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Kegel Exercises after Prostate Removal

What are Kegel exercises?

Kegel exercises are used to strengthen the muscles responsible for bladder control.   These pelvic floor muscles are the same muscles you use to prevent urination or to keep from passing gas at an inappropriate moment.  When you squeeze your anal sphincter, you are also squeezing your urinary control muscle.

How do I learn Kegel exercises?

These muscles should be tightened without tightening the abdominal, thigh, or buttocks muscles at the same time.  If you are not sure which muscles to tighten, the next time you urinate, try stopping the stream.  Another helpful hint is to imagine that your doctor is performing a prostate exam; envision squeezing the doctor’s finger (anal sphincter) but not the fist (buttocks muscles).  For those patients who still have trouble identifying the correct muscles, Dr. Miller will arrange computerized biofeedback training under the direct supervision of a therapist.

How often should I perform these exercises?

To do the exercise, tighten the pelvic floor for a slow count to 5 and then relax.   Perform one set of 10 reps 3 times per day (30 total per day).  With this intensity, any more often might over-fatigue these muscles and temporarily worsen your bladder control.  After 2-3 weeks of “training”, the next step is to consciously contract these muscles when you are about to sneeze, cough, stand, or whatever causes your “stress incontinence” (actions that cause you to lose bladder control).  As these actions become automatic, you will continue to see improvement in your symptoms.

When should I start?

Although some urologists recommend Kegel exercises immediately (even with the urinary catheter in place), Dr. Miller performs a very complex reconstruction of the pelvic floor to help ensure recovery of urinary function.  To avoid disruption of this reconstruction, Dr. Miller usually recommends starting these exercises approximately 4-6 weeks following surgery.  In many cases, quick recovery of urinary function entirely eliminates the need for Kegel exercises.