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How To Train Your Bladder After Prostate Surgery

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Will Kegel Exercises Help With My Urinary Control

Kegel Exercises for Men AFTER Prostate Surgery

Kegel exercises are recommended and contribute to regaining urinary control. Dr. David Samadi even encourages patients to start them before surgery as a type of pre-conditioning. Kegels are a simple exercise of clenching and releasing the muscles that control your urine flow.

Kegels must be done every day to strenghten the pelvic floor muscles. Check this Mayo Clinic article on how to perform these exercises.

What Have I Learned By Reading This

You learned about:

  • What a Kegel exercise is
  • Why you should do Kegel exercise
  • How to find your pelvic floor muscles
  • How often you should do your Kegel exercises.

If you have any questions, please talk to your doctor or health care team. It is important for you to think about and plan how you will take care of yourself before and after your prostate cancer treatment. This knowledge will help you take better care of yourself and feel more in control so that you can get the most from your treatment.

How Long Does Urinary Incontinence After Prostate Surgery Last

It’s impossible to say exactly how long it lasts. The chances of you having urinary problems may be influenced by your age, weight and the physical characteristics of your urethra .

However, a majority of men are eventually continent after a radical prostatectomy. In many cases, men are able to go safely without any kind of incontinence product after about three months. This is especially true of men who are healthy overall and fall into the age range of 40 to 60 years. If you are having persistent problems, its important to know that there are ways to treat urinary incontinence after prostate surgery.

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Are There New Techniques That Minimize The Chance Of Becoming Incontinent

When removing the prostate, surgeons attempt to conserve as much of the area around the sphincter and the bladder muscles around the urethra as possible, hence curbing damage to the sphincter.

Surgeons have likewise fine-tuned the procedure of putting radioactive seed implants, utilizing advanced computer system forecasts that permit the seeds to damage the prostate while limiting damage to the bladder.

Still, at this point, any male who is going through radiation or surgical treatment to deal with prostate cancer needs to anticipate establishing some issues with urinary control.

Some men will have just temporary issues managing their urine, and lots will gain back complete control of their bladder in time.

The Long Wet Road Back To Normal

Male Vitality

Incontinence after radical prostatectomy sucks. But for nearly all men, it goes away. For the very small percentage in whom it doesnt, there is help.

JP Mac is an Emmy award-winning animation writer who worked for Warner Bros. and Disney, and a novelist. He is also very funny.

So, when he wrote a short ebook about his experience with prostate cancer including his diagnosis in 2014 at age 61, the rush to find the right treatment and get it done before his health insurance was going to expire, his laparoscopic-robotic prostatectomy and the complications afterward, and his five-month battle to recover urinary continence after the surgery he could legitimately have written a soap opera, or maybe even a tear-jerker but he didnt.

Instead, his ebook has a title that sounds like 1950s pulp fiction: They Took My Prostate: Cancer, Loss, Hope. Its not Prostate Cancer Lite, and it doesnt minimize what he or anyone else has gone through to get back to normal after radical prostatectomy. Far from it in fact, his short, hopeful essay is a testament to what it takes to recover from this difficult but life-saving surgery: a balanced perspective, a good sense of humor, a great support system, and plain old hard work and persistence.

Heres a message you hardly ever hear about prostate cancer, or any illness, for that matter: Its okay to laugh! That doesnt mean its not scary, and that it doesnt wear you down, or that youre not afraid you wont ever get back to normal.

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Hip Flexor Stretch: 3 X 15 Sec Holds

You might feel sore and tight around your hips and abdominals after surgery from having many incision sites around the area. This stretch hits the area and works to combat the issues associated with spending more time sitting down during recovery. However it is important to remember to completegently as there is potential to aggravate your surgical sites.

Post Prostatectomy Urinary Incontinence: How Its Treated

Despite improvements in surgical techniques, and robotic assisted prostatectomy in particular, there is still a risk of urinary incontinence following prostate cancer surgery. This type of incontinence is known as Post Prostatectomy Incontinence .

