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slowpoke2 01-05-2008 04:45 AM

Lingering Incontinence? Try "Stream Control" Kegel Exercises
I had robotic surgery 14 months ago but still suffered some leakage despite gallant efforts with standard Kegel exercises. I tried every regime imaginable, from four sets of 10 exercises every day to one intense set every day. It seemed that I had hit a plateau with no further improvement and had resigned myself to wearing pads permanently.

Since the standard Kegel exercises didn’t help, I started experimenting with other variations. By chance, I seem to have stumbled on to an entirely different exercise approach that really works! I have had significant improvement in only ONE WEEK.

I call this new approach the “Stream Control” Kegel Exercises. It consists of two practices:

Practice 1 - Whenever you urinate, stop the stream after five seconds and hold for five seconds. Then start the stream again for five seconds and hold for another five seconds. Continue this sequence until your bladder is empty. Repeat these exercises every time you urinate.

Practice 2 - Instead of urinating frequently, try to hold off until your bladder is fuller. Forcing the muscles to oppose a full bladder seems to strengthen them quickly.

This approach has a number of advantages. First, it targets the actual muscles that control the stream – it can be difficult to identify them otherwise. Second, you don’t have to set aside a special time for Kegel exercises because you do them every time you urinate. Third, this approach seems to minimize the problem of “over exercising” the key muscles that can lead to muscle fatigue and less control. Finally, it seems to be very effective and works quickly.

I don’t know if this exercise regime will help others with lingering incontinence, but why not give it a try? If you have some success, please respond to this post.


mudrunner 01-08-2008 08:56 AM

Re: Lingering Incontinence? Try "Stream Control" Kegel Exercises

I think you may want to do some research on the stop and start method you are advocating. As with so much of medical “science” there are conflicting opinions on this practice.

I’ve been on pads 24/7 since my RRP in 2000. In my last (of many) attempt to get the incontinence under control I went thru the bio-feedback drill. They hook your buns up with electrodes so you can watch on a scope to learn the specific muscles for leakage control. As I suspect is the case of many men doing the big K maneuvers, I was not doing them correctly. I told the nurse my prior practice was doing the stop and start technique which was recommended by many of the medical resources on the net.

She told me in no uncertain terms that experience has shown this to be potentially dangerous to the ureters and kidneys because of back pressure. Micturating is a complicated interaction of some muscles relaxing and some contracting. Once the detrusor muscle starts expelling urine, slamming the sphincter shut doesn’t instantly cause it to relax, thus causing a hydraulic pressure wave back up. The ureters are tiny little tubes and repeated pressure hits MAY cause problems for some people.

Just a thought…..

MoLu 01-08-2008 07:28 PM

Re: Lingering Incontinence? Try "Stream Control" Kegel Exercises
My husband is still struggling with incontinence after his RRP in July. When I saw this thread I grabbed him and made him sit down to read it. I thought it was such a good idea. He is going to PT right now working on the biofeedback too. Pt says he's too stressed and needs to learn how to relax. He has a very stressful job and it is getting to him not to mention having to deal with PC. Now I'll grab him again and have him read the second reply and tell him to hold up! He'll check with his PT and see what they have to say also. Thanks for posting.

slowpoke2 01-09-2008 06:53 PM

Re: Lingering Incontinence? Try "Stream Control" Kegel Exercises

Thanks for the update. There seems to be a lot of conflicting recommendations out there about this practice. I can see that it could be potentially dangerous if one were to try the "start-stop" when the bladder was bursting. However, I have seen this suggested approach in more than one place. I am going to ask my urologist in April to see what he thinks.

In any event, this method has really helped me in a short time. Perhaps, it is just a coincidence, but I don't think so. In reality, it is somewhat like real-time biofeedback. Maybe I will modify the approach to do the exercises without actually stopping the stream.

Thanks again,

Kemahsabe 01-10-2008 05:28 AM

Re: Lingering Incontinence? Try "Stream Control" Kegel Exercises

I'm with you. Interrupting the stream seemed like a good, logical excercise to do during my recovery. Never did it on a full bladder because I never HAD a full bladder. And there was no way my sphincter was going to "slam shut".

Best of luck to you - and keep up the excercises!


slowpoke2 01-11-2008 03:59 AM

Re: Lingering Incontinence? Try "Stream Control" Kegel Exercises

Thanks for the encouragement. I think a lot of men who have had surgery are surprised about incontinence problems. I remember that my uroligist said there was a small chance for a lasting problem, but he and all of the literature made that seem unlikely. In reality, the problem is probably significantly underreported by men. Since my surgery, I have spoken with around 10 men who had surgery - all of them still have some leakage and many still wear pads years later. Let's face it - men don't like to admit that anything is wrong physically (especially related to sex).

I also suspect that many men give up on Kegels fairly early. Incontinence seems to improve with time, even with any exercises. What I hope is that doing Kegels as described below enables me to be completely or virtually dry. So far, the improvement has been significant after only a few weeks.

Thanks again,

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