Kegels, 3 kinds ...

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MartinP
Regular Member


Date Joined Mar 2017
Total Posts : 37
   Posted 4/6/2017 3:34 AM (GMT -7)   
I wonder if it has been discussed here, but these two guys (a physiotherapist and a specialist nurse) indicate that kegeling is not just kegeling, however, 3 parts of the pelvic floor are players in that game: The part that feels around the anus, the part that feels "in the middle" (the perineum) and the part which kind of "clamps" the penis. (Or should clamp it ...) smile

And actually it is especially by controlling the 2 last ones you will gain control of urination.

Anyway: kegeling is not just one forcefull tightening down there, you must know the difference between these 3 parts of the pelvic floor.

The interesting part in the long video you'll find (imo) from 4:40 to about 16:00.

https://www.youtube.com/watch?v=ZlCTRhQQ_g8
and:
https://www.youtube.com/watch?v=QHwVglPQR_w

(I am not sure that these links will work as written here, so I write them below once more for copy-pastingsmile

https://www.youtube.com/watch?v=ZlCTRhQQ_g8

https://www.youtube.com/watch?v=QHwVglPQR_w[url]
Born 1950.
PSA preOP 6,5 - 6 - 5,5
Diagnosed: end of January 2017
Gleason preOP (biopsy) 3+5 = 8
RP (robot-guided) 2-28-17
Prostate 96 g. Cancer totally contained. Clean margins. (Happy!).
Gleason adj. to 3+4 = 7
Cath out 3-10-17
Dry at night, dry sitting, am in the proces of learning when and how to kegel to avoid dripping when walking, rising etc ... That involves a good deal of mental energy.

Post Edited (MartinP) : 4/6/2017 6:14:08 AM (GMT-6)


raypaul
Regular Member


Date Joined Jan 2017
Total Posts : 65
   Posted 4/6/2017 8:34 AM (GMT -7)   
MartinP

Thank you for the information. Very helpful. I am 3.5 weeks out from RALP and I think the info about incontinence and ED was spot on.
PSA
8/14 3.89
12/15 5.61
6/16 6.1
1/17 7.5

Biopsies
4/15 Atypical cells
6/15 Atypical cells
12/15 MRI 3 pirad, 4 pirad
1/16 1 core G6 in pirad 3 area, pirad 4 atypcial cells

3/16 Oncotype: 86% favorable pathology, 91% freedom from high grade, 93% organ confined

AS 14 months
RALP 3/14/17 3+4=7 <10% of prostate 1.2cm
no aggressive features pT2c

BillyBob@388
Veteran Member


Date Joined Mar 2014
Total Posts : 2689
   Posted 4/6/2017 8:50 AM (GMT -7)   
Thx for the interesting link, Martin.
PSA 10.9 ~112013
Bx on 112013 at age ~65yrs, with 5 of 12 pos with one G9(5+4), 1 PNI, T2B.
RALP with lymph nodes at Vanderbilt 021914. (nodes clear, SV+, G9 down graded to 4+5, cut wide, but 1 tiny foci right at the edge of margin ) Pros. 106.7 gms!
At 15 months, not wearing a pad most days, mostly dry
PSA <.01 on 6/14 and all until 9/15 = .01, still .01 9/16, .02 on 3/17

MartinP
Regular Member


Date Joined Mar 2017
Total Posts : 37
   Posted 4/6/2017 8:56 AM (GMT -7)   
Thank you.
Yes, I certainly was not aware that "kegeling" is not just one tightening of a muscle, but actually can be differentiated into 3 different squeezes. Where the middle and the "foremost" maybe are the most important since they produce the "kink" on the urethra that stops the flow.
So as of today I'm really trying to differentiate my kegal practice accordingly. And (probably just coincidence) I believe that I already feel the left-over little weak sphincter is working better. smile
I see you are just 2 weeks "behind" me in the proces - my experience is that it mostly gets better from day to day, only now and then a little worse.
Good luck with everything!
Born 1950.
PSA preOP 6,5 - 6 - 5,5
Diagnosed: end of January 2017
Gleason preOP (biopsy) 3+5 = 8
RP (robot-guided) 2-28-17
Prostate 96 g. Cancer totally contained. Clean margins. (Happy!).
Gleason adj. to 3+4 = 7
Cath out 3-10-17
Dry at night, dry sitting, am in the proces of learning when and how to kegel to avoid dripping when walking, rising etc ... That involves a good deal of mental energy.

Gemlin
Veteran Member


Date Joined Jul 2015
Total Posts : 623
   Posted 4/6/2017 9:09 AM (GMT -7)   
You are absolutely right about the different squeezes. In the beginning it was a bit tricky to release the anus part to pass gas and in the same time squeeze the urethra to not leak there. After a while it is fully automatic, you don't think about it anymore.

MartinP
Regular Member


Date Joined Mar 2017
Total Posts : 37
   Posted 4/6/2017 10:23 AM (GMT -7)   
smile Sounds good!
Born 1950.
PSA preOP 6,5 - 6 - 5,5
Diagnosed: end of January 2017
Gleason preOP (biopsy) 3+5 = 8
RP (robot-guided) 2-28-17
Prostate 96 g. Cancer totally contained. Clean margins. (Happy!).
Gleason adj. to 3+4 = 7
Cath out 3-10-17
Dry at night, dry sitting, am in the proces of learning when and how to kegel to avoid dripping when walking, rising etc ... That involves a good deal of mental energy.

raypaul
Regular Member


Date Joined Jan 2017
Total Posts : 65
   Posted 4/6/2017 10:24 AM (GMT -7)   
Leaking while walking is my biggest challenge at this point. I am working on posture which he suggests in the video and that seems to make a little difference. The issue with tightening the kegel while walking is eventually you have to release it and that is when I get the leakage.