PPI can affect daily life from how able you are to work, to how confident you feel in social situations. It can feel embarrassing, stressful to manage, and incredibly isolating.

King Edward VIIs Hospital consultant urologist Mr Jeremy Ockrim takes some time out to discuss how treatment for prostate cancer can lead to urinary incontinence, and what the treatment options are.

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Improve Bladder Control Regain Your Continence Sooner After A Robotic Prostatectomy

Kegel exercise strengthens the group of muscles called the pelvic floor muscles These muscles contract and relax around the bladder and the bladder opening at your command. When these muscles are weak, urine leakage may result. You can exercise these muscles just like any other muscle in your body, and building them up may help reduce your symptoms. It is important that you perform these exercises correctly and consistently to gain maximum benefit after prostate cancer surgery.

What Are Pelvic Floor Muscles

Post-Prostatectomy: How to take control of your continence and your life.

Your pelvic floor muscles are a network of muscles that support your bladder and help you control your urine flow. There are three pelvic muscles:

  • The bladder. Your bladder is a muscle shaped like a balloon and holds your urine.
  • The sphincter muscles. These muscles help you open and close your urethra, the tube that drains urine from your bladder. And,
  • The pelvic floor muscle supports your bladder and rectum and helps control your urine flow.
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    Does Incontinence Happen If I Treat Prostate Cancer With Radiation

    Some men need radiation therapy after prostate removal. During radiation therapy, some of the normal tissues around the urinary sphincter, urethra and bladder may be exposed, causing irritation to occur post therapy, leading to incontinence. This typically subsides within a few months after radiation therapy, however if it persists, additional treatments described below may be helpful.

    How Bladder Training Can Help

    After going through bladder training, you should be able to:

    • Go longer periods of time between bathroom visits
    • Hold more liquid in your bladder
    • Have more control over the urge to go

    Although you probably want to see results right away, be patient. Bladder retraining can take six to 12 weeks to be successful.

    If you’ve been trying bladder training for several weeks and it still isn’t working, check back in with your doctor. You might need to try other approaches, like medication or surgery.

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    Urinary Continence And Incontinence

    The functional male lower urinary tract system consists of the bladder, which acts as a reservoir, and the bladder neck, urethra and the urethral sphincter complex, which form the outlet . Voluntary urination is a fundamental human function that is dependent on the coordination of the collection, storage and the controlled periodic release of urine from the bladder. The change from a storage to a voiding function occurs under voluntary control, following either a strong sensation that bladder emptying is necessary or in anticipation that future emptying might be difficult or not possible. Voluntary urination is a highly integrated function, and relies on a complex hierarchy of peripheral and central nervous system regulation that coordinates the activity of the smooth and striated musculature of the bladder and urethra,. The micturition cycle is defined according to two phases: the bladder functioning as a reservoir and the urine being expelled .

    Fig. 2: A sagittal view of the anatomy of the male lower urinary tract system.

    The action of the puborectalis, striated urethral sphincter and bulbocavernosus muscles during voluntary pelvic floor muscle contraction is indicated by the arrows. Reprinted with permission from ref., Elsevier.

    Exercise Your Pelvic Floor Muscles

    Prostate Surgery

    Learning how to control the pelvic floor muscles can speed up the recovery process and reduce leakage. If you don’t strengthen these muscles, the leakage may persist.

    Please note: Performing pelvic floor muscle exercises before and after prostate surgery is vital to your recovery. Resume pelvic floor exercises once the catheter has been removed to avoid bladder irritation and discomfort. It is recommended that you seek help from a mens, womens and pelvic health physiotherapist, Nurse Continence Specialist, or urology nurse to learn the correct technique.

    More information about the pelvic floor muscles can be found on our pelvic floor and male pelvic floor pages. You can also learn more about pelvic floor friendly exercises at pelvicfloorfirst.org.au.

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    Incontinence After Prostate Surgery Forums

    Going through prostate cancer and having your prostate removed can be a physically and emotionally trying time in life. Many men are unprepared for the extent to which they may experience bladder leaks after prostate removal and it can be disheartening to have undergone surgery only to experience a loss of bladder control for a period afterward.

