Starting PT pre Prostate Surgery - not what I expected

lesjanes

My Dr suggested that I do some pre-surgery PT to help shorten the incontinence period after surgery, and then continue with therapy aftwwards.

Going into PT I thought I was going to get tips on how to do Kegel excersises properly. But instead the focus was on strengenthing the Pelvic Floor. The therapist first checked my hips for flexibility prior to the actual Pelvic Floor excersises. He explained that after Prostate Surgery there is swelling in the pelvic pocket where the Prostate is removed and also in the scrotum. Strengthening the pelvic floor is suppose to help reduce internal swelling, which I guess can affect incontinence.

He put me on a React Table, which is a non-invasive neuromuscular therapy that basically does muscle stimulation in the pelvic floor (i.e. Kegel like). I sat on the table and the machine would send pulses (similar to the sound of an MRI) into the target region. In my case that was the area between the scrotum and my butt cheeks. I could definitely feel an affect in the region you notice when you do Kegel exercises.

Has anyone else experienced this type of therapy for Prostate surgery, either Pre or Post Op?

As I said this is not what I expected and feels a bit of an odd approach. But I guess it overall can't hurt. I was expecting just Kegel tips.

68 years old 3+4=7,  Prostatectomy via da Vinci schedule for 7/11

jc5549

Penile, rehab post nerve sparing, prostatectomy, meta-analysis, 2020.pdf

Alex PFE routine.pdf

Alex anti-urge contraction .pdf

V Patel penile rehab and post Prost PSA follow up.pdf

KEGELS.pdf

I hope these attachments help. I have ZERO experience with a react table.
Like you I was doing exercises pre-op with the intention of shortening my post op incontinence.
My experience 3 months post prostatectomy is it still took almost 3 full months for continence to get to about 2 moderate absorption pads per day.
For me at least, this points out that there is some degree of injury/inflammation to the pelvic floor after prostatectomy. Perhaps your levator muscle and react table work will help mitigate the surgical effect. I did get very sore post prostatectomy in exactly the area your PT person mentioned as I did my post op rehab.
My PT person put a finger in my behind to check the strength and effectiveness of my contractions. She did stress the importance of contracting the anterior part of my pelvic floor vs the posterior or anal sphincter. You can do this (emphasize the anterior pelvic muscles) by trying to make your penis twitch or move with the contractions. Similar to make your penis move or, “bounce,” when erect (TMI perhaps but I think this stuff matters).
I hope things go well for you and you find this information useful. I was frustrated for the first two months post op because I was really expecting more rapid improvement. My advice is to just do your best and be patient. I think aggressively doing pre-op work should pay off and encourage you to keep it up.

jc

Clevelandguy

Hi,

The Kegals I learned about were to squeeze like when your peeing and getting out the last squirt or drops. I do about 180 a day of the “squeezes”. Some folks say to do them while you squat, never tried that.

Dave 3+4

lesjanes

https://csn.cancer.org/discussion/comment/1715200#Comment_1715200

Thank you for all the information. I've got some reading to do. I glanced at them and it all looks very helpful.

lesjanes

https://csn.cancer.org/discussion/comment/1715205#Comment_1715205

Thank you. How long did you experience incontinence after surgery?

Clevelandguy

https://csn.cancer.org/discussion/comment/1715207#Comment_1715207

Hi,

It gradually got better over about 1.5 yrs. to the point of using a light pad every day. I still drip a drop or two now and then(9 yrs later)when I move an odd way or strain but as long as my cancer stays in remission I’m OK with that. Adapt to your fate good or bad and get on with life is my moto. Do what the doctors recommend, seek a specialist if need be, then you can’t complain later on “why didn’t I try that”. The pelvic floor electrical stimulation seems interesting, hope it helps. I had an electrified pad placed on my lower back when I injured it to stimulate the muscles. The electric shock therapy felt odd but it did help. Good luck….

Dave 3+4

Steve1961

all in all small price to pay for beating the big C

lesjanes

Definitely a small price to pay, considering the alternative !