contractions per set, aiming to hold for a duration of 10 s, with an equal rest time, providing a total of 30 contractions per day, each set performed once each, in supine, sitting, then standing, in accordance with previously reported interventions.

The improvement for the six set group seemed huge concerning regaining continence and QOL. One key difference is the control group did not do the fast twitch kegel sequence.

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luger51 | @luger51 | Mar 16 7:32am

One thing that I have to keep telling myself is “Don’t Over Think This!” The only wrong answer to kegels is not doing them. You are strengthening a muscle, so do what seems right. Also be aware of the relax phase of the kegels. The muscles can’t get stronger if they’re never allowed to recover. My PT person says most men struggle relaxing and resting those muscles. You’ll be fine, it’s a journey!

fritzo | @fritzo | Mar 16 8:08am

In reply to @luger51 "One thing that I have to keep telling myself is “Don’t Over Think This!” The only..." + (show)

@luger51 Yeah, relaxing...so key. Easier to think of in terms of workouts and rest phase in an exercise routine. But relaxing during this life phase, not sure I'm succeeding. Thanks for the great advice!

quaddick | @quaddick | Mar 16 11:45am

I was recommended a program by a physical therapist of 6 sets per day. A set was 5 long holds of 60 seconds and 15 quick contractions with 2 seconds of rest between. I did that for about 5 weeks. After surgery, I had to work my way back up gradually to the same level and I'm there now at 7 weeks post RALP. I couldn't do the quick contractions standing up without leaking for a few weeks, but I can now with only a couple of drops if I lose concentration. I stood over the toilet at first so that I could train my muscles. I'm fairly continent now and get through the day with only one Tena light pad. Hopefully, I won't even need that in the near future.
Good luck, you can do it!