    Fortunately, this is usually resolved within a year. During that time though, you may find that you need someone to talk to about your experience. Finding a forum or message board filled with people who can relate can help ease some of the tensions that you may be going through.

    The NAFC message boards are a great way to connect with others who may also be experiencing incontinence, due to prostate surgery or other conditions. Theyre free to join and the forum is anonymous so you can speak freely without the worry of feeling embarrassed or ashamed. NAFC is proud of this amazing group of individuals who visit the forums and courageously share their stories, offer support, and provide inspiration to each other. We encourage you to check it out!

    Questions To Ask Your Doctor Or Nurse

    • Is the treatment Im having for prostate cancer likely to cause any urinary problems?
    • What type of urinary problems might I get?
    • What should I do if I cant urinate?
    • Will my urinary problems get better?
    • What treatments are available?
    • What are the risks and side effects of treatments for urinary problems?
    • What can I do to help myself?
    • Where can I get pads and other products?

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    How Common Is It

    Most men thatâve had prostate cancer treatment, especially surgery or radiation therapy , experience some level of urinary problems. The challenges will be different based on the treatment youâve had, but most issues are treatable and will improve over time.

    Make sure to talk to your doctor or care team, as theyâll know whatâs normal and where you may need more support.

    If youâve already had treatment or want to know more aboutrelated urinary problems, check below to see whatâs typical:
    After surgery for prostate cancer, men might experience:
    • uncontrollable leaking

    • stress incontinence

    • temporary leaking after your catheter is removed

    • blood in your urine

    After radiation therapy, common urinary side effects are:
    • needing to urinate suddenly

    • needing to urinate more often

    • going to the toilet several times at night

    • pain when you urinate

    More on radiation therapy and urinary problemsâ

    Hormone therapy alone does not cause urinary problems. But often, men will have hormone therapy in combination with another treatment , which can cause urinary problems. Speak to your doctor or care team if you are experiencing urinary problems.

    Chemotherapy treatment itself is not a common cause of urinary problems. Please speak to your doctor or care team if you are experiencing urinary symptoms.

    After HIFU, some men experience leakage, although this is rare .

    How Do I Do A Kegel Exercise

    Bladder Retraining

    Now that you have located your pelvic floor muscles, you can exercise them even when you do not have to urinate by following these simple steps:

  • Tighten and hold your pelvic floor muscles for five seconds .
  • Relax your pelvic muscles. You have just done one Kegel exercise. You should plan to do 10 to 20 Kegel exercises three to four times each day.
  • Another way to tighten your pelvic floor muscles is to:

  • Squeeze the muscles in your anus .
  • Relax your pelvic floor muscles after each attempt.
  • Repeat this exercise 10 to 20 times.
  • When you do your Kegel exercises, remember

    • Do not hold your breath.
    • Do not push down. Squeeze your muscles together tightly and imagine that you are trying to lift this muscle up.
    • Do not tighten the muscles in your stomach, buttocks, or thighs.
    • Relax your pelvic floor muscles between each squeeze.

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    Choosing An Incontinence Product

    Choosing an incontinence product depends on the severity of your incontinence and your mobility. If you only have the occasional light leak, a low absorbency light product is ideal. Typically, small incontinence pads are the most ideal for light incontinence. For more moderate leaks, a larger pad or pant product is recommended. For heavy to severe incontinence, an all in one pad is ideal. However, it is very rare that people have heavy incontinence after Prostate Surgery.

    If you have low mobility or are immobile, a pad is your better option. Pants are harder to put on and take off than simple pads, as they require a full product change.

    What Happens If You Cant Pee After Surgery

    What are the potential complications of difficulty urinating after surgery? The main complication of postoperative urinary retention is overfilling the bladder, which can stretch the bladder muscles too much. This injures the bladder muscles. In most cases, the damage is temporary, but it can be permanent.

