A different kegel method ?

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Regular Member

Date Joined Nov 2009
Total Posts : 206
   Posted 4/15/2010 8:43 AM (GMT -6)   
My visit to the urologist today included a new lesson on doing kegels. I'm not convinced they work but since I'm still incontinent 12 weeks post surgery, I'll try anything.
His assistant, a soon to be urologist suggested I try a new ( to me) method and that is to do a kegel, hold for ONE second, relax for ONE second and repeat 100 TIMES!
Do this three times per day but so far I can
only do about 40, before tireing out.
Age, only 71.
July 2009, PSA 9.1, free ratio 0.16
September GLEASON 4+4=8, T2A
Prostate 44cc.
Calcium: 2.46  (range: 2.20 - 2.65 mmol/L)
25 Hydroxy Vitamin D: 102 (range: sufficiency:
76 - 250 nmol/L)
Bone Scan: Negative
CT Scan scheduled for Dec. 1st. Negative.
Started Casodex 50mg. on Nov. 6, first pill of 30.
Got Lupron 22.5mg ( 90 day ) on  November 19.
No real side effects as of Dec. 15 except dry skin and hair but getting quite 'porky' in the belt area even though now I go to the gym, three times a week. Also I dont have a need to shave anymore so now I can save my 'shaving' allowance and direct it to my stash of Depends !
Christmas Day got my first hot flashes. Thanks Santa!
Open surgery done on Jan. 20th. by Dr. J. Chin at London's University Hospital.
Cath removel scheduled for Feb. 8th. Yes, I know,
that will be 19 days. Dr. is out of country until then.
Pathology Report:
Gleason Score: cannot be determined due to hormone therapy effects. ???????
Extraprostatic Extension:
present, left radial, multifocal
present, left basal, multifocal
Resection Margins:
Apical: involved by invasive carcinoma, multifocal
Bladder Neck: involved by invasive carcinoma, unifocal on left side.Other: non-tumoural prostatic present at resection margin.
Perineural Invasion: present.
Seminal Vesicle Invasion: absent
Lymphovascular Invasion: absent
Lymph Node Status: no malignancy in regional lymph nodes
Additional path. findings:
high grade prostatic intraepithelial neoplasia
Pathology Stage: yp T3a NO MX
Radialogist appointment was on Friday Feb. 26 with Dr. Glenn Bauman in London.
Got another Lupron 90 day shot today and he wants to start IMRT soon. CT Scan plus measure scheduled in about 3 weeks. ( march 15)
First PSA test since surgery on March 18th.
with the results of 0.03 !!!
Next appointment with the surgery Doc is April 13.
Started a Facebook page for bikers with prostate issues at:
IMRT to start approx. April 26.

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4849
   Posted 4/15/2010 8:56 AM (GMT -6)   
hmmm. Sounds normal to me. How were you doing them?
Age 55   - 5'11"   215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.

Veteran Member

Date Joined Sep 2009
Total Posts : 3172
   Posted 4/15/2010 9:35 AM (GMT -6)   
Kegels don't make you continent...they make you continent faster than you would otherwise be without doing them.  This is not me speaking, this is the results of peer-reviewed, journal published medical studies.
I like the pattern that your soon-to-be-urologist suggested, but an important key is "how" you are squeezing.  Here's an excellent description I've seen written (I call it "cutting off a fart" in man-language):

Imagine trying to stop yourself from passing wind. To do this, you would squeeze the muscle around the anus. Try squeezing that muscle as if you really did have wind. You should be able to feel the muscle move. You should be aware of the skin around the anus tightening and the anus being pulled up and away from whatever you are sitting on. Do not move the buttocks and thighs. Do not hold your breath - breathe normally. Do not tighten your abdominal or buttock muscles - keep them relaxed. Later, you can check whether you are contracting the correct muscles by touching [you can skip this part; I did] the opening at the rectum as you are tightening the muscle - you should feel the opening of the rectum contract at the same time.

Combine this "how" with your urologist's "how many", and pretty soon you should be fine.

best wishes...

Forum Moderator

Date Joined Jan 2010
Total Posts : 7084
   Posted 4/15/2010 9:59 AM (GMT -6)   
I was told 10 times, held 10 seconds with 10 seconds relaxed between, at least 3 times a day. I have also seen the 1 second approach discussed - the theory is that there are two grades or strengths of muscle involved - the long contraction gets both, the short just one, but that one is what you need most to quick-stop a leak. The others are general support accross the pelvic floor.

Post Edited (142) : 4/15/2010 9:05:23 AM (GMT-6)

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2218
   Posted 4/15/2010 10:03 AM (GMT -6)   

I was told to do Kegels something like ten times a day for about ten seconds each time, but I can only ever manage about three seconds a time before I start to feel really weird.

Luckily I have my continence pretty well under control. I just do Kegels occasionally each day to hope that it helps, though with RT now coming I am doing them a bit more once again.

Guys not being sure about which muscle it is, is where the practising before surgery part comes in handy. I was told to find the right muscle before surgery by having a pee and then trying to stop it mid stream.

It also seems to be the same muscle that is used to make an erection bounce, twitch or wave up and down. (come on guys you know what I mean)

How incontinent are you by the way, and have you seen any improvement since catheter came out on Feb 8th as that is only just over two months ago? Has the weight you put on on your tummy had any negative effect.

