How I used biofeedback techniques to make a significant improvement to my severe incontinence.

I have found, in talking to people and reading forums, that improvements to continence seem to happen almost overnight, but often taking months to occur.  My experience as described below leads me to believe that it is the ability to attain a measure of control over the proper involuntary muscles is what makes this happen and that the below technique can start this process in a matter of days.

 

I had my second Foley catheter removed 15 days after my Oct. 17, 2007 laparoscopic radical prostatectomy operation. (That’s another story). With the catheter removed, I was leaking 90 to 100 percent when standing or walking, about 50 to 80 percent when sitting but almost not at all when lying down.  First thing in the morning, the only time I had anything in my bladder, I could start and stop the stream without problem with my Kegel muscles.  During the day I couldn’t go much more than an hour on one large pad.  The dripping frequency was about every 2 to 10 seconds.  I also did Kegel exercises at least 5 times a day.  After two weeks I hadn’t noticed any significant improvement.

 

After the first week, in my search for a solution on the internet, I found a reference to a biofeedback technique involving walking around a room holding a Styrofoam cup (with pants off) watching for and catching the drips and concentrating on stopping them.  I thought that this had possibilities and I tried it about every other day for about a half hour each time.  When it worked, I felt a heightened alert feeling similar to anticipating a tennis serve and I wasn’t holding my muscles nearly as tight as if I was doing Kegels.  On a Wednesday, two weeks after having the catheter removed, I had it working pretty well but I would drip as soon as my mind wandered and its effect didn’t carry over when I stopped doing it. This time, to maintain my concentration, I began continuously repeating a mantra such as “don’t drip any more”, “don’t drip any more”.  After another 10-15 minutes of this with the addition of the “mantra”, I had to get dressed and go do some errands.  I continued repeating the words to myself as I drove my car, filled my gas tank and then got something to eat before picking up my son at work.  In that half hour I only dripped a half dozen times, usually when I lost concentration for a split second.

 

The next two days, I used only one medium size pad for each workday, repeating the mantra when I had to walk around (Admittedly this wasn’t too often because I have a sit-down job).  That evening I washed dishes and did other busy work.  I leaked more than I had during the day but if I gave the mantra more of an emphasis when I had to reach or bend down I could usually maintain control.  By the weekend, I had maintained the lower rate of dripping even when I got lazy about repeating the mantra.  I was physically busy doing yard work and hiking on a hilly trail. The pad became only about a quarter to a half full after several hours of this activity.

 

Today, Tuesday. Nov. 20^th I feel that I am getting better every day.  On Monday I used one pad all day, it stayed dry with my body heat soon evaporating any occasional leaks. I feel that I have conscious control of the proper muscles now but the mantra is still useful when making a sudden physical movement.

 

I found the original reference at the prostate cancer forum link below, the “mantra” part was my improvement to the method;

www.healingwell.com/community/default.aspx?f=35&m=239259&p=3

Peter & Swim,

Stan's Austin Tx Urologist that Swim spoke of came to Austin from Tulane after Katrina.
He and his partner were my surgeons, S. Karnik and K. Shaw at Austin Diagnostic Clinic - practicing at North Austin Medical Center.

The cup method "works" to isolate and develop the pelvic floor muscles - for anyone I think.
However, to avoid anyone giving up discouraged when it doesn't work so quickly for him I must add:

Perhaps not guaranteed in one week as it took much more work for me and others.

Dr. Karnik's expectation for one week (then for me two, then three, then four, then why not now!) did encourage me to work harder.  When it took more than two weeks after the catheter removal - Dr. karnik sent me back to the bio-feedback therapist for coaching and encouragement and monitoring.  (I went to the therapist before the surgery to properly learn the Kegel Exercises.)
These escapades can be found under "Other Topics" in the Helpful Hints thread (second thread at the top of this forum's page) under my link "Zen and the art of Symphonic Continence."

I would add using the cup method while going up and down the stairs with a full bladder isolates the muscles needed.  
When you feel confident, cough with a full bladder while walking nude up the stairs.

