Posted 10/15/2008 9:21 AM (GMT -6)
Hi surfing...okay here is my take on why to do the kegels from the very beginning. As said before the bladder spincter is tramatized and while it will recover it will take time. Men have another spincter that (as said before) is secondary or backup (used during sex to control ejaculation) Strenghtening this muscle will help with urine control to some degree until the bladder recovers fully. For the most part this will help when standing up and walking immediately after surgery. I am still recovering and I am just beginning to do the squeeze without having to think about it when I stand and walk now so the leakage is getting less and less while walking...in fact if the bathroom isn't too far away I can make it without leaking at all.

You are asking great questions..keep it up and you will get first-hand knowledge and great answers from this forum
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base)
Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1,2008
Gleason 7 (4+3) Staged pT2c NO MX
Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
14 tumors in prostate - largest being 6 cm 

Posted 10/15/2008 10:58 AM (GMT -6)

Surfingspouse,

One of my doctors loaned me a booklet with audiotape on Kegals.  I started a month prior to my surgery, and still do some to this day.  I have been fortunate to be almost pad free right away, and completely free within a few weeks.  (Just used a womens light pad most of the time - heavier men's pads were not needed.)  There are times now when I move a certain way that I have a drip - annoying but not unexpected.  I would recommend Kegals right away, and do the research so he does them correctly.

In addition, it would be a good idea to get in a little better shape prior to surgery.  I officiate high school sports, do a significant amount of running, and while not in the best of shape, started more walking prior to surgery.  It will be just as important to do the same following surgery.  I don't know if you've checked on this, but Dr. Walsh's book, " A guide to Surviving Prostate Cancer" is a good reference, and worthwhile to purchase.  (I hope that I have the title correct - I'm on the road and don't have my copy.)

Good luck


Age 57 at diagnosis (2006),  PSA 4.7 (up from 3.2 one year previous)
Biopsy November 8, 2006 1 of 10 cores positive 5% LEFT Side Gleason 3+3
Robotic surgery January 19, 2007
Post Surgery Pathology Stage T3a, Gleason 3+4, positive margins and capsular penetration RIGHT Side
Post Surgery PSA:  March 5, 2007:  0.01    5 month PSA  0.08
Adjuvant therapy began June 26, 2007 with Zoladex injection
Radiation began August 23, 2007, ended October 8
First post radiation PSA, December 18, 2007:  0;  March 2008 - still 0;  July 2008 - 0; Sept. 2008 - 0;
 
 

Posted 10/15/2008 11:31 AM (GMT -6)

As you can see, there are different opinions about Kegels.

But being that it doesn't cost you anything, doesn't hurt, and only takes a few seconds each time you do them, I would suggest that your husband do them.

He can only benefit from doing them.

 

Good luck to you!


Phillysub.

Age: 52
Last PSA before diagnosis: 2.9
Diagnosed: Oct 2007 (age 51)
Gleason: 3+3=6
RALP surgery: Jan 23, 2008 (Dr Costas Lallas @ Thomas Jefferson Hospital in Philadelphia)
1st Post-op appt: Feb 1, 2008 (negative margins, cancer contained within the capsule)
1st PSA post-op: May 23, 2008 - <0.1 undetectable
2nd PSA post-op: August 28, 2008 - <0.1 undectectable

Posted 10/15/2008 4:11 PM (GMT -6)

My Urologist provided me with a good-sized packet of information pre-surgery and included was a 2/3 page flier containing kegel exercise instructions.  I was asked to begin the exercises one-month prior to surgery, and now that I'm post-op I've been asked to continue them into the future - until the incontenence lessens or becomes a non-issue.  Do the exercises help? My Urologist has told me, repeatedly, that most of the patients of his who have long-term problems of incontenence did not do the kegel exercises.  The advice of my Urologist is sufficient for me to do the exercises, which aren't intrusive and don't take much time.  I'm inclulding a link below to some information about kegel exercises used pre-surgery in instances of prostate surgery, maybe they'll help you and your husband get started (if that's what you choose to do):

Kegel Pelvic Floor Muscle Exercises

http://tinyurl.com/4lv2yq

 


Age:  59 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (19 days post-op)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

 

Posted 10/15/2008 4:31 PM (GMT -6)
Dear Surfer,  After the operation I was prepared w/depends, menstral pads, and any other pad just in case...My husband used one depend after the catherer was removed and did not need another pad thereafter because from his diagnosis he did his Kegals like it was part of his exercise regimen.  
It worked for us.   I, therefore, suggest you add it into his daily routine.   Let's put it this way--I don't think it can hurt.
Keep asking and we'll keep answering.
Pat
Age 55
PSA 2005 - 2.5
PSA 2007 - 4.9
Biopsy - Dec. 2007.  1 of 12 cores - 15% cancer
Gleason 3+3
DaVinci - 4/24/08 - Dr. Michael Esposito - Hackensack Univ. Hosp., NJ
Post Op. Gleason 3+4
Both nerves spared
 
 
 
 
 
 
 
 
 
 
 
 
 

Posted 10/15/2008 7:39 PM (GMT -6)
The whole purpose of this, just my opinion is to get your brain to gain control of the muscle group that controls that spinkter. The kegel exercise helps, my doctor is a big believer. Other Doctors recomend that you just stop the flow when you are unrinating a couple of times each trip to the bathroom. My experince was I got bored quickly with the exercise, just the type of person I was. But trying to control the flow after surgery was like a game and I could tell if I was wining or not. That what worked for me. I was totally dry at 8 weeks, except for the ocassional drip that I still have. It is funny the drip appears to have more to do with what I have drank as opposed to the about my bladder is full.