And if your PSA is only 0.03 why are they wanting to start RT?

Age at Dx 48 No Family history of Prostate Cancer
Married 25 years, and I cannot thank my wife enough for her support.
April 2009: PSA 8.6 DRE: negative. Tumour in 2 out of 12 cores. Gleason 3+3.
RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29th July 2009. Stay 1 night.
Partial erections on while catheter still in. Catheter out on 6th Aug 2009.
Dry at night after catheter came out
Post-op Gleason 3+4. Tumour mainly in left near neck of bladder.
Left Seminal Vesicle invaded, (=T3b!)
no perineraul invasion, no vascular invasion. clear margins,
Erection 100% on 15th Aug 2009, but lots of leaking
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc.
Nov 17th 2009 PSA = 0.1
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist

Post Edited (English Alf) : 4/15/2010 9:08:46 AM (GMT-6)

Veteran Member

Date Joined May 2009
Total Posts : 2692
   Posted 4/15/2010 10:02 PM (GMT -6)   
Cleveland clinic has a technique with a kitchen timer every 12 minutes, you hold for 1 minute, as long as you are awake.

I did the rapid reps also. The every 12 minute deal was tough to do while working.
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 injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01

Regular Member

Date Joined Nov 2009
Total Posts : 206
   Posted 4/16/2010 9:39 AM (GMT -6)   
Steve and Casey: yes I believe I've been doing them right, some thing I learned from earlier postings on this great forum.

Elf: Yes, I too was wondering why IMRT with the psa at <0.03. That is why I had an appointment with the surgery guy who explained in very fine details that there are extraprostatic extensions plus problems around the bladder neck area. Since I'm still quite a bit incontinent, both he and the oncologist/radiation expert agreed to postpone the start of the radiation from April 26 to May 10th.
Prior to this appointment, I has hesitate about even starting IMRT but now I'm convinced that in my case, it's neccessary.

Post Edited (JB71) : 4/16/2010 8:45:24 AM (GMT-6)

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2218
   Posted 4/16/2010 10:02 AM (GMT -6)   
Seems sensible to postpone RT to May to give you more recovery time.

A week after surgery the "nasty" bits of my post-op pathology (bladder neck involved and seminal vesicles invaded) also suggested that there might be going to be a need for RT sometime, but it was still decided to wait till the PSA actually went over 0.2. They don't like doing RT till your body has had a good time to recover from the surgery if possible.

It is indeed about getting the explanation about the fine details. (They are still working on the details of my RT plan so I have not yet had the dates, but could be next week)


Regular Member

Date Joined Nov 2009
Total Posts : 486
   Posted 4/16/2010 7:14 PM (GMT -6)   
Jerry,  The National Assoc. for Continence (NAFC) recommends both the short count as well as the long count Kegels.  They say they are both important to achieving and maintaining continence.  This link,  www.nafc.org/uploads/pdf/Pelvic_floor.pdf  might br helpful.  I think Canada also has a similar site.

Diagnosed 2/2008 at age 71, Gleason score 5+3=8, stage T1c, PSA 9.1. 
Robotic surgery 5/2008, nerves spared, All margins, SV and lymph nodes negative. 
Staged pT2c, Gleason score 5+3=8.  PSA <0.1 at 20 months, Jan. 4, 2010.

Veteran Member

Date Joined Sep 2009
Total Posts : 6080
   Posted 4/16/2010 9:00 PM (GMT -6)   
Its interesting to note, the passing gas technique, cause I have always used that as a major milestone in incontinence. When you can let that gas out and NOT squirt... well my friend, you have arrived!!. It can be done but, no pun intended, its as delicate as walking the razors edge.
age 66 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of W Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
8 week psa 0,o

" Hypocrisy is vice's homage to Virtue " read it in Bartlet's book of quotation years ago stuck with me, can't remember who said it.

New Member

Date Joined Nov 2009
Total Posts : 3
   Posted 4/17/2010 6:01 PM (GMT -6)   

I've been watching posts on this topic now for over a year and I've yet to see anyone who has tried this routine.  My husband's uro said that he could Kegel until the cows came home but it would not be as effective as using the old Suzanne Somers' Thigh Master.  You can find them online or on Ebay. Give it a try - they are cheap - and my husband is dry (he really never did the Kegel thing).

Age 55
Robotic Surgery 2/13/09
Gleason 6 Stage T2a
Pathology - Excellent



Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 4/18/2010 1:20 PM (GMT -6)   
JB71 said...
My visit to the urologist today included a new lesson on doing kegels. I'm not convinced they work but since I'm still incontinent 12 weeks post surgery, I'll try anything.

I'm still incontenent, lightly so, 1.5 years post-surgery. During my most recent visit with my Urologist he confessed that there's no "proof" that doing kegels makes any difference in rate of flow. At 12-weeks post-op I was leaking badly, so I don't know if you should be too worried about your own situation - if my experience is similar to the experiences of others.

Age:  60 (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 (1 light (woman's style) pad per day)

ED: Combination of Cialis and MUSE (alprostadil) once weekly: started 9-27-08

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

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0; 3/10: 0.0


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