Any link between specific exercises and incontinence improvement?

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mountain top high
Regular Member


Date Joined Mar 2009
Total Posts : 22
   Posted 3/29/2009 8:11 PM (GMT -6)   
I'm at 7 weeks past the DaVinci procedure and still soaking 4-5 pads a day. I'm 43 and was very active pre-surgery (mountain backpacking, kayaking, karate,...) and not at all happy with this. Noticed last week an odd change that I haven't read or heard about anywhere. Wasn't allowed to do any real exercises until 6 weeks out so last week I started light. Monday/Wednesday/Friday morning exercises for my back (I have some disc problems) that involve crunches, abdominal twists, lunges and core movement. Tuesday/Thursday exercised arms and shoulders only. Noticed the day after the abdominal workouts that I only needed 2 pads, then back to 4-5 (constant dripping) on the other days. I don't usually do these exercises on the weekends but decided this morning to do the ab ones again just to test the theory and sure enough, only needed one pad today.
 
During the 6 weeks recovery I walked 2-3 miles every couple of days per doctor's instructions but only noticed minimal if any improvement after that exercise.
 
Anyone ever heard of anything like this before? I'm happy to do the back & ab exercises every morning if it takes me from 4-5 pads a day to 1-2.

Mountain Top High, Age 43
PSA 1.6 (2006), 1.9 (2007), 6.0 (6/2008), 3.9 (7/2008 after Cipro course)
8/08 biopsy--high grade PIN
11/08 biopsy--Dx (age 43), Gleason 7 (3+4), T1c, N0, MX
Da Vinci RP 2/9/09 (Dr. Abaza, Head of Robotic Uro, James Cancer Center @ Ohio State)
Path--PCa 9%, 39.5 grams, contained in capsule, margins & lymph nodes clear
Catheter 1 week, no nighttime incontinence
@ 6 wks: morning best but still ~4-5 pads/day
Complete ED, pump daily, insurance denied Viagra :-(


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/29/2009 9:16 PM (GMT -6)   
Hi Mountain,
Sorry to welcome you here but it is what it is...Welcome to HealingWell...I am sorry for the rough start. I did well with the plumbing in my DaVinci but the disease was advanced. I was, er, am young too. I was 44 in 2006 when I joined the club. I will say it is highly unusual to not be told about Kegel excercises. Is that the case? These are pelvic muscle excercises that help strengthen the urinary sphincter muscle. Perhaps you may want to look into them. Regardless, I did not do them uch and I did not leak but a tiny bit after surgery. I hope you are at least done with the cancer and that all the future tests are undetectable. Again welcome and I hope you stay with us...

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Roger G
Regular Member


Date Joined Apr 2008
Total Posts : 150
   Posted 3/30/2009 6:22 AM (GMT -6)   
Hello Mountain,

Welcome to the younger half of The Club for Men :) Like Tony said, start doing those Kegels and hopefully the incontinence will improve. I personally found for about the first three to four months that certain lifts and kicks (I'm into Karate) would cause me to leak. Heck picking up my daughter's hockey bag caused a small leak. This is no longer a problem. ED I'm still working on.

Good Luck and stay in contact with us.
Age: 43 (2008)
DRE Small Ridge on prostate, PSA 1.5
07/2007: Diagnosed cancer, T2c, Gleason 3+4=7
09/2007: Laparoscopic prostectomy @ Hamilton General, 4 hrs.
01/2008: Still working on ED.
 
 


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 3/30/2009 6:50 AM (GMT -6)   

    Hey Mountian,  Do not worry too much.  Your only 7 weeks post op.  Your body has been through a major surgery and it will take time to fugure things out.  I'm sure you will dry up within a few months.  All of the studies say 6 months or more is still in the normal range!  I would ease into the exercises and see how it goes.

    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.  Working Great, only light drips and dribbles.
    Jan, 31st, 2009 - PSA 0.00  Next test in July, 2009  


mountain top high
Regular Member


Date Joined Mar 2009
Total Posts : 22
   Posted 3/30/2009 10:41 AM (GMT -6)   
Thanks for the encouragement guys. Forgot to mention I have been doing Kegels, although at my 4 week checkup we found out the doctor's office missed a communication at the catheter removal that I should be ramping them up. Was only doing 2 sets a day and they said I should be doing 7. So started doing more and then what control I had in the AMs got worse (from what I've read, to be expected if you do too many). Been doing them still but haven't seen any improvement from them or anything until this recent revelation with the ab exercises. Going strong again today. Looks like I'll be doing those exercises daily.
 