There are real champions still incontinent here (Berb, KW, and more) that have tried every method and work harder at overcoming incontinence than any of us -  
     - and are still not continent. 
They lead full, productive, active (none so active as Berb!) lives and have not yet given up working at healing - without artificial sphincters and surgery.

Thanks Peter.  I liked your Mantra.
I'm using one these days:
"I am a healthy most loved child of God.  I am the head not the tail!"
I have every confidence E.D., like incontinece, will be history, too.

Standing with all of you.

C^Cedar
ICTHUS!

WADR, if you had your surgery in October of this year, then your recovery of incontinence could be merely from passage of time. The great majority of patients recover continence over several weeks to several months after the procedure, regardless of what they do mentally or physically.

However, if you feel something helps you gain control, it can't be discounted. Whatever works for you. Walking around with a cup would definitely help you monitor your progress, if nothing else.

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Abnormal DRE 12/06
Diagnosed 1/23/07
Biopsy 6 cores 1 positive
T2b Gleason 3+3 PSA 1.4
Laparoscopic Prostatectomy 5/11/07
pathology: less than 5% tumor by volume
no cancer in margins or vesicles
cath out on 5/22
PSA test Aug. 2007= less than zero
Continence: none while standing
Diagnosed with "stricture" as the cause of incontinence 8/30/07
Sept 2007 3-5 pads/day
Stricture treated by progressive dilation on 10/17/2007
No change in continence, stream was improved
Bladder neck incision on Oct. 30
Cath removed on November 6
November 12: no change in continence, follow up with surgeon, he prescribes clamp

  Hi ~ Peter, Thank you for your personal thread!!! and thank you for caring enought to share!!  The title is perfect and it's really nice that you linked the thread that made a difference for you!  This is a powerful forum and you have just added strength to it.  Thank you!! If and when the time is right.... we hope you will share a little more of "Your Journey" in a signature.  This will help all of us!! Our thought and prayers will be with you as you continue to move forward. In New Friendship ~ Lee & Buddy mama bluebird - Lee & Buddy… from North Carolina   v           We invite you to visit our personal thread :   Click Here:   “Our Journey” ~ Sharing is Caring   April 3, 2006  53 on surgery day RRP / Radical Retropubic Prostatectomy PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate 3rd PSA 08-07-2007 Less than 0.1 Non-Detectable :)

I asked my Physical Therapist about stoping and starting my flow while emptying. She advised not to do this too often because it can mix up the signals the bladder is receiving when trying to empty.
I will ask her what she thinks of the cup exercise when i go back in a couple of weeks.

KW

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    43

    PSA 5.7 - Discovered during Annual Physical with Family Practice Dr.

        Biopsy Sept. 27, 2006 - Diagnosis Sept. 29 - 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7

        RRP on Oct. 17, - Nerves on right side saved.

    All Lab's clear.  No Cancer outside prostate

    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

    Office visit on Jan. 19th due to continued excessive urine leakage.

    Feb.20th Cystoscope and 2nd Post Op PSA. Another 0.00.....:)

    Dr. said everything looks fine.  Continue to work Kegeal's. Leaking appears to have improved  after Cystoscope?!?!?!  Down to 3-4 pads per day!

    March 1st  Leaking has crept back up to 6 - 8 pads a day ??????? 

    March 29th Collagen injection into sphincter / bladder neck area to control excessive leaking.  Worked for a couple of days then back to leaking.

    April 17th (Six Months Post Op) 2nd Collagen Injection to control excessive leaking.  Leaking started back next day at work!

    May 14th Second Opinion about my leaking and Options at OU Medical Center.  After reviewing my records the Dr. feels I will probably need some surgical intervention to stop my leaking.  But did agree to try Bio-Feedback and work hard on the Kegeal's first!

    May 30th Follow up with my Dr. and 3rd Post Op PSA 0.00 agian!!!

    June 1st Start Bio-Feedback to try to control my leaking.