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zachattack
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 12/17/2009 10:16 AM (GMT -6)   
Being kinda new here I have just seen a few post on kegeling.I have seen only a couple of post with the pros and cons on this subject and know you vets are probably wore out on this subject but I am at a point where I don't know if the kegeling is doing any good.thanks for any help.

Zach
age 55dx 12-2008,psa at biopsy 8.6
biopsy 12/12 gleason 3+4=7
da vinci surgery 6-09 nerve sparing by DR. John W. Scott (my hero)
Hospital 3 days cath 7days still leaking from cough(bad lungs)
still have ed may be the hormones.
9-09 psa 2.2 hormone inj
10-09 nuclear bone scan no results yet I will have gold markers placed 12-29-09
start rad 1-10-10
organ confined
extracapsular seminal vesicle involvement
lymph node involvement


Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 310
   Posted 12/17/2009 10:48 AM (GMT -6)   

I followed Scardino on this one and rejected the advice of my surgeon.  Per Scardino:

Do not start Kegel exercises before surgery.  Most men will recover continency naturally (very occasional minor leakages are nearly impossible to completely eliminate, however).

If after a reasonable time post-surgery continency still hasn't returned, you can try Kegels - but if they work at all they will usually only alleviate the problem, not solve it.  Further, for many men they will not work at all.

If they don't work, see a specialist.

Zen9



No family history of PC.  PSA reading in 2000 was around 3.0 .  Annual PSA readings gradually rose; no one said anything to me until my PSA reached 4.0 in September 2007, at which point my internist advised me to see a urologist.   
Urologist advised a repeat PSA reading in six months = 4.0 .  Diagnosed May 2008 at age 56 as a result of 12 core biopsy.  Biopsy report by Bostwick Laboratories = Gleason 3 + 3. 
Interviewed two urologists - the one who did the biopsy and another - the latter had the biopsy slides re-examined = Gleason 3 + 3. 
Then went to M. D. Anderson Cancer Center in Houston in July 2008 and met with a urologist and a radiologist.  Biopsy slides re-examined yet again, this time by MDA's internal pathology department = Gleason 3 + 4.   
Chose da Vinci surgery over proton beam therapy; surgery performed at M. D. Anderson Cancer Center on August 15, 2008.  Post-operative pathology report = four tumors, carcinoma contained in prostate, clean (negative) margins, lymph nodes clear, seminal vesicles clear.  Gleason = 4 + 3. 
Minor temporary incontinence; current extent of ED uncertain due to lack of sexual partner; refused treatments for ED as being pointless under the circumstances. 
PSA readings: 
November 2008 = <0.1 ["undetectable"]
June 2009 = <0.1   
December 2009 = <0.1
 

Post Edited (Zen9) : 12/17/2009 12:56:14 PM (GMT-7)


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 12/17/2009 10:54 AM (GMT -6)   
I can't argue with Scardino !

They are a sort of thing that takes a long time to see much progress. In fact, one doesn't really know if they helped at all. But, they don't hurt anything, and just in case they do help, wouild hate to lose 2 or 3 months without doing them.

You will also find several different ways to do them. I shopped around on google until I found a method that worked for me.

I can't say I was religious about them, and maybe that is why it took me 8 months insetad of 4, who knows ?

Goodlife
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injections


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 12/17/2009 11:21 AM (GMT -6)   
I can't tell that they are doing a thing for my long term continence. They do help me get to the bathroom when I first stand up. Psychologically, I need to do them so I feel like I still have some input and my recovery is not just nature taking its course. Either way I am still leaking.
I do them when I am watching TV, sitting in front of the computer, in bed, but never when I am out since I squirt and will readily fill a pad if I am standing.
DX Age 56. First routine PSA test on April 8th: 17.8. Start 2 weeks of Cipro to rule out protatitis.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7 Tumor size: 2.5 x 1.8 cm location: both lobes and apex. No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Extraprostatic extension present; Perineural invasion: present, extensive
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11.
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day (I'm going to try cutting down on fluids. Bad idea. I know.)
. 9/27 2 months: Still 3 pads per day.
11/14 4 months: Still 3 pads per day. 420ml/day, 91 um leak.
12/11 5 months: Still 3 pads per day. 400-450ml/day Experimenting with Nyquil.
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04 undetectable.


cocrgolfer
Regular Member


Date Joined Oct 2009
Total Posts : 171
   Posted 12/17/2009 11:36 AM (GMT -6)   
Zach,

I've come around to agreeing that the Kegel exercises won't solve the problem by themselves. We have two sphincters to retain urine in the bladder, one above the prostate and one below. Both can be traumatized during the surgery. They are comprised of smooth muscle and contract around the urethra when enervated by nerves we cannot directly control. The bottom one does have another component of skeletal muscle we can control and if it is "toned" by exercise, like those six pack abs we all wish we had, it can help somewhat in slowing the dribbles. Also, by flexing the muscle during Kegels a signal is sent to the bladder telling it to retain urine. I'm still doing them religiously but I don't think I'm going to get continent until my sphincters heal and start working by themselves.

Patience, patience, patience is my mantra.

Steve

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 12/17/2009 11:41 AM (GMT -6)   
Zach, I started doing Kegels at least five years before I even suspected PCa. I had serious ED problems since my early 50's and read in a men's health mag that kegels would help. The kegels didn't help the ED but I kept on doing them anyway. I used the info from the Mayo clinic on how to do kegels. I have no way of knowing if they helped with incontinence. I was completely dry at six weeks. May have just been good luck. Good luck to you.