Its a work in progress
PSA
8/14 3.89
12/15 5.61
6/16 6.1
1/17 7.5

Biopsies
4/15 Atypical cells
6/15 Atypical cells
12/15 MRI 3 pirad, 4 pirad
1/16 1 core G6 in pirad 3 area, pirad 4 atypcial cells

3/16 Oncotype: 86% favorable pathology, 91% freedom from high grade, 93% organ confined

AS 14 months
RALP 3/14/17 3+4=7 <10% of prostate 1.2cm
no aggressive features pT2c

MartinP
Regular Member


Date Joined Mar 2017
Total Posts : 37
   Posted 4/6/2017 10:34 AM (GMT -7)   
I fully understand you, Rayapul.

I've read this "trick" by a Danish physio: (The breathing-thing added by me according to experience.)
1: Stand still.
2: Kegel for 30 seconds, only half power. This should make the bladder relax and your urge disappear. Breathe deep while squeezing.
3: Think of everything but toilets and peeing. Breathe deep.
4: Move on, maybe squeezing 20% most of the time.

The effect might not last for hours, but I've often felt that there is a mechanism there which is working.
Born 1950.
PSA preOP 6,5 - 6 - 5,5
Diagnosed: end of January 2017
Gleason preOP (biopsy) 3+5 = 8
RP (robot-guided) 2-28-17
Prostate 96 g. Cancer totally contained. Clean margins. (Happy!).
Gleason adj. to 3+4 = 7
Cath out 3-10-17
Dry at night, dry sitting, am in the proces of learning when and how to kegel to avoid dripping when walking, rising etc ... That involves a good deal of mental energy.

BillyBob@388
Veteran Member


Date Joined Mar 2014
Total Posts : 2689
   Posted 4/6/2017 7:50 PM (GMT -7)   
raypaul said...
Leaking while walking is my biggest challenge at this point. I am working on posture which he suggests in the video and that seems to make a little difference. The issue with tightening the kegel while walking is eventually you have to release it and that is when I get the leakage.

Its a work in progress


This is so true: You can not squeeze forever! And walking was my biggest challenge, I leaked like a sieve even squeezing hard. And that used to worry me a lot: am I going to have to consciously squeeze forever? The answer, for most of us, is NO! Other than the occasional bladder spasm that I still suffer from which requires swift action and clamping down, or maybe in prep for any sudden move like hopping up out of a chair or lifting something heavy, I normally walk around, even with a fairly full bladder, with no conscious contraction at all. I can even hike off trail up and down steep hills. All, at least most of the time, without a thought. And since I am not trying to squeeze all day long, this leaves me plenty of muscle strength left for the occasion when I do need to do a quick clamp down. This most likely will be you guys, either sooner or later, or you might do even better.
PSA 10.9 ~112013
Bx on 112013 at age ~65yrs, with 5 of 12 pos with one G9(5+4), 1 PNI, T2B.
RALP with lymph nodes at Vanderbilt 021914. (nodes clear, SV+, G9 down graded to 4+5, cut wide, but 1 tiny foci right at the edge of margin ) Pros. 106.7 gms!
At 15 months, not wearing a pad most days, mostly dry
PSA <.01 on 6/14 and all until 9/15 = .01, still .01 9/16, .02 on 3/17

MartinP
Regular Member


Date Joined Mar 2017
Total Posts : 37
   Posted 4/6/2017 10:32 PM (GMT -7)   
Encouraging, BillyBob, so good to see light at the end of the tunnel. Thanks.
Born 1950.
PSA preOP 6,5 - 6 - 5,5
Diagnosed: end of January 2017
Gleason preOP (biopsy) 3+5 = 8
RP (robot-guided) 2-28-17
Prostate 96 g. Cancer totally contained. Clean margins. (Happy!).
Gleason adj. to 3+4 = 7
Cath out 3-10-17
Dry at night, dry sitting, am in the proces of learning when and how to kegel to avoid dripping when walking, rising etc ... That involves a good deal of mental energy.

sks61
Regular Member


Date Joined Dec 2016
Total Posts : 20
   Posted 4/7/2017 7:43 AM (GMT -7)   
I think at least the first video, should be required watching for anyone that has had RALP.

I learned a lot from it, and actually have been doing some of the ideas(phasing), trying to hold my bladder for longer periods, and adding volume of fluids.

MartinP
Regular Member


Date Joined Mar 2017
Total Posts : 37
   Posted 4/10/2017 12:36 AM (GMT -7)   
This video, also with Stuart Baptist, is interesting as well:

https://www.youtube.com/watch?v=S7d1z_jJ5wo
Born 1950.
PSA preOP 6,5 - 6 - 5,5
Diagnosed: end of January 2017
Gleason preOP (biopsy) 3+5 = 8
RP (robot-guided) 2-28-17
Prostate 96 g. Cancer totally contained. Clean margins. (Happy!).
Gleason adj. to 3+4 = 7
Cath out 3-10-17
Dry at night, dry sitting, am in the proces of learning when and how to kegel to avoid dripping when walking, rising etc ... That involves a good deal of mental energy.

shudderingThud
Regular Member


Date Joined Mar 2016
Total Posts : 74
   Posted 4/11/2017 1:02 AM (GMT -7)   
Stuart Baptist - my Urol sent me there to do their pelvic floor program. He's well regarded.
RALP 11 April 2016
Dr Scott Leslie, Chis O'Brien LifeHouse Sydney Aus.
Age 66. G 3+4, Stage T2c
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