Each person is different, but it is like a bell that goes off in your head when you brain gets what needs to happen without you trying. You will quickly move from a lot of pads to one or two and then none.

Hope everything turns out well for you. Be positive.
Age 51
Father died of prostate cancer at 73
Yearly PSA testing.
Biopsy after PSA went up .75 in one year
6 of 12 in needle biopsy where cancerous
DaVinci surgery 4/15/2008
Last PSA .008
 

Posted 10/15/2008 7:59 PM (GMT -6)
hello surfingspouse. I actually paid $500 for biofeedback sessions to learn how to do kegels. the nurse stuck a rod up my xxx and shocked me because i couldn't find the muscle. $500 later and recovering here is what you need to do:

have you husband go pee and stop mid-stream. that is the muscle you want to work on. don't stop and go much because the doctor told me it could cause problems.

I was told to lay on my right side and do the kegel (hold the muscle) for 5 seconds and relax for 10 and repeat for 5 minutes. do this twice a day (morning and night).

There are other ways to do the kegels but this is what i was told to me. also, don't do too many because you do not want to tire the muscle.

on another note, there is no modesty with prostate cancer. I believe I dropped my pants for nurses and doctor's more than I have done before.
 
Age 48
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
decision - surgery (robotic)
surgery may 9, 2008 - houston, tx
pathology report -gleason 8
margins clear
4 week and 6 week PSA >.04 (undetectible)
12 week PSA <.04
continent at 10 weeks (no pads!)
kegel's twice a day 20 reps

Posted 10/15/2008 10:33 PM (GMT -6)
I had no idea I would get so many responses. This forum is amazing.

Okay, now I have enough input to give me some idea of where to go with this. I think I will encourage him to do the Kegels if only to give him something that (at the least) makes him feel like he's got some amount of control over this situation. I know he currently can't stop mid-stream because I brought that up in our initial Kegel discussion. That's when he looked at me as if I'd started speaking in another language mid-sentence. I'm thinking that if nothing else, doing the Kegels and learning to control the muscles involved will help him psychologically, if not physically.

Can you tell I'm one of those people who believes your attitude is as important as anything else?
Husband's biopsy: 10/3/08
Husband's diagnosis: 10/10/08
Husband's age at time of diagnosis: 54
PSA: 5.0
Gleason: 3+4
Clinical stage at time of diagnosis: T1c
DRE: No nodules

Posted 10/15/2008 11:04 PM (GMT -6)
hey there surfin spouse , i emplore ya to get hold of the wife you live in the very place i had surgery please consider what i said you live in the presence of the 5th best surgeon in the entire world in your own backyard please call us so we can at least shrare our story PLEEZE 530-742-3823............call christina

Diagnosed November 2007   (43 years old )
PSA 3.9 / Gleason 6 / TC1 6 cores 1 shows 25%
Sugery scheduled 5/29/08 - City of Hope - Dr. Mark Kawachi
 "First show of the day"
 and now for the new ive been waiting for
 FINAL PATH REPORT:gleason upgraded to 3+4 T2c bilateral disease,tumor involvment 5%
extra prostatic extention:absent
seminal vesical invasion :absent
pathological staging:pTNM pT2 ORGAN CONFINED
margins free of carcinoma
usable erections ;6-6-08 with little blue pill
continence; 1 pad a day, dry at night

Posted Yesterday 4:19 PM (GMT -6)
I am one who would advocate to start doing them now. I had the anal area pain where the prostate was removed and it was hard to do for a while. I had been doing kegels to try to strengthen the area to stop some other pain I have had for several years. I feel it helped as I am not yet three months out and think I will quit pads totally at anytime now.
 
I have basically switched from the male pads to just some smaller unisex liners. I had found a buy a package, get a package free deal and at this point I have a lot of the male pads left. I wasn't expecting to improve so fast.

Don't get discouraged!!
CalifGuy
 
Diagnosed Feb 2008  54 years old
3+4=7 gleason
7.5 PSA
4 out of 20 biopsies were cancerous
daVinci Robotic surgery July 24, 2008
Univ of Calif San Francisco Med Center  Dr Peter Carroll
In hospital 2 nights altho I had option of leaving the next day but stayed due to distance home.
Contained in prostate, not spread
Six weeks post surgery PSA less than .01

Posted Yesterday 10:25 PM (GMT -6)
You might look for a Physical Therapist that uses bio-feedback to isolate the pelvic floor muscles. This will let you know you have the right muscles.
Good Luck,
KW
    43 at Dx and Surgery (RRP)
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second Opinion Consultation for Incontinance at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 22nd, 2008 - Surgery to install the AMS AdVance Male Sling.
    March 27th, 2008 - Sling not working, Little or no improvement.
    April 18, 2008 - Collagen injection.  Back to using 4-6 full pads a day within a week.
    May 14, 2008 - Another collagen injection to try to Band-Aid the leaking for our June cruise.  Will start making conusultation appiontments for AUS after we return.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    July 30, PSA 0.00.
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
    Oct. 6th, 2008 - AUS Activation by Dr. Morey
     

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