Carlos
Diagnosed 2/2008 at age 71, PSA 9.1, Gleason 8 (5+3)and stage T1c.  CT and bone scan neg.
Robotic surgery 5/2008, nerves spared, bladder neck spared with pelvic floor reconstruction.
All margins, SV and lymph nodes were neg. 
Staged pT2c, Gleason sum 8 (5+3).
Continent at 6 weeks. 
PSA <0.1 at 18 months, Nov. 2009.


Bluenose
Regular Member


Date Joined May 2008
Total Posts : 260
   Posted 12/17/2009 1:16 PM (GMT -6)   

 

    Kegels didn't really help me, unless I had the urge really bad, and pre PCa I was doing them sometimes and didnt know it after one too many beers before running to the head.  So I really didn't do them as a normal routine. My body and time took care of it I guess..

 


 
  age: 53 @ Dx, Pre-op PSA Feb 08' 5.0, April 08' 4.1
  Biopsy 5.1.08, 5 of 15 cores postive, T2a, Gleason 3+4=7
  DaVinci performed 7.29.08
  Bladder sling installed, umbilical hernia repaired during surgery.
  Path report, "cancer fully contained, margins clear".
  Cath removed 8.8.08, ED therapy begins 8.9.08
  100mg Viagra three times a week, pump for ten minutes daily
  and hold for ten minutes.
  8.16.08 switched to Levitra 20mg, immediate results
  9.15.08 Pad free at night, one thin (light) pad during the day
  9.18.08 1st Post-op PSA Undetectable Zero's....Yes!
  12.22.08 2nd Post-op PSA  Zero's still...
  6.23.09 1yr Post-op PSA Still a zero..
  Pads gone 1.3.09, finally found the courage...Thanks ya'll
          ".....tryin' to reason with hurricane season...."
       


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 12/17/2009 2:21 PM (GMT -6)   
Zen,

Your doctor's advice was almost identical to my own uro/surgeon. His attitutde, was if you want to do them, do them. He doesn't feel they help, and he didn't see any point in doing them pre-surgery.

David
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA:
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 310
   Posted 12/17/2009 2:29 PM (GMT -6)   

Purgatory,

You didn't read my post carefully.

My doctor's advice was to start doing Kegels religiously a month before surgery, then continue to do them religiously after the catheter had been removed post-surgery - even after continency had been restored.

I rejected that advice in favor of the advice Scardino gives in his writings, which I summarized above.

Zen9


No family history of PC.  PSA reading in 2000 was around 3.0 .  Annual PSA readings gradually rose; no one said anything to me until my PSA reached 4.0 in September 2007, at which point my internist advised me to see a urologist.   
Urologist advised a repeat PSA reading in six months = 4.0 .  Diagnosed May 2008 at age 56 as a result of 12 core biopsy.  Biopsy report by Bostwick Laboratories = Gleason 3 + 3. 
Interviewed two urologists - the one who did the biopsy and another - the latter had the biopsy slides re-examined = Gleason 3 + 3. 
Then went to M. D. Anderson Cancer Center in Houston in July 2008 and met with a urologist and a radiologist.  Biopsy slides re-examined yet again, this time by MDA's internal pathology department = Gleason 3 + 4.   
Chose da Vinci surgery over proton beam therapy; surgery performed at M. D. Anderson Cancer Center on August 15, 2008.  Post-operative pathology report = four tumors, carcinoma contained in prostate, clean (negative) margins, lymph nodes clear, seminal vesicles clear.  Gleason = 4 + 3. 
Minor temporary incontinence; current extent of ED uncertain due to lack of sexual partner; refused treatments for ED as being pointless under the circumstances. 
PSA readings: 
November 2008 = <0.1 ["undetectable"]
June 2009 = <0.1   
December 2009 = <0.1
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 12/17/2009 2:33 PM (GMT -6)   
Excuse me. My reply was still the same ,but I had the opinion tied to the wrong doctor. There were two doctors in reference in your post.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA:
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 12/17/2009 3:33 PM (GMT -6)   
Zach, One source for good information on kegels and continence is the National Association for Continence, www.nafc.org. They have some articles on the web site and sell some pamphlets on pelvic muscle exercises.

Carlos
Diagnosed 2/2008 at age 71, PSA 9.1, Gleason 8 (5+3)and stage T1c.  CT and bone scan neg.
Robotic surgery 5/2008, nerves spared, bladder neck spared with pelvic floor reconstruction.
All margins, SV and lymph nodes were neg. 
Staged pT2c, Gleason sum 8 (5+3).
Continent at 6 weeks. 
PSA <0.1 at 18 months, Nov. 2009.


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 12/17/2009 3:51 PM (GMT -6)   
I have a feeling that walking or (eeeek! jogging) is a satisfactory substitute for Kegels. I was a walker many years before surgery and have continued since. No continence problems. I do a few Kegels when I think of them, as like Carlos, I have seen reports they may help with ED. But I can't say they have helped me any in that department sad
Pre-op:
Age 63 at diagnosis, now 64.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve sparing RRP on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
19-month: 0.09 (maybe)
ED:
After a learning curve, Bimix injections (0.2ml) worked well. From 14 months, occasional nocturnal erections. Have "graduated" to just the pump.


opt53
New Member


Date Joined Dec 2009
Total Posts : 1
   Posted 12/18/2009 5:13 PM (GMT -6)   
Zach just had surgery five weeks ago and the catheter removed three weeks ago.. I do the kegels morning noon and night with little progress (alot of dripping) My doc told me that alot of what is happening is due to the fact my nerves have yet to heal..I still can't tell during the day when my bladder is full hence i don't have to go. Still fill the depends. Must say that the nights are getting better. Less dripping and better urination in the morning. What i would like to know is the average time it takes to become "normal".

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 12/18/2009 5:34 PM (GMT -6)   
My wife says I'll never be normal.

But I would say give it 3 to 6 months and you will be pretty good.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injections

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