My wife has pointed out a problem with my overachiever mentality. When they told me pre-surgery it would take 3 months or more to see improvement, I immediately set 3 weeks as my goal (it's backpacking season again, the rivers are warming up, and I prefer to be ahead of the class). Apparently recovery refuses to be rushed, though.  ;-)
 
Thanks guys.
Mountain Top High, Age 43
PSA 1.6 (2006), 1.9 (2007), 6.0 (6/2008), 3.9 (7/2008 after 30-day Cipro course)
8/08 biopsy--high grade PIN
11/08 biopsy--Dx (age 43), Gleason 7 (3+4), T1c
Da Vinci RP 2/9/09 (Dr. Abaza, Head of Robotic Uro, James Cancer Center @ Ohio State)
Path--PCa 9%, 39.5 grams, contained in capsule, margins & lymph nodes clear
Catheter 1 week, no nighttime incontinence
@ 6 wks: morning best but still ~4-5 pads/day
Complete ED, pump twice daily, insurance denied Viagra :-(


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 3/30/2009 11:21 AM (GMT -6)   
Welcome Mountain Top...here is my take on the exercise for incontinence. At first I was so intent on solving the issue that I actually overworked the muscles and had a much harder time trying to control the flow. It got so bad that I couldn't make it to the bathroom without leakage when I stood up or moved about. I got frustrated and my uro suggested to take some time off from the Kegals to let things heal...kinda like overused muscles that ache and have little strength left in them. I took about a week off from the routine and then things started to improve. After that I did the same routines, just scaled down a little to not to over work the muscles again. Some of this might be due to age in my case, but the point is...try not to over do it. I know you want to be free of the incontinence, but in your effort to resolve the issue by overworking the muscles, you could actually prolong the problem.

As others have said...give it your own bodies natural healing time...it will happen soon or later.
You are beating back cancer, so hold your head up with dignity
 
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
4 tumors in prostate - largest being 6 cm 
PSA 5 week Oct 2008 <.05
       3 month Jan 2009 .06


sandstorm
Regular Member


Date Joined Dec 2008
Total Posts : 194
   Posted 3/30/2009 12:19 PM (GMT -6)   
mountain top high

Welcome to the board just sorry you had to join. I was advised after catheter removal to do kegels 2 to 3 times a day and only do ten in a set instead of the original recommendation 25. that was so I did not tire out the muscles. Sorry you are having a tuff time with the pads. I'm lucky to be 11 weeks out now and down to a female thin pad when I leave the house. I hope things improve for you and believe they will.
Age at DX 57
5-18-07 PSA 7.7
5-06-08 PSA 4.6  8% free psa, but stable
10-23-08 PSA 5.65 4% free psa
11-04-08 biopsy
11-11-08 2 of 12 cores positive
Gleason 3+3  6  stage t1c / post-op 3+4  7  stage t2c
CT and Bone scan negative
Da Vinci RRP 01-09-09
Catheter removed 1-15-09
Pathology Report says it's gone!
First Post-op PSA 2-17-09   0.00


Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 3/30/2009 2:15 PM (GMT -6)   

Hey MT,

As far as exercise goes my Uro was not very specific, so I continued with my walking and Jogging-in-place since post surgery.   I've been at about 1 pad for a while, but of course if very active that would go up.   Also Jogging In Place with all the vertical jouncing that it causes would cause a good amount of leaks.   The actual amount of leakage I know pretty well since I use the famous CUP method while Jogging in place (that's a 10 oz plastic cup attached to left leg with the old latex strap you used to use for your leg bag.   Mr Floppy goes over and in and you catch the drips -- add tissue if you don't want to slosh between emptyings.   (This only works well if you are naked while jogging or with a bathrobe or tarzanwear,  in your own exercise room).    For the last month (weeks 4-8) the drip rate has been about the same (per mile or minute or any other method you'd like to use to gauge).    I have not tried going back to any abdominal exercises.  I was thinking it's about time to start.   Will report back if I notice any drop in rate similar to what you have seen.

jim 


Age 58, 192lbs, 6'4", 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
Biopsy Nov2008 1 of 12 cores 5%, Gleason 3+3 - Sona showed 140+ cc (110 grams post op) prostate size.
open RP surgery 02/03/09, Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
Pathology Report - All margins clear - No Invasive spread - no change in Gleason score.
2/18/09 Cath out, passed a STONE within hours. To be analyzed by doc.
Using pump (encore) daily since catheter out -- Viagra and Levitra samples now and then (no effect).
03/06/09 Started Levitra 20mg rehabbing -> 3/23 no real effect yet.
03/20/09 First post-PSA blood drawn -> 04/01 will be meeting w/PA.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 3/30/2009 2:25 PM (GMT -6)   
Jim, i will be hoping hard that you pull your first zero in a couple of days, good luck there.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 6 month on 5/9
 
 


hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 3/30/2009 2:31 PM (GMT -6)   

Here's another take on the exercise. I started walking 5 miles a day as soon as I could and along with the kegels, noticed that it made a big improvement. By the 4th week after surgery, I would leak only when getting up, crossing a high curb or straining to life something. I went back to work at 6 weeks but took a restroom break every hour on the hour. Continuing walking in the evening and was up to 7 miles at some point.

At the 9th week, I stopped wearing pads. I did not have the daVinci surgery but had a great surgeon I guess.