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    What Kinds Of Surgeries Treat Urinary Incontinence After Your Prostate Is Removed

    There are two types of surgery for urinary incontinence: the urethral sling and the artificial urinary sphincter. Usually, the incontinence needs to last for about one year after the prostatectomy to be sure there is not going to be further improvement before your healthcare provider suggests this type of therapy.

    Frequent Urination Or Urgency

    Bladder Cancer

    To help deal with frequent urination and/or the urgent need to urinate it may be helpful to reduce the number of drinks you consume daily that contain alcohol and caffeine. Some beverages and foods can be more likely to irritate your bladder than others, and it may be helpful to try to determine if you have any of these sensitivities. You may find that reducing your intake of the more irritating foods and beverages may help. In addition to alcohol and caffeine, some men find that their bladders are sensitive to carbonated drinks, chocolate, tomatoes, acidic fruits and juices, spicy foods, and artificial sweeteners.

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    Thread The Needle: 1 X 15 Reps

    Again, more mobility for your thoracic spine but this time by adding in rotation movements. This exercise will feel great in your upper back to reduce joint stiffness. If you have a foam roller this can be helpful to get more range of movement. Push down on it with the back of the forearm during the rotation movement.

    Find Your Pelvic Floor Muscles

    Overactive bladder is one common cause of bladder control problems, especially among women. Doing regular Kegel exercises can help treat this condition. These exercises also called pelvic floor muscle exercises.

    Kegel exercises are relatively easy to do. But before you can start, you need to find your pelvic floor muscles. The next time you urinate, try to stop your flow of urine midstream. The muscles you use to do that are your pelvic floor muscles.

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    Patient Instruction Training And Biofeedback

    PFMT programmes can be delivered by health-care professionals, for example, physiotherapists with a special interest and training in mens health and a scope of practice that includes continence management. A 2019 meta-analysis comprising 22 studies reported that PFMT delivered by a health professional and/or physiotherapist led to faster recovery and increased odds of becoming continent at 1, 3, 4 and 12 months after radical prostatectomy, compared with controls : OR and 95% CI at 1, 3, 4, 6, 12 months postoperatively: 1 month 2.79 , P=0.0008 , 3 months 2.80 , P< 0.0001 , 4 months 2.93 , P=0.02 , 6 months 4.11 , P< 0.0001 and 12 months 2.41 , P=0.004 .

    A progressive patient-centred PFMT programme can incorporate a stepwise approach . Teaching and training pelvic floor muscle function preoperatively can commence with isolated pelvic floor muscle contractions in stationary positions . The patient can progress to training the pelvic floor musculature during more complex dynamic tasks where men are likely to experience postprostatectomy incontinence symptoms including coughing, lifting weighted objects, sitting to standing and when walking,,. Training men to consciously activate, coordinate and correctly time voluntary pelvic floor muscle contractions is essential to increase and maintain urethral closure pressure in order to avoid urinary leakage following radical prostatectomy.

    Fig. 4: Components of a progressive pelvic floor exercise training programme.

    The Bladder Retraining Technique

    Restoring Bladder Function After Surgery

    Before you begin bladder control training, your doctor will probably ask you to keep a diary. In your bathroom diary, you’ll write down every time you have the urge to go, as well as when you leak. Using your diary as a guide, you’ll use the following techniques to help you gain more control over urination.

    Schedule bathroom visits. Determine how often you’re going to the bathroom based on your diary entries. Then add about 15 minutes to that time. For example, if you’re going to the bathroom every hour, schedule bathroom visits at every one hour, 15 minutes. Use the bathroom at each scheduled visit, regardless of whether you actually feel the urge to go. Gradually increase the amount of time between bathroom breaks.

    Delay urination. When you feel the urge to urinate, hold it for another five minutes or so. Then gradually increase the amount of time by 10 minutes, until you can last for at least three to four hours without having to go to the bathroom. If you’re feeling a strong need to go, try distracting yourself by counting backwards from 100 to one or practicing relaxation techniques such as deep breathing. When you just can’t hold it any longer, use the bathroom, but go again at your next scheduled void time to stay on your bladder retraining schedule.

    To improve your success with bladder retraining, you can also try these tips:

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