Kegals forever?

It's been almost 65 months since my RARP and I still do daily kegels for pelvic floor maintenance. One set of 5-10 reps in the morning and another set of 5-10 reps before bed. Each rep is a 10 second kegel hold followed by two to three diaphragmatic (belly) breaths to relax my pelvic floor before the next reps. I do them standing while brushing my teeth, while showering, or while standing at the toilet after having urinated. Stacking them onto another habit/activity makes it more habitual for me to do them and I'm less likely to slack off. My Pelvic Floor Physical Therapist (PFPT), my URO and his PA all told me that it was kegels for life or wear pads. Each patient may have a different amount that they need to do for pelvic floor maintenance and the amount may change over time.

It took me about 7 months after my RARP, with the last four of those including PFPT, to regain my continence just in time for my adjuvant radiation therapy (RT) to start. Shortly after RT ended, I had a recurrence of incontinence, which time and a little more PFPT fixed. I was able to slowly back down from three sets of 10 reps twice a day to what I stated above for maintenance.

I did falter about three years later when I had a BioChemical Recurrence of my cancer and stopped doing my maintenance kegels. Paid the price with incontinence once again. A refresher course of PFPT solved that issue.

Remember to keep doing some body core exercises, since your core supports the hammock that is your pelvic floor musculature. Tone equals strength AND flexibility. Your bladder will enjoy nestling onto a hammock and not a rock hard board of a pelvic floor.

Have you tried PFPT? It can help to fine tune your kegel technique. It helped me immensely.

Yes, I started PFPT about 3 months after my RARP.

Something else my urlogist said was not everyone regains full continence, no matter what.

Guess I'm part of that lucky 15%.....

I still leak, but only when I run. It's just too much repetitive impact on everything. Used to leak when I rode a bike and hit too many bumps or hopped a curb, and solved that by switching to a recumbent bike. Every now and then I get a quarter sized wet spot if I'm inattentive and don't kegel in time too bladder urge. Not perfect, but good enough to not interfere with daily activities. I do put a shield in for high value activities like my son's high school graduation or an evening out with my wife, when I don't want to risk getting a spot.

@kenhorse
This has been a common problem with those who had RP and those who had radiation.

I had radiation and the urgency to go increased dramatically. I read on MCC about kegels and started doing them. They help me control the incontinince when I really needed to go.

What my PCP and I did was do somethings to lesson the leaking. One was to go to restroom when you just feel the need to not wait until there is a urge. This way you can keep the amount of urine low and it's impact on bladder. The kegels do help. But somewhere along the line that your doctor was saying you can actually get to tight from doing a lot of them. I read this and so what I did was every time I drive I do them rather than do them every day several times a day. Seems to work and only occassionally if wait to long to go will leak both before and after.

kenhorse: although I did tight margin radiation in 2023, to this day, I carry a plastic urine container in my car. Good thing too because a month after treatment, two highway service center bathrooms were closed and I was happy to have it.

For me, stopping Kegel's at six months post-op did not result in any change in my continence status.

Immediately post-op, I had a 2 month period of rapidly improving continence, which then kept improving more slowly for another 2 months. At that point, I was not losing any urine with stress (including running), and I was able to go 3 hours minimum with no sense of needing to urinate. I stopped Kegel's 2 months after that.

Currently when I urinate, I make sure my bladder and urethra are as empty as I can get them before I zip up. That may take a few extra pushes and some milking of the underside of the penis, at which point I'm left with one drop at the end, which I can shake or blot off.

I still wear one #1 pad, but it doesn't weigh any more on a gram scale when I take it off than when I put it on.

So for me, I have found no problem with stopping Kegel's. I will note that I'm 75 with a BMI of 22.5, and had no radiation or ADT after surgery.

It's been 2.5 years since my RARP and my experience is much the same as @farmanerd. I need a smallish pad when I run, but otherwise only use a light Tena shield if I'm concerned about a minor leak at an inopportune time and place. Most times it just serves as insurance.

With regard to Kegels, I still do them daily. I use a video from Michelle Kenway, an Australian physical therapist. Am I convinced that they make a difference at this point? No, but I don't think they do any harm. Occasionally I think I overdo it a bit and get some muscle spasms in the pelvic area, and then I hold off doing the Kegels for several days.

I found the Michele Kenway videos on YouTube exceptionally simple and helpful!

I'm glad to hear it! Actually it was my wife who found those videos and showed them to me. I think that she's sorry she did as she now claims to hear that voice in her sleep.