PELVIC FLOOR CONDITIONING
You have been informed that, in most people, surgery to remove the prostate results in a temporary loss of urinary control. Control of urine flow is regulated by a complex mechanism. The muscles supporting the bladder and urethra are an important part of this mechanism. Prior to your prostatectomy, there are exercises that you can do to strengthen these muscles. Strengthening these muscles should enhance the return of urinary control after surgery.
Pelvic floor exercises, also known as “Kegel” exercises, should be performed at least three times daily. Initially, we encourage you to set aside dedicated times to focus on exercising these muscles. Once you have gained expertise, you will find that you can do these exercises virtually at any time and in any place, even while doing other activities.
Identifying Which Muscles to Exercise You want to exercise the muscles within the pelvis, that help support the bladder and urethra. The muscles used in the following activities are the ones that you need to target:
1)The muscles you tighten to interrupt or stop urine flow, when you are urinating.
2)The muscles you tighten around your anus (opening through which stool exits the body), to prevent the passage of gas..
3)The muscles you tighten or squeeze, while sitting in a chair, to lift the perineum (area between the scrotum and anus) up and away from the surface of the chair.
4)The muscles of your inner thighs and buttocks are NOT the main muscle groups to target.
When you squeeze or tighten your pelvic floor muscles, think of it as pulling your muscles up and in. You don’t want to be pushing out or bearing down.
1)Contract (tighten) your pelvic floor muscles and hold the contraction for 3-5 seconds. Remember to exhale while you are doing this. Relax for 3-5 seconds.
2)Contract your muscles then relax your muscles, as described above, for a total of 10 repetitions.
3)As your strength and control improve, you will be able to hold the contraction for a longer time interval. Gradually, try to work your way up to tightening your pelvic floor muscles and holding the contraction for 10 seconds followed by resting your pelvic floor muscles for 10 seconds. It may take several weeks to work up to a 10 second hold.
4)Once you are able to hold the contraction for a longer time interval, try to increase the number of repetitions from 10 to 15. Short/Quick Kegels Each session of Endurance Kegels should be followed by a session of Short/Quick Kegels.
1)Contract your pelvic floor muscles and hold the contraction for 1-2 seconds. Relax your pelvic floor muscles for 1-2 seconds.
2)Contract your muscles then relax your muscles, as described above, for a total of 5 repetitions.
By doing the pelvic floor exercises outlined above, you will be actively preparing yourself for surgery. Strengthening the support structures of your pelvic floor will contribute to improving your urinary control while recovering from surgery. During recovery, you will be given the option of continuing pelvic floor exercises under the direction of a certified pelvic floor physical therapist.
Deb Crider, Nurse Practitioner, Urology … 4.6.09