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A Note about Kegels and Sphincters

WHW's picture
WHW
Posts: 189
Joined: Jul 2009

To the newly searching prostate cancer and to those that are recovery from whatever alternative they selected to address, I offer the following;

About Kegels and sphincters. I was talking with my dr's follow up nurse a couple of days ago about when I should resume Kegel training. She told me that it had been long enough and I should continue. I am 17 days post surgery.

Then she added something I had not heard or understood.

Prior to surgery we have 2 sphincters, on is involuntary and the other is voluntary. The involuntary is the one contained within the prostate. It is this one that keeps urine from flowing out with ejaculate, thus killing sperm. And the one that men know about that makes it difficult to go when you have an erection. The other is the voluntary, the one we control. This is the one that we use to keep from going until we make it to the john. The one we use to squirt those last few drips out when we are done. This is the one that we have left. By exercising it and making it stronger (but not overdoing it to the point of weakness) we train it to stay in a more flexed and controlled position. Thus stopping flow when we don't want it to. By having it flexed and shutting off, when we want to go we voluntarily tell it to relax and let it fly.

This made a world of sense to me. Now it may have been her way of telling me it is a mind over matter thing. But it just makes too much sense. We go through life with our body telling us things but a lot of the time we just don't listen. It just comes natural.

I mean, how many of us actually knew that we had two sphincters to control urine flow in the first place? I'll raise my hand, I certainly did not. Just knew there was something that I could do to start and stop some things and other times when it just stopped on it's own.

Don't know if this helps, but just thought I would contribute it.

Good luck and God Bless,

Sonny

luckyman2's picture
luckyman2
Posts: 54
Joined: Sep 2009

Thanks WHW! Fortunately, I knew about the two different sphincters and specifically why they were there and their functions long before I joined the prostate cancer club (of which no one wants to be a member). That little bit of knowledge has help me tremendously in dealing with incontinence... and conquering it. We all go through life thinking that we have complete control over our bodies... what our body sees... what it feels... and finally how it will react to the world around us. It takes just three simple words strung together, "You have cancer" to undo all our beliefs in what we can or cannot do. For those who have just been diagnosed with prostate cancer, you are not alone... you have so many people (just like WHW) who are there for you! For those who have been through it, or are just going through various procedures in your journey to a cure, please share your experiences. You have no idea now just how much you are indeed helping those around you.

jhagerup
Posts: 68
Joined: Oct 2009

Sonny - So you're saying all we're left with is the voluntary one after surgery. Question: Does the volunatary one eventually become involuntary or do we always have to "hold it" (after healing is complete)?

WHW's picture
WHW
Posts: 189
Joined: Jul 2009

My surgery was 3 weeks ago and so I can only speak from my experience.

It appears to me that the stronger the muscle is the more involuntary work it does. During the day I don't leak from sneezing, laughing, coughing, etc. I feel the urge to go and try to as soon as I can. If it is urgent I feel myself reacting to it on a voluntary basis. You know using the kegel to contain it until I release it. During the night I am wakened by a strong sense of urgency and the same thing occurs.

I have only had 1 leak during the night. I think this was partly caused by the fact that I suffer from insomnia and take a sleep aid. That particular night I may have been more tired than usual and just did not awaken at the first feeling of needing to go.

I have also adopted the PCa survivors mantra, "Never Pass up on a chance to Pee". Many times throughout the day I will make a stop even if I don't feel the urge. It can't hurt and is just additional training of the muscle.

My personal feeling is the muscle is just like those you notice from working out and body building. The stronger the muscle is, the more it looks like it is always in a semi-flexed or tightened position. It is almost as if you have to make a concentrated effort to thoroughly relax the muscle. Maybe it is just in my head but that thinking works for me. I find myself doing kegels many times through the day without even really thinking about it. Maybe it is because my biggest fear from having surgery was the incontinence. I was never concerned that the cancer could be addressed, I just didn't want the IC to be something that dictated how I lived going forward. I am a college baseball/softball official and extreme IC would have ended my career. So maybe I work at it harder than most.

Just my thoughts for what they are worth,

Sonny

jhagerup
Posts: 68
Joined: Oct 2009

Thanks Sonny - I agree with your views. The thing I'm struggling with is knowing if I'm kegalling the right muscle. I think I am, but not exactly sure. The other thing is that I've been doing them for about 2-3 weeks now and I still feel like it is not very strong. Seems like by now I should be able to flex it & hold it for 10 sec without any trouble. Sometimes I can and sometimes not. What was your experience before surgery - did you see good strength increase (noticable)?

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

ONe way to determine if you are doing the Kegel correctly is to try and stop the urine flow while you are actually peeing. Stop it and hold it by tightening your butt muscles. HOld as long as you an then release the pee again.

I did Kegel's pre surgery and in time was able to hold the muscle longer, so yes I did see some strength increase.

Larry
Surgery was Aug. 12 2009

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