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Kegel Exercises following RP

tpelle
Posts: 151
Joined: Aug 2003

A few weeks after my RP surgery in January 03, I began doing Kegel exercises per my doctor's recommendation. I am now 15 months following surgery and still am incontinent. When standing for more than a few minutes, I experience a constant drip, drip, drip into my Depends pad, although I'm using only one per day.

"Just Thinking" indicated that her husband attributes his great success in overcoming incontinence to his Kegel program and exercise. I'm wondering what program others have used, specifically how and how many Kegel exercises were done, and to what success.

My doctor recommended that I do hundreds of kegels while sitting or driving, after I did a few standing at the toilet to get the hang of it. I started a year ago to do them in sets of 30 at first, building up to about 100 each time I drove, for a total of about 200 per day. But, they caused pains throughout the lower abdomen, and it appears that the urinary control was less after days of Kegels. After many off and on attempts to do the Kegels with the resulting pain, I have returned to doing them only while voiding at the toilet while standing. Now, I know there is some controversy among doctors as to how and how many Kegels to do. My doctor was trained at the Mayo Clinic.

Dr. Patrick Walsh of Johns Hopkins has a very different recommendation. He says: Every time you urinate, do it standing up. You CAN'T practice the following [kegel] exercises while you're sitting down. Start your stream, and once it's in full force, stop the stream by contracting the muscles in your buttocks -- not your abdominal muscles, not the muscles "up in front" around the penis. Tighten your buttocks; imagine you're trying to hold a quarter between your cheeks. Hold the urine back for five or ten seconds, and repeat as many times as you can. Note: Only perform these exercises when you're urinating; if you keep contracting these muscles throughout the day, you'll overdo it -- the sphincter tires easily -- and you'll end up wetter than you would otherwise.

So, while I am hopeful that my problem stems from my age of 72, meaning that it will take longer for the sphincter to come around, I'm beginning to get concerned that I am in that small percentage of survivors of RP who will never regain full urinary control. I would appreciate your advice, as I suspect many of us are in a similar situation. tpelle@innercite.com

ehart
Posts: 7
Joined: Mar 2004

I am about 7 weeks past my RP and like you, I have been Kegeling on a consistent basis. I think I have experienced a "very slight" improvement. I do well while sleeping and can get to the bathroom without any loss and have a normal flow. After sitting, I can usually get to the bathroom and have a normal flow. I think my bladder is actually beginning to hold a little. But my problem is when I'm moving around on my feet, such as doing light house chores or fooling around outside. I tend to have a constant drip while doing these activities.

I started out doing ten sets, then 15 sets. My current routine is twenty sets of tightening the pelvic muscle for ten seconds, then relaxing for ten seconds, which is one set. I try to do these in the morning, noon, evening and at bedtime. And also whenever I'm waiting on a redlight or standing in line at the checkout counter.

I return to work on Monday and am concerned about managing my incontinence in the office. I plan to use the Depends pads and a booster pad.

Good luck and keep up those Kegels. I'm no doc, but you might be overworking the muscle with the number of excercises you're doing. I think the muscle needs time to rest between excercises. I must admit, I am getting tired of doing them, but will hang in there for awhile.

rogermoore's picture
rogermoore
Posts: 265
Joined: Mar 2002

Hang in there guys. It will eventually become so second nature, you won't even realize you are performing the exercises.

Roger

tpelle
Posts: 151
Joined: Aug 2003

Thanks, Roger, for your encouragement. I am needing it about now.

tpelle
Posts: 151
Joined: Aug 2003

Hi JagMan: Thanks for your comments. Your urine control capability seems to mirror mine in the early months. But, as time went on I seemed to have more success in holding the urine when the bladder was full. When it was empty, ie just after voiding, if I continued to stand, as soon as any urine accumulated in the bladder it dripped out.

One question, have you ever experienced any abdominal pains after a day of kegels? I plan to try to increase the number of kegels and relax more in between squeezes during each set per your comment. Perhaps this will work for me.

If your job allows you to sit much of the day, and you are near a bathroom, you should manage quite nicely. I have always managed quite well as long as I was home either in bed, sitting in my recliner reading or watching t.v., sitting at the computer or driving. Like you, controling the urine was and still is only a problem when I stand to work in the yard, go shopping, or socialize where standing is necessary. I think you are doing well for about 2 months post surgery where I am at 15 months.

Please let us know how you progress as you return to work and beyond.

ehart
Posts: 7
Joined: Mar 2004

Hello tpelle, I have occasionally experienced a little pain in the pelvic area after excercising. But not on a consistent basis.

As for work, yes I do sit a lot at my computer and in various meetings during the day. Maybe I'm just paranoid with having to return to work with this condition. I'm sure I'll be fine after a few days back in the ofice and "be snowed under" with projects just like the old days before my surgery. God bless.

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