Age 60
PSA 2007 4.1
PSA 2008 10.0
Diagnosed April 2008
Biopsy: 6 of 12 cores positive
Gleason 4 + 5 = 9
CT and Bone Scan negative
Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared
Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th
pT2c
lymph nodes negative
PSA Sept 28, 2008 0.00
PSA Jan 22, 2009 0.00


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2457
   Posted 3/30/2009 6:36 PM (GMT -6)   
High Mountain,
I'm 7 weeks since surgery and still use at least one pad a day sometimes 2. My worse days are when I play golf. Every time I swing the club I leak, also when I squat to mark my ball on the greens. I'm seeing some weekly improvements with therapy doing Kegel exercises every day.
Age: 67
Retired in 2001 and living in Austin TX.
PSA 3.5 free PSA 11%
Dx 12/30/08
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
Post op Pathology report:
Prostate weighed 57 grams
size:5.2 x 5.0 x 4.9 cm
10-20% involved
Bilateral
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
Lymph nodes: not dissected
seminal vesicles clean


RBinCountry
Regular Member


Date Joined Apr 2008
Total Posts : 270
   Posted 3/30/2009 10:10 PM (GMT -6)   
I am going to mention something I learned from James C. Along the road of drying up, I got to where I was leaking only occassionally and then not much, but still things happened here and there. Living in South Texas and also exercising, those pads really get hot, and caused me to sweat excessively down south. Well, I started wearing a woman's panty liner instead of a pad. I found it to work great, and because it is so much thinner - things are much cooler down south. Well, my wife had no idea that someday her husband would be wearing a kotex. Life is strange.

RB
Age 61 (now 62)
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04
2nd Post PSA <.01 10/30/2008


brodie12
New Member


Date Joined Dec 2007
Total Posts : 18
   Posted 3/30/2009 10:38 PM (GMT -6)   
Mountain There is a book written by Peter Dornan a Australian called Conquering Incontinence . He incorporates ab exercises with kegels and claims a very high success ratio with his patients Brodie

Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 3/31/2009 9:29 AM (GMT -6)   
Hey PG ... thanks for the support on my upcoming 1st Post-PSA .... will report in 4/1 -- unless Conficker has other plans for the internet. I am optimistic on PSA results -- the only way to be.
jim
Age 58, 192lbs, 6'4", 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
Biopsy Nov2008 1 of 12 cores 5%, Gleason 3+3 - Sona showed 140+ cc (110 grams post op) prostate size.
open RP surgery 02/03/09, Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
Pathology Report - All margins clear - No Invasive spread - no change in Gleason score.
2/18/09 Cath out, passed a STONE within hours. To be analyzed by doc.
Using pump (encore) daily since catheter out -- Viagra and Levitra samples now and then (no effect).
03/06/09 Started Levitra 20mg rehabbing -> 3/23 no real effect yet.
03/20/09 First post-PSA blood drawn -> 04/01 will be meeting w/PA.

Post Edited (JimStars) : 3/31/2009 10:39:29 AM (GMT-6)


justus1292
Regular Member


Date Joined Feb 2009
Total Posts : 63
   Posted 4/2/2009 3:24 PM (GMT -6)   

Yea, I was in pretty good shape pre op as well.  Took about nine months to be dry all night....or maybe it was that beer thingy.  Any way, after about 18 months all is 99.99999% normal.  Still liftiing something REALLY HEAVY will get a drop or two at night. redface

If you dream that your peeing....you probably are. blush


mountain top high
Regular Member


Date Joined Mar 2009
Total Posts : 22
   Posted 4/6/2009 4:54 PM (GMT -6)   

Well, I had another response to you guys typed up several days ago but don't see it here so I must have walked away without hitting the Submit button. Depending more and more on my wife for the little things.  ;-)

I haven't been doing the Kegels for a week or so now but have been doing the ab/core exercises and have consistently been using only 1-2 pads a day. I'm now doing my karate katas most mornings as well. I've even had a couple of times where I missed all the exercises for a day but no decrease in bladder control. Only one day was an exception--I have sinus problems so I took one Sudafed that day. Hadn't been able to take Sudafeds for a few years prior to surgery because it made for painfully constricted urination with my BPH. I assumed it would therefore help the post-surgery incontinence but it got worse that day. I don't do anything according to the rules.

I am noticing that as the bladder control gets better, I have to go more often and it gets pretty uncomfortable if I wait.
 
RBinCountry--planning on spending some time in S Fla in a few weeks--thanks for the tip.
 
brodie12--ordered the book from Amazon and got it within 2 days. Looks good.
 
Thanks for all the suggestions and support, guys!
Mountain Top High, Age 43
PSA 1.6 (2006), 1.9 (2007), 6.0 (6/2008), 3.9 (7/2008 after 30-day Cipro course)
8/08 biopsy--high grade PIN
11/08 biopsy--Dx (age 43), Gleason 7 (3+4), T1c
Da Vinci RP 2/9/09 (Dr. Abaza, Head of Robotic Uro, James Cancer Center @ Ohio State)
Path--PCa 9%, 39.5 grams, contained in capsule, margins & lymph nodes clear
Catheter 1 week, no nighttime incontinence
@ 6 wks: morning best but still ~4-5 pads/day
Complete ED, pump twice daily, insurance denied Viagra